肝素在产科领域中的应用

The use of Heparin in Obstetrics

妊娠期血液处于高凝状态,使胎盘绒毛血管血栓形成及纤维蛋白沉积,造成血管部分或完全受阻,从而造成反复流产、死胎、早产、羊水过少、胎儿宫内生长受限,脐血流收缩/舒张(S/D)比值升高、妊娠期高血压疾病及肝内胆汁淤积症等,肝素作用机制是与抗凝血酶-Ⅲ(抗血栓素)结合,抑制纤维蛋白原转化成纤维蛋白,阻止血小板聚集,起到抗凝作用。另外,肝素治疗妊娠合并内外科疾病、产科弥漫性血管内凝血(DIC)的高凝状态,通过抗凝起到抗炎、消肿、降血脂、预防血栓形成的作用。

The blood in pregnenay has hypercoagulabale state, which results in habitual abortion,fetal death,premature birth,oligohydramnios ,fatal growth restriction（FGR） ,rising in S/ D radio of umbilical artery flow, hypertensine disorder and intrahepatic cholestasis companyed by pregnancy and so on resulting from part or whole vessel block caused by thrombosis and fibrin deposition in placental villus. Heparin has antieogulation by inhibiting the transformation from fibrinogen to fibrin and aggregation of platelet through combining with antithrombase-Ⅲ. In the therapy of hypocoagulation in pregnancy with surgical and internal diseases and DIC in obstetrics, it can also has effects of anti-inflammation, detumescence, lipid lowering and thrombotic prevention by its anticoagulation.