正常孕妇早、晚孕期凝血指标变化  

Variations of coagulation biochemical markers in normal pregnant women in early and late pregnancy

作　　者：孔令英[1] 杨慧霞[1] 魏玉梅[1] Kong Lingying;Yang Huixia;Wei Yumei(Department of Obstetrics and Gynecology,Peking University First Hospital,Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus,Beijing 100034,China)

机构地区：[1]北京大学第一医院妇产科,妊娠合并糖尿病母胎医学北京市重点实验室,100034

出　　处：《中华围产医学杂志》2019年第12期867-871,共5页Chinese Journal of Perinatal Medicine

摘　　要：目的探讨正常孕妇早、晚孕期凝血指标的变化。方法回顾性分析2013年8月至2014年9月在北京大学第一医院分娩的196例正常孕妇早、晚孕期的凝血指标,包括活化部分凝血活酶时间、活化部分凝血活酶时间比值、凝血酶原时间、凝血酶原时间比值、凝血酶原活动度、国际标准化比值、纤维蛋白原及凝血酶时间。比较早孕期孕7周前、后以及早、晚孕期这些指标的差异,并计算正常参考值。采用配对t检验及秩和检验进行统计学分析。参考值以P2.5~P97.5表示。结果早孕期孕7周后与早孕期孕7周前相比,活化部分凝血活酶时间[30.3(26.1~35.5)与32.1(27.9~36.8)s,Z=25.850]及凝血酶时间[13.8(12.2~16.0)与14.5(12.3~16.4)s,Z=16.720]缩短,纤维蛋白原[3.3(2.5~4.3)与2.9(2.2~3.8)g/L,Z=43.180]升高(P值均<0.001)。晚孕期与早孕期相比,活化部分凝血活酶时间[(27.5±1.6)与(31.4±2.4)s,t=24.736]、凝血酶原时间[(9.7±0.5)与(11.0±0.8)s,t=18.647]和凝血酶时间[(13.3±0.8)与(14.2±1.0)s,t=9.255]缩短,纤维蛋白原[(4.4±0.5)与(3.1±0.4)g/L,t=-29.152]升高(P值均<0.001)。活化部分凝血活酶时间、凝血酶原时间、纤维蛋白原和凝血酶时间的参考值范围在早孕期分别为26.5~36.0 s、9.4~12.4 s、2.4~4.0 g/L、12.3~16.4 s,在晚孕期分别为25.0~31.2 s、8.8~10.6 s、3.4~5.4 g/L、12.0~14.9 s。结论孕妇凝血指标从早孕期开始即发生明显变化。与早孕期相比,晚孕期活化部分凝血活酶时间、凝血酶原时间和凝血酶时间缩短,而纤维蛋白原升高。Objective To investigate the changes of coagulation indexes in normal pregnant women in early and late pregnancy.Methods The coagulation indexes in early and late pregnancy including activated partial thromboplastin time(APTT),APTT ratio,prothrombin time(PT),PT ratio,prothrombin activity,international normalized ratio,fibrinogen(Fib)and thrombin time(TT)were retrospectively collected from 196 normal pregnant women delivered in Peking University First Hospital from August 2013 to September 2014.Differences in these indexes before and after the seventh gestational week of early pregnancy and in early and late pregnancy were compared.In addition,the normal reference values were calculated.Paired t test and sum-rank test were used for statistical analysis.The reference values were presented with P2.5-P97.5.Results In early pregnancy,some coagulation indexes after the seventh weeks were shorter than those before,such as APTT[30.3(26.1-35.5)vs 32.1(27.9-36.8)s,Z=25.850,P<0.001]and TT[13.8(12.2-16.0)vs 14.5(12.3-16.4)s,Z=16.720,P<0.001],but Fib[3.3(2.5-4.3)vs 2.9(2.2-3.8)g/L,Z=43.180,P<0.001]became higher.APTT[(27.5±1.6)vs(31.4±2.4)s,t=24.736,P<0.001],PT[(9.7±0.5)vs(11.0±0.8)s,t=18.647,P<0.001]and TT[(13.3±0.8)vs(14.2±1.0)s,t=9.255,P<0.001]were significantly shorter,while Fib[(4.4±0.5)vs(3.1±0.4)g/L,t=-29.152,P<0.001]was higher in late pregnancy than in early pregnancy.The reference values of APTT,PT,Fib and TT in early pregnancy were 26.5-36.0 s,9.4-12.4 s,2.4-4.0 g/L and 12.3-16.4 s,and those in late pregnancy were 25.0-31.2 s,8.8-10.6 s,3.4-5.4 g/L and 12.0-14.9 s,respectively.Conclusions The coagulation indexes of pregnant women change significantly since the beginning of early pregnancy.APTT,PT and TT are shorter,while Fib is higher in late pregnancy than in early pregnancy.

关 键 词：部分促凝血酶原时间 凝血酶原时间 凝血酶时间 纤维蛋白原 妊娠初期 妊娠末期 

分 类 号：R71[医药卫生—妇产科学]