妊娠糖尿病孕妇部分凝血指标的检测及其意义

Study on the coagulation changes in patients with gestational diabetes mellitus

目的 探讨妊娠糖尿病(GDM)孕妇的部分凝血相关因子及血栓分子标志物水平对GDM孕妇合并高凝状态的诊断意义。方法 采用双抗体夹心ELISA法检测44例GDM、43例正常晚孕及44例正常非孕妇女血浆组织型纤溶酶原活化物活性(tPA)、纤溶酶原活化物抑制物活性(PAI)、D-二聚体(DD)、血管性假血友病因子抗原(vWF:Ag)、凝血酶原断片(F1+2)、血小板α颗粒膜蛋白(伽'140)水平。结果 GDM组PAI、DD、vWF:Ag、F1+2和GMP140水平。差异有非常显著性(p<0.01);GDM组、正常晚孕组各指标水平均比正常非孕组高,差异有显著性(p<0.05-0.01);GDM孕妇血浆F1+2、GMP140、DD与血浆vWF:Ag水平呈显著正相关(r分别为0.563,0.597,0.394,均p<0.01);GDM孕妇血浆tPA、PAI、ATⅢ与血浆vWF:Ag水平无显著相关(r分别为0.182,0.191,-0.117,均p>0.05)。结论 GDM孕妇存在较正常晚期妊娠更严重的血液高凝状态。

Objective To explore the changes of the hemorrheology coagulation and fibrinolytic system in patients with gestational diabetes mellitus(GDM) .Methods The initial plasma levels of tissue plasminogen activator(tPA) .plasminogen activator inhitor(PAI) ,D- dimer(DD), von Willebrand factor(vWF: Ag) , prothrombin fragment ( F1+ 2 ) and platlet alpha- granule membrane protein (GMP140) were measured by EOSA in 44 GDM women, 43 normal late pregnancy women, and 44 non - pregancy women. Results In GDM group PAI 、 DD、 vWF: Ag x F1+ 2 , GMP140 were obviously higher than those of control(p < 0.01) . In GDM group and normal late pregnancy group the initial plasma levels of tPA,PAI,DD,vWF:Ag,F1+2,GMP140 were obviously higher than those of non- pregnancy group(p< 0.05 - 0.01) .Initial plasma levels of F1+2,GMP140,DD are correlated with those of vWF: Ag(p < 0.01) . Initial plasma levels of tPA,PAI, ATⅢ are not correlated with those of vWF: Ag( p > 0.05 ) . Conclusion Hypercoagulative state was shown in normal late pregnancy women. Obvious Hypercoagulative state was shown in GDM women.