孕晚期妊娠高血压孕妇和健康孕妇的凝血指标差异研究  

Difference Research of Blood Coagulation Indicator Between Pregnant Women with Gestational Hypertension and Healthy Pregnant Women in the Third Trimester

作　　者：敖治群 丘创华[3] 顾大勇[3] AO Zhi-qun;QIU Chuang-hua;GU Da-yong(Shantou University Medical College,Guangdong Shantou 515041;Shenzhen Maternal and Child Health Hospital,Guangdong Shenzhen 518028;Shenzhen Second People's Hospital,Guangdong Shenzhen 518035)

机构地区：[1]汕头大学医学院,广东汕头515041 [2]深圳市妇幼保健院,广东深圳518028 [3]深圳市第二人民医院,广东深圳518035

出　　处：《深圳中西医结合杂志》2022年第16期15-18,I0003,共5页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的:通过比较深圳地区孕晚期妊娠高血压孕妇和健康孕妇凝血指标的差异,探讨凝血检验指标在妊娠期孕妇临床诊疗中的应用价值。方法:选取2021年4月至2021年12月在深圳市妇幼保健院做产前检查的393例健康孕妇,分为孕早期组177例,孕中期组108例,孕晚期组108例,另选取同期的130例健康未孕妇女作为对照组,以及160例孕晚期妊娠高血压孕妇为病例组。检测并统计所有孕妇凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)、凝血酶时间(TT)、抗凝血酶Ⅲ(AT–Ⅲ)和D–二聚体(DD)数据。结果:病例组PT、AT–Ⅲ均低于正常早、中、晚孕期组,Fib、DD高于正常早、中、晚孕期组,差异具有统计学意义(P<0.05);以孕晚期高血压为结局作二元logistic回归分析,Fib、DD是孕晚期妊娠高血压的危险因素;在鉴别诊断孕晚期妊娠高血压诊断效能时,其中PT、Fib、AT–Ⅲ、DD、联合检测的曲线下面积(AUC)分别为0.684、0.571、0.646、0.688、0.790,P<0.05。结论:检测孕晚期妊娠高血压凝血参数的变化,可为医生准确诊断和治疗妊娠期疾病提供有效的依据。Objective To explore the application value of coagulation test index in clinical diagnosis and treatment of pregnant women with hypertension in the third trimester of pregnancy in Shenzhen by comparing the difference of coagulation indicator between pregnant women and healthy pregnant women.Methods A total of 393 pregnant women who underwent prenatal examination in Shenzhen Maternal and Child Health Hospital from April 2021 to December 2021 were selected and divided into the first trimester group(177 cases),the second trimester group(108 cases),and the third trimester group(108 cases).In addition,130 healthy non-pregnant women in the same period were selected as the control group,and 160 pregnant women with gestational hypertension in the third trimester were selected as the case group.The prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(Fib),thrombin time(TT),antithrombinⅢ(AT-Ⅲ)and D-dimer(DD)data of all pregnant women were detected and statistically analyzed.Results PT and AT-Ⅲin case group were lower than those in the normal first,second and third trimester group,while Fib and DD were higher than those in the normal first,second and third trimester group,and the differences were statistically significant(P<0.05).Binary logistic regression analysis showed that Fib and DD were risk factors for gestational hypertension in the third trimester.The area under curve(AUC)of PT,Fib,AT-Ⅲ,DD and combined detection were 0.684,0.571,0.646,0.688,0.790,respectively,P<0.05.Conclusion Detection of the changes of coagulation parameters of gestational hypertension in the third trimester of pregnancy can provide effective basis for doctors to accurately diagnose and treat gestational diseases.

关 键 词：妊娠高血压 凝血指标 孕妇 

分 类 号：R654.2[医药卫生—外科学]