孕期血浆D-二聚体监测对妊娠结局的临床观察  

Clinical Observation of Pregnancy Outcome by Monitoring of Plasma D-two Polymer during Pregnancy

作　　者：祁小丹 易媛媛[2] QI Xiao-dan;YI Yuan-yuan(lnner Mongolia Medical University,Hohhot Inner Mongolia 010030;Inner Mongolia Medical University Affiliated Hospital,Hohhot Inner Mongolia 010030)

机构地区：[1]内蒙古医科大学,内蒙古呼和浩特010030 [2]内蒙古医科大学附属医院,内蒙古呼和浩特010030

出　　处：《世界最新医学信息文摘》2018年第24期56-58,共3页World Latest Medicine Information Electronic Version

摘　　要：孕期在胎盘产生的激素参与和神经内分泌的影响下,孕妇体内各系统发生一系列生理变化以适应胎儿生长发育的需要并为分娩做准备。妊娠期血液处于高凝状态。由于孕期血液处于高凝状态,产后胎盘剥离面血管内迅速形成血栓,是预防产后出血的另一重要机制。血浆D-二聚体是血浆交联纤维蛋白的特殊降解产物,在各种血栓形成性疾病及生理性高凝状态时均有增高,是反映体内纤溶活性的特异性分子标志物。相关文献支持,孕期血浆D-二聚体指标检测有助于诊断妊娠及分娩期并发症。血流处于持续的病理性高凝状态,并有继发性纤溶的可能,形成血栓前状态,引起子宫局部组织和胎盘形成微血栓,子宫内膜及胎盘血流灌注不足,引起胎盘组织缺血缺氧坏死,最终导致妊娠期高血压疾病、胎盘早剥、反复流产、早产、死产、FGR、弥散性血管内凝血(DIC)及产后大出血等不良妊娠结局。严重威胁孕产妇及围产儿的生命安全。妊娠期生理正常值及疾病的诊断不同于非孕期。积极预防妊娠不良结局的发生是高危妊娠管理的重要任务。During pregnancy,the hormones produced by placenta are involved in the process of neuroendocring.A series of physiological changes occur in of growth and development,so as to prepare for childbirth.The blood in pregnancy is in a state of hypercoagulability. It is another important mechanism to prevent postpartum hemorrhage due to the hypercoagulability of the blood in pregnancy and the rapid formation of thrombus in the blood vessel of postpartum placental detachment.Plasma D-dimer is a special degradation product of plasma crosslinked fibrin, which is increased in various thrombotic diseases and physiological hypercoagulable state. It is a specific molecular marker reflecting the fibrinolytic activity in vivo.Relevant literature supports that the detection of plasma D-two polymer index during pregnancy helps to diagnose complications of pregnancy and childbirth.The blood flow in the pathological hypercoagulable state continuously, and secondary fibrinolysis may form a prothrombotic state, causing uterine local tissue and placenta formation of microthrombi, endometrial and placental hypoperfusion caused by placental ischemia and hypoxia and necrosis, resulting in pregnancy induced hypertension, placenta abruption, recurrent abortion, premature birth FGR, stillbirth, and disseminated intravascular coagulation（DIC） and postpartum hemorrhage and adverse pregnancy outcomes.It is a serious threat to the life and safety of pregnant women and perinatal infants. The normal physiological values of pregnancy and the diagnosis of disease are different from those in non pregnancy. It is an important task for the management of high risk pregnancy to proactively prevent the occurrence of bad pregnancy outcome.

关 键 词：不同孕期 妊娠不良结局 临床观察 

分 类 号：R714.12[医药卫生—妇产科学]