妊娠高血压综合征患者凝血、抗凝及纤溶系统的变化及其临床意义

Changes and clinical value in coagulation、anti-coagulation and fibrinolysis system of patients with pregnancy induced hypertension

目的探讨妊娠高血压综合征(妊高征)患者凝血、抗凝、纤溶功能指标的改变及其临床意义。方法分别应用凝固法、发色底物法和免疫法检测85例妊高征患者、50例晚期妊娠者及50名正常非孕妇女血浆凝血酶原时间(PT)、活化的部分凝血酶原时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fbg)、抗凝血酶Ⅲ(AT-Ⅲ)、纤溶酶原(PLG)、α2-抗纤溶酶(α2-AP)、D-二聚体(D-dimer)。所有测定均在SysmexCA-7000全自动血凝仪上完成。结果与对照组比较,晚孕组及妊高征各组PT、APTT、Fbg、AT-Ⅲ、PLG、α2-PI、D-dimer差异有统计学意义(P<0.05或P<0.01);与晚孕组比较,妊高征及各组PT、APTT、Fbg、AT-Ⅲ、PLG、α2-PI、D-dimer差异亦有统计学意义(P<0.05或P<0.01);且随病情加重差异有增高趋势。结论正常晚孕妇女处于高凝状态,而妊高征患者存在明显的高凝状态,且有血栓形成倾向。产前进行凝血与纤溶功能的检查对妊高征的监测和治疗有一定临床意义。

Objective To evaluate Changes and clinical value in coagulation、anti-coagulation and fibrinolysis system of patients with induced pregnancy hypertension(PIH).Methods Plasma value of prothrombin time(PT)、active partial thromboplastin time(APTT)、thrombin time(TT)、Fibrogen(Fbg)、antithrombin-Ⅲ(AT-Ⅲ)、plasminogen(PLG)、α2-antiplasmin(α2-AP)and D-dimer were determined in 50 non-pregnancy(control group)、50 normal pregnancy women(normal pregnancy group)and 85 patients with PIH(PIH group).Results PT、APTT、Fbg 、AT-Ⅲ、PLG 、α2-AP and D-dimer in PIH group and normal pregnancy group were significently difference than those of control group(P<0.05或P<0.01);All these indexes in PIH group were also significently difference than those of normal pregnancy group(P<0.05或P<0.01).Conclusions Normal pregnant wemon are in a hypercogulable state and the PIH patients show a tendency to develop thrombosis.Detaction cogulation and fibrinolysis indexes play a role in monitoring development of PIH.