血栓弹力图参数水平及凝血系统功能指标在妊娠不同时期的分析

Analysis of thromboelastogram and coagulation system function in different stages of pregnancy

目的:探讨妊娠不同时期血栓弹力图(thrombelastography,TEG)及凝血系统功能指标的变化趋势。方法:选择2016年10月~2018年6月在我医院产科进行产检的孕妇86例为研究对象。其中早孕组23例,中孕组30例,晚孕组33例。另选同期我院健康体检的未孕女性27例作为对照组。对上述病例进行TEG检测和凝血系统功能指标水平的测定,分析TEG的R、K、Angle角、MA参数和凝血系统功能指标(PT、APTT、TT、AT-Ⅲ、PC、PS、FIB、FDP和D-D)水平的变化。结果:孕妇组的R、K值较非孕组有显著性地缩短,并且随着孕周增加R、K值逐渐降低。早孕、中孕和晚孕组的Angle角和MA参数水平均有明显升高,并随着孕周增加而逐渐升高;血小板α颗粒膜蛋白-140(α-granular membrane protein-140,GMP-140)在晚孕组中明显高于非孕组、早孕组和中孕组;凝血系统功能指标水平PT、APTT、TT、AT-Ⅲ、PC、PS随孕周增加逐渐降低,而FIB、FDP和D-D则随着孕周增加逐渐升高,差异均具有显著性差异。结论:妊娠不同时期TEG的R、K、Angle角、MA参数,GMP-140和凝血系统功能指标均存在差异性。TEG、GMP-140和凝血系统功能指标均可作为监测不同时期妊娠妇女凝血功能的指标。

Objective To investigate the changes of thrombelastography(TEG)and coagulation system function indexes in different stages of pregnancy.Methods From October 2016 to June 2018,86 pregnant women who underwent obstetric examination In our hospital were selected as the study subjects.There were 23 cases in early pregnancy group,30 cases in middle pregnancy group and 33 cases in late pregnancy group.Another 27 non-pregnancy women who underwent physical examination in our hospital during the same period were selected as the control group.The changes of R,K,MA parameters of TEG and coagulation system function indexes(PT,APTT,TT,AT-Ⅲ,PC,PS,FIB,FDP and D-D)were analyzed.Results The R and K values of pregnant women were significantly shorter than those of non-pregnant women,and gradually decreased with the increase of gestational weeks.Compared with non-pregnant group,Angle and MA of early pregnancy,middle pregnancy and late pregnancy groups were significantly higher,and gradually increased with the increase of gestational weeks.Alpha-granular membrane protein-140(GMP-140)in late pregnancy group was significantly higher than those in non-pregnancy group,early pregnancy group and middle pregnancy group.The levels of PT,APTT,TT,AT-Ⅲ,PC and PS decreased with the increase of gestational weeks,while FIB,FDP and D-D increased with the increase of gestational weeks,with significant differences.Conclusion There are differences in R,K,Angle,MA parameters of TEG,GMP-140 and coagulation system function indexes in different stages of pregnancy.TEG,GMP-140 and coagulation system function indicators can be used to monitor the coagulation function of pregnant women in different periods.