妊高症患者凝血参数变化的临床意义

Clinical significance of the changes of coagulation makers in patients with hypertensive disorders in pregnancy

目的通过观察妊娠期高血压疾病(简称"妊高症")患者分娩前后血浆中各凝血指标的变化,探讨其临床意义。方法检测正常非孕组、正常晚孕组、妊娠期高血压组、轻度子痫前期组(各20例)及重度子痫前期或子痫组(18例)妇女分娩前后外周血血浆的凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、D-二聚体(DD)、纤维蛋白原水平(Fig)。结果与正常非孕组或正常晚孕组比较,子痫患者分娩前后血浆的D-二聚体和纤维蛋白原水平显著升高,抗凝血酶活性显著降低(P<0.01);分娩后,子痫组与正常晚孕组、正常非孕组比较,血浆的D-二聚体和纤维蛋白原水平升高,抗凝血酶活性降低(P<0.01),差异均无显著统计学意义(P>0.05);结论正常孕晚期妇女分娩前处于轻度的血栓前状态,分娩后短期内无明显改变;妊高症患者分娩前存在明显的血栓前状态,分娩后缓解。

Objective To explore the clinical significance by studying the changes of coagulation makers in patients with hypertensive disorders in pregnancy.Methods The prothrombin time(PT),thrombin(TT),activated partial thromboplastin time(APTT),D-dimer(DD) and fibrinogen(Fig) were examined in 0 non-pregnancy women,20 normal late-pregnancy women,20patients with gestational hypertension,20 patients with mild preeclampsia and 18 patients with severe preeclampsia or eclampsia before delivery and after delivery.Results The levels of DD and Fig were obviously higher in the three groups of PIH,but were obviously lower in the activity of AT compared with the non-pregnant women and the normal late-pregnancy women(P<0.01).The levels of DD and Fig were slightly lower in normal late-pregnancy women after delivery and were slightly higher in the activity of AT compared with before delivery.There were no significant differences in two groups.Conclusions Before delivery the normal late-pregnant women were in mild pre-thrombotic state and it has no significant changes in the short term after delivery.However,the serious pre-thrombotic state of the patients with PIH before delivery relieves after delivery in the short term.