血栓弹力图及常规凝血检测对妊娠期妇女凝血状态的评价

Analysis and evaluation of pregnancy women coagulation status by thrombus elasticity graph and conventional coagulation test

目的:通过血栓弹力图(TEG)及常规凝血结果的检测,研究正常妊娠妇女在不同孕期的凝血状态。方法:随机选取200例正常妊娠妇女(早孕63例、中孕58例、晚孕79例)和100例健康非妊娠女性(对照组),分别进行TEG、常规凝血指标(APTT、PT、TT、FIB、FDP、D-D)和血小板(PLT)检测,并对检测的结果进行统计学分析。结果:1TEG指标中,与非妊娠组相比,妊娠组的R、K值明显降低,α角、MA值及CI数明显升高,差异有统计学意义(P<0.05);常规凝血指标中,与非妊娠组相比,妊娠组的PT、TT值明显降低,APTT、FIB、FDP及DD值明显升高,差异有统计学意义(P<0.05)。2R值:中、晚孕组较早孕组明显降低(P<0.05);K值:晚孕组较早孕组明显降低(P<0.05);α角:晚孕组较早孕组明显增高(P<0.05);MA值:妊娠组各时期无显著变化;CI值:中、晚孕组较早孕组明显增高(P<0.05);结论:妊娠期妇女与非妊娠妇女在TEG和常规凝血指标上均存在显著差异,TEG指标中的R值、K值、α角以及CI值在不同的妊娠时期亦存在显著差异。

Objective：To research the coagulation state of normal pregnant women by thrombosis elastic graph （TEG） and the conventional coagulation test results. Method：Firstly, randomly select 200 normal pregnant women （63 in early pregnancy, 58 in mid-pregnancy and 79 in late pregnancy） and 100 healthy non-pregnant women （control group）. Secondly, respectively take TEG, conventional coagulation index test （APTT, PT, TT, FIB, FDP, D-D） and platelet （PLT） detection; Finally, make an statistical analysis for all the test results. Result：①TEG index： compared with the non-pregnancy group, R value and K value of pregnancy group obviously decreased, while alpha angle, MA value and CI index remarkably increased. This difference has a statistical significance （P 〈0.05）. In conventional coagulation index, compared with the non-pregnancy group, PT and TT values of pregnancy group were obviously lower, while APTT, FIB, FDP and D-D values were greatly increased, reflecting a significantly statistical differences （P〈0.05）. ②R value was clearly higher in middle and late pregnancy group than that in early pregnancy group （P〈0.05）. K value of late pregnancy group was much lower than that of early pregnancy group （P〈0.05）. Alpha Angle of late pregnancy group increased evidently compared with early pregnancy group （P〈0.05）. MA： There was no significant change in different periods of pregnancy. CI value of middle and late pregnancy group was far higher than that of early pregnancy group （P〈0.05）. Conclusion：Pregnancy women and non pregnant women on the TEG and conventional coagulation indexes may be significant different, TEG index value of R, K value, a horn and CI may be significant different in different periods of pregnancy as well.