妊娠高血压综合征与妊娠期糖尿病患者凝血功能检测的价值探讨  

The value of detecting coagulation function in patients with pregnancy-induced hypertension syndrome and pregnancy-induced diabetes mellitus

作　　者：朱虹[1] 宣荣荣[1] 刘莉萍[1] 王琳[1] 蒋伟春[1] 周宁[1] ZHU Hong;XUAN Rong-rong;LIU Li-ping(Department of Obstetrics and Gynecology,Affiliated Hospital of Medical College of Ningbo University,Ningbo, Zhejiang 315020, China)

机构地区：[1]宁波大学医学院附属医院妇产科

出　　处：《中华全科医学》2019年第10期1711-1713,共3页Chinese Journal of General Practice

基　　金：浙江省医药卫生基金项目(2018KY710)

摘　　要：目的探讨妊娠高血压综合征与妊娠期糖尿病患者凝血功能检测的价值。方法选取2016年1月—2018年1月宁波大学医学院附属医院收治的孕妇作为研究对象,所有研究对象及家属均对本研究知情同意。根据合并症类型分为糖尿病组338例,高血压组188例,另取360例正常孕妇为对照组。观察并分析其不同妊娠阶段的血浆凝血酶原时间(prothrombin time,PT)、纤维蛋白原(fibrinogen,FIB)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)及D-二聚体(D-dimer,DD)含量的变化及不良结局等之间的差异。结果孕早期凝血功能指标PT、APTT、FIB、D-D在3组间比较,差异均无统计学意义(F=0.804、0.401、1.115、0.813,P=0.528、0.754、0.359、0.809)。孕中期及晚期糖尿病组与高血压组的PT、APTT明显低于正常组,FIB、D-D明显高于正常组。3组间不良结局发生率比较,差异具有统计学意义(χ^2=15.449,P=0.001);糖尿病组与高血压组的不良结局发生率明显高于正常组。结论妊娠期糖尿病患者及妊娠期高血压患者在其孕中、晚期时机体处于相对高凝状态,动态检测各项凝血指标具有重要意义。Objective To explore the value of blood coagulation function test in patients with pregnancy-induced hypertension syndrome and gestational diabetes mellitus. Methods From January 2016 to January 2018, 338 cases of gestational diabetes admitted to our hospital were used as diabetes group, 188 cases of hypertensive syndrome of pregnancy were used as hypertension group, and 360 cases of normal pregnant women admitted to hospital at the same time were selected as normal group. All patients and their families had informed consent to the study. The changes and adverse outcomes of plasma prothrombin time(PT), fibrinogen(FIB), activated partial thromboplastin time(APTT) and D-dimer(DD) in different pregnancy stages were observed and analyzed. Results In the first trimester, PT, APTT, FIB, and D-D were not significantly different between the three groups(F=0.804, 0.401, 1.115, 0.813, P=0.528, 0.754, 0.359, 0.809). In the second trimester, the PT and APTT in the diabetic group and the hypertension group were significantly lower than those in the normal group. The FIB and D-D in the diabetic group and the hypertension group were significantly higher than those in the normal group. In the third trimester, the PT and APTT in the diabetic group and the hypertension group were significantly lower than those in the normal group;the FIB and D-D in the diabetic group and the hypertension group were significantly higher than those in the normal group. The incidence of adverse outcomes was statistically significant among the three groups(χ^2=15.449, P=0.001). The incidence of adverse outcomes was significantly higher in the diabetic group and the hypertension group than in the normal group. Conclusion GDM patients and hypertensive patients with gestational age are in a relatively hypercoagulable state during the middle and late pregnancy, and it is of great significance to dynamically detect various coagulation indexes.

关 键 词：妊娠 高血压 糖尿病 凝血功能 

分 类 号：R714.25[医药卫生—妇产科学] R587.1[医药卫生—临床医学]