妊娠期高血压疾病患者凝血功能变化分析  

Analysis of changes of coagulation function in hypertensive syndrome of pregnancy

作　　者：王秋霞 刘巍[1] 张健光 张晗[1] 王义[1] WANG Qiu-xia;LIU Wei;ZHANG Jian-guang;ZHANG Han;WANG Yi(不详;Maternal and Child Health Hospital of Jilin Province,Changchun,Jilin 130061,China)

机构地区：[1]吉林省妇幼保健院,吉林长春130061 [2]吉林省人口生命科学技术研究院

出　　处：《中国妇幼保健》2023年第19期3625-3628,共4页Maternal and Child Health Care of China

基　　金：吉林省财政厅项目(2022CZT019)。

摘　　要：目的评估妊娠期高血压疾病对孕妇凝血功能的影响并判断该功能变化对孕妇的临床意义。方法选取2021—2022年于吉林省妇幼保健院产科住院分娩且临床诊断为孕晚期妊娠期高血压疾病的120例孕妇为观察组,其中妊娠期高血压组(A组)40例、子痫前期组(B组)40例、重度子病前期(C组)40例。正常晚期妊娠孕妇(D组)40例为对照组。观察组与对照组孕妇入院后采肘静脉血,查凝血四项[凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(FIB)、血酶时间(TT)]、D-二聚体、血小板(PLT)、血栓弹力图[反应时间(R值)、凝血时间(K值)、从血凝块形成点至描记图最大曲线弧度做切线与水平线的夹角(α角)、血块强度(MA值)]。比较观察组与对照组孕妇上述观测指标的差异,同时对比两组产妇产后血栓发生率、产后出血量及新生儿1 min Apgar评分等指标差异。结果4组孕妇凝血四项比较,差异均有统计学意义(均P<0.05);4组孕妇PLT与D-二聚体比较,差异均有统计学意义(均P<0.05);4组孕妇R值、K值、α角及MA值比较,差异均有统计学意义(均P<0.05)。两组孕妇术后血栓发生率比较,差异无统计学意义(P>0.05)。4组新生儿1 min Apgar评分比较,差异有统计学意义(P<0.05)。结论随着妊娠期高血压疾病进展,血液高凝状态加重,更易形成血栓,影响母婴预后。Objective To evaluate the effect of pregnancy-induced hypertension on coagulation function in pregnant women and to evaluate its clinical significance.Methods A total of 120 pregnant women who were hospitalized in obstetrics Department of Jilin Maternal and Child Health Hospital from 2021 to 2022 and clinically diagnosed as hypertensive in the third trimester of pregnancy were selected as the observation group,including 40 cases of hypertensive in pregnancy(group A),40 cases of preeclampsia(group B)and 40 cases of severe predisease(group C).40 normal pregnant women(group D)were the control group.Elbow venous blood was collected after admission in the observation group and the control group.Check the blood clotting four items(prothrombin time(PT),activated partial prothrombin time(APTT),fibrinogen(FIB),hematase time(TT)),D-dimer,platelet(PLT)),thromboelasmogram[reaction time(R value),clotting time(K value),Angle between the tangent line and the horizontal line from the point of clot formation to the maximum curve curve of the graph(αAngle),clot intensity(MA value)].The diferences of the above observed indicators between the observation group and the control group were compared,and the differences of postpartum thrombus incidence,postpartum blood loss,1-min Apgar score and other indicators between the two groups were compared.Results There were statistically significant differences in coagulation among 4 groups(all P<0.05).There were significant differences in PLT and D-dimer among the 4 groups(all P<0.05).There were significant differences in R value,K value,a Angle and MA value among the 4 groups(all P<0.05).There was no significant difference in the incidence of postoperative thrombosis between the two groups(P>0.05).The difference of 1 min Apgar score among the 4 groups was statistically significant(P<0.05).Conclusion With the progression of hypertensive diseases in pregnancy,the hypercoagulable state of blood is aggravated,and thrombosis is more likely to be formed,which affects the prognosis of mother and ch

关 键 词：妊娠期高血压疾病 凝血功能 血栓弹力图 

分 类 号：R714.246[医药卫生—妇产科学]