妊娠妇女在孕晚期和产褥早期的抗凝血酶活性和D-D的变化  

作　　者：於王骐[1] 赵翊 范超明[1] 范睿嘉 徐佳丽[1] 

机构地区：[1]杭州师范大学附属医院,310000

出　　处：《浙江临床医学》2020年第4期547-548,共2页Zhejiang Clinical Medical Journal

摘　　要：目的研究正常妊娠妇女在孕晚期及产褥早期的抗凝血酶Ⅲ(AT-Ⅲ)活性和D-二聚体(D-D)水平的变化.方法选取2017年6月至2018年6月间,无妊娠并发症的正常妊娠妇女502例,分为阴道分娩组(256例)和剖宫产分娩组(246例).剖宫产分娩组分为2个亚组,非疤痕子宫组124例,疤痕子宫组122例.对孕晚期和产褥早期的AT-Ⅲ活性和?D-D水平进行检测,其中应用发色底物法检测AT-Ⅲ活性,免疫比浊法检测D-D水平,组间差异采用t检验或非参数检验分析.结果阴道分娩组:AT-Ⅲ活性在产褥早期显著高于孕晚期(P<0.05),而D-D水平在产褥早期则显著低于孕晚期(P<0.001).剖宫产分娩组:AT-Ⅲ活性、D-D水平在产褥早期显著低于孕晚期(P<0.001).产褥早期:剖宫产分娩组与阴道分娩组比较,AT-Ⅲ活性显著下降、D-D水平显著性升高(P<0.001).剖宫产亚组分析:无论是无疤痕子宫组还是疤痕子宫组,与孕晚期比较,产褥早期的AT-Ⅲ活性和D-D水平明显下降(P<0.05).而疤痕子宫组的AT-Ⅲ活性在孕晚期较无疤痕组升高(P<0.001).结论正常妊娠妇女剖宫产分娩组在产褥早期AT-Ⅲ活性较阴道分娩组偏低,而D-D水平则增高.Objective To observe the changes of activity for plasma antithrombin-Ⅲ and the D-dimer level of the normal pregnant women at the third trimester and early puerperium.Methods The normal pregnant women(502 subjects)excluding pregnancy complications were enrolled form June 2017 to June 2018,including vaginal delivery group(256 subjects),cesarean section delivery group(246 subjects).The cesarean section delivery group was no scar group(124 subjects)and scar group(122 subjects),the activity of AT-Ⅲ was detected by chromogenic substrate method,the D-D level was detected by immunoturbidimetry and the results were analyzed between the third trimester and early puerperium.Results(1)vaginal delivery group:the activity of AT-AT-Ⅲ D-dimer Pregnancy Third trimester Early puerperium in the early puerperium was significant higher the third trimester,but the D-D level in the early puerperium was significant lower the third trimester(P<0.001).The early puerperium:Compared with vaginal delivery group,the activity of AT-Ⅲ was significant lower and the D-D level was significant higher in the cesarean section delivery group:(P<0.001).(2)cesarean section delivery subgroup:Compared with the third trimester the activity of AT-Ⅲ and the D-D level in the early puerperium was significant lower(P<0.05)both the no scar group and the no scar group.Conclusion The activity for AT-Ⅲ is significance lower,but D-D is higher in the early puerperium compared with the third trimester in the normal pregnant women without pregnancy complications.

关 键 词：抗凝血酶 D-二聚体 妊娠妇女 孕晚期 产褥早期 

分 类 号：R71[医药卫生—妇产科学]