妊娠妇女凝血功能变化的临床研究

Analysis of variation of women's blood coagulation function in normal pregnancy

目的了解妊娠妇女凝血功能变化,探讨妊娠妇女凝血指标变化的规律及临床意义。方法对156例正常孕妇和20例健康非孕妇女的凝血酶原时间(PT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)及纤维蛋白原(Fg)、D-二聚体(D-D)、抗凝血酶Ⅲ(AT-Ⅲ)进行检测。结果妊娠组与对照组比较,PT、APTT指标差异无统计学意义(P>0.05),且PT、APTT在妊娠早、中、晚期组间差异也无统计学意义(P>0.05);TT值在对照组、早孕组、中孕组之间差异无统计学意义(P>0.05),而晚孕组的TT检测结果较前三组明显缩短(P<0.05);妊娠组与对照组比较,AT-Ⅲ活性显著下降,差异有统计学意义(P<0.01),且随孕期增加有不断下降的趋势(P<0.01);而妊娠组的D-D、Fg水平都显著高于对照组(P<0.01),Fg在孕早、中期无明显变化(P>0.05),孕晚期明显升高(P<0.01),D-二聚体在孕早、中、晚期不断升高(P<0.01)。结论正常孕妇处于高凝状态,孕期进行凝血指标的监测,可早期发现凝血功能的异常变化,对预防和抢救产科一些并发症有重要意义。

Objective To investigate the variation of coagulation function in pregnancy. Methods Prothrombin time（PT） ,activated partial thromboplastin time（APTT）, thrombin time （ TT）, fibrinogen （Fbg）, D-Dimer （D-D） and antithrombin Ⅲ （ AT- Ⅲ ） in fifty-two pregnant women and twenty normal non-pregnency women were determined by ACL-9000 system. Results Compared with those of the control group, the levels of PT, APTT were not obviously changed in pregnancy（P〉0.05） ;the levels of TT were obviously shorter compared with the late-pregnant women and the other group（P〈0.01） ; but there was no significant difference among the control group, the early and middle pregnant women groups（P〉 0.05） ;compared with the control group, the activity of AT- Ⅲ were obviously dropped in pregnancy（P〈0.01 ）, and decreased with the progress of pregnancy（ P〈 0.01 ） ; in contrast, the levels of D-D and Fg increased with the progress pregnancy（P〈0.01）. Conclusion The pregnant women have the hypercoagulation state. The detection of blood concretion functions plays an important role in preventing from complications.