妊高征及妊娠期肝内胆汁淤积症患者血浆肝素水平测定及其变化  

Level and changes of plasma heparin in patients with pregnancy induced hypertension and intrahepatic cholestasis of pregnancy

作　　者：戴华康[1] 董旻岳[1] 姚琦玮[1] 

机构地区：[1]浙江大学医学院附属妇产科医院,杭州310006

出　　处：《中国实用妇科与产科杂志》2004年第6期346-348,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的　探讨妊娠晚期孕妇血浆肝素水平降低对妊高征、妊娠期肝内胆汁淤积症 (ICP)发生的影响。方法　对 1 999年 1 0月至 2 0 0 0年 1 0月 70例孕妇用生色法测定血浆肝素 ,并同时测定血小板数与血浆纤维蛋白原水平。其中妊高征组 2 0例、ICP组 2 0例、正常妊娠组 30例。随机选取 30例非孕妇女作对照组。结果　三组孕妇血浆肝素水平均明显低于对照组 (P <0 0 5 ) ,妊高征组显著性低于正常妊娠组和ICP组 (P <0 0 1 ) ;正常妊娠组血小板数量明显低于对照组 (P <0 0 1 ) ,但其与妊高征组及ICP组的比较差异均无显著性 (P >0 0 5 ) ;三组孕妇血浆纤维蛋白原水平均极显著性高于对照组 (P <0 0 1 )。结论　随着妊娠终止 ,血浆中肝素和血小板随之恢复至正常范围。而妊高征患者产后血浆肝素尚未达到正常水平范围 。Objective To identify the influences of decreased level of plasma heparin on the development of pregnancy induced hypertension and intrahepatic cholestasis of pregnancy(ICP).Methods From October 1999 to October 2000,70 women in the third trimester pregnancy were divided into pregnancy induced hypertension group(n=20),ICP group(n=20)and normal pregnancy group(n=30).Control group consisted of another 30 healthy non pregnant women.The levels of plasma heparin,blood platelet counts and blood fibrinogen were measured and analyzed respectively.Results In three pregnancy groups,the levels of plasma heparin were significantly lower than that in the control group (P<0 05).However,the level of plasma heparin in the pregnancy induced hypertension was significantly redueed compared with that of ICP and normal pregnant group (P<0 01);in the normal pregnant group,blood platelet counts had significantly decreased than that of the control group(P<0 01).All of the pregnancy groups had significantly higher blood fibrinogen concentration than that of control group(P<0 01).Conclusion There is significant decrease in the levels of plasma heparin and platelet counts in pregnant women.The level of plasma heparin and platelet count returns to normal after pregnancy termination,while in patients with PIH,the level of plasma heparin doesn't return to normal.The results suggest that the pathophysiological changes of pregnancy induced hypertension are associated with the decreased level of plasma heparin.

关 键 词：妊高征 妊娠期肝内胆汁淤积症 血浆 肝素 测定 血小板数 

分 类 号：R714.246[医药卫生—妇产科学] R714.255[医药卫生—临床医学]