妊娠期高血压疾病患者血栓前状态及凝血功能指标变化的临床研究  

Clinical study on the changes of prethrombotic state and coagulation function in patients with HDP

作　　者：王秋霞 王义[1] WANG Qiu-xia;WANG Yi(Jilin Provincial Maternal and Child Health Hospital,Changchun,Jilinl30061,China)

机构地区：[1]吉林省妇幼保健院,吉林长春130061

出　　处：《中国妇幼保健》2023年第6期975-979,共5页Maternal and Child Health Care of China

基　　金：吉林省科学技术厅立项基金(20220228)。

摘　　要：目的 比较各类型妊娠期高血压疾病(HDP)孕妇与正常妊娠晚期孕妇血栓前状态及凝血功能指标的变化。方法 选取2019—2020年内于吉林省妇幼保健院住院分娩的60例HDP孕妇为实验组,其中妊娠期高血压30例(妊娠期高血压组),子痫前期30例(子痫前期组),同期正常妊娠晚期孕妇30例为对照组,比较实验组和对照组孕妇凝血四项[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)]、D-二聚体、血小板(PLT)、血栓四项[凝血酶抗凝酶复合物(TAT)、纤溶酶-抗纤溶酶复合物(PIC)、血栓调节蛋白(TM)、组织型纤溶酶原激活抑制复合物(t-PAIC)]的差异。结果 3组孕妇年龄:对照组年龄(29.27±3.96)岁,妊娠期高血压组年龄(30.92±2.11)岁,子痫前期组年龄(28.37±4.58)岁,3组比较差异无统计学意义(P>0.05)。3组孕妇入院时体质指数(BMI)比较,对照组BMI为(28.72±3.74)kg/m^(2),妊娠期高血压组BMI为(31.43±5.41)kg/m^(2),子痫前期组BMI为(30.86±4.13)kg/m^(2),差异无统计学意义(P>0.05);3组孕妇凝血四项[APTT值:对照组(27.42±1.50)s,妊娠期高血压组(26.8±1.85)s,子痫前期组(26.14±1.25)s;PT值:对照组(10.89±0.54)s,妊娠期高血压组(10.64±0.53)s,子痫前期组(10.44±0.53)s;TT值:对照组(13.827±0.80)s,妊娠期高血压组(13.376±1.93)s,子痫前期组(13.037±0.83)s;FIB值:对照组(4.49±0.33)g/L,妊娠期高血压组(4.67±0.34)g/L,子痫前期组(4.87±0.45)g/L]、PLT值[对照组(213.23±42.565)×10^(9)/L,妊娠期高血压组(183.2±28.796)×10^(9)/L,子痫前期组(157.83±44.948)×10^(9)/L]及D-二聚体[对照组(0.799±0.413)μg/ml,妊娠期高血压组(1.069±0.686)μg/ml,子痫前期组(1.461±1.282)μg/ml]比较,差异均有统计学意义(均P<0.05)。3组孕妇TAT[对照组(7.82±2.70)ng/ml,妊娠期高血压组(7.82±2.70)ng/ml,子痫前期组(13.16±2.81)ng/ml]、PIC值[对照组(0.72±0.32)μg/ml,妊娠期高血压组(1.15±0.66)μg/ml,子痫前期组(1.Objective To compare the changes of prethrombotic state and coagulation function between pregnant women with different types of hypertensive disorder complicating pregnancy and normal late pregnancy.Methods 60 pregnant women with hypertensive disorder complicating pregnancy who delivered in our hospital from 2019 to 2020 were selected as the experimental group, including 30 cases of hypertensive disorder complicating pregnancy(Group B), 30 cases of preeclampsia(Group C), and 30 cases of normal late pregnant women in the same period as the control group(Group A).The differences between the experimental group and the control group in four items of blood coagulation(PT, APTT, FIB, TT), D dimer, platelet(PLT), and thrombus(TAT, PIC, TM, t-PAIC) were compared.Results The age of pregnant women in the three groups was(29.27±3.96) years old in Group A,(30.92±2.11) years old in Group B, and(28.37±4.58) years old in Group C.The difference was not statistically significant(P>0.05).Compared with the BMI at admission, the BMI of Group A was(28.72±3.74)kg/m^(2), that of Group B was(31.43±5.41)kg/m^(2), and that of Group C was(30.86±4.13)kg/m^(2), with no significant difference(P>0.05);Three groups of pregnant women had four items of blood coagulation [APTT value: Group A(27.42±1.50)s, Group B(26.8±1.85)s, Group C(26.14±1.25)s.PT value: Group A(10.89±0.54)s, Group B(10.64±0.53)s, Group C(10.44±0.53)s.TT value: Group A(13.827±0.80)s, Group B(13.376±1.93)s, Group C(13.037±0.83)s.FIB value: Group A(4.49±0.33)s, Group B(4.67±0.34)s, Group C(4.87±0.45)s].PLT value: [Group A(213.23±42.565)×10^(9)/L, Group B(183.2±28.796)×10^(9)/L, Group C(157.83±44.948)×10^(9)/L].D-dimer [Group A(0.799±0.413)μg/ml, Group B(1.069±0.686)μg/ml, Group C(1.461±1.282)μg/ml],the difference was statistically significant(P<0.05);There were statistically significant differences in TAT[Group A(7.82±2.70)ng/ml, Group B(7.82±2.70)ng/ml, Group C(13.16±2.81)ng/ml] and PIC[Group A(0.72±0.32), Group B(1.15±0.66), Group C(1.69±0.91)

关 键 词：妊娠期高血压疾病 凝血功能 血栓前状态 血栓四项 

分 类 号：R714.246[医药卫生—妇产科学]