健康孕妇孕期血小板计数的变化

Clinic Study on the Change Tendency of Platelet Count in Healthy Pregnant Women.

目的了解健康孕妇孕期血小板（platelet，PLT）计数变化趋势，探讨血小板计数与产后出血、妊娠结局的关系。方法研究对象为2006年7月至2007年6月在四川大学华西第二医院分娩的健康孕妇2655例，对其血小板水平及其他临床资料进行回顾性研究。结果①随着妊娠进展，本组健康孕妇孕期血小板计数呈下降趋势，95％健康孕妇的血小板计数〉80×10^9／L。②本组健康孕妇分娩前妊娠期血小板减少症（gestational thrombocytopenia，GT；incidental thrombocytopenia of pregnancy，BGT）（目前我国对妊娠期血小板减小症的诊断标准为血小板计数〈100×10^9／L）的发生率为22．29％。③孕次、产次、年龄、职业等因素与孕期血小板水平无明显相关性（P〉0．05）。④剖宫产术中出血量，按血小板计数不同进行组间比较，差异无显著意义（P〉0．05），对血小板计数〈150×10^9／L的孕妇预防性静脉输注血小板，可有效减少剖宫产术中和阴道分娩时出血量。⑤孕妇血小板值与新生儿结局无明显相关性（P〉0．05）。结论妊娠期血小板减少症发生率较高，但对妊娠结局无明显影响。对血小板计数〈50×10^9／L的孕妇预防性静脉输注血小板，可减少剖宫产术中和阴道分娩时出血量。

Objective To investigate the change tendency of platelet（PLT） count in healthy pregnant women, and study the correlation between platelet count and postpartum hemorrhage, and perinatal outcomes. Methods From July 2006 to June 2007, the clinical data of 2 655 healthy pregnant women who delivered in the West China Second University Hospital, Sichuan University were investigated retrospectively. Results ① The reference value of platelet count 〉 80× 10^9/L for the healthy pregnant women. The platelet count decreased during normal pregnancy. ② The incidence of gestational thrombocytopenia （GT） of healthy pregnant women before delivering was 22. 29%. ③ There were no significant correlation between platelet count and the gravidity, parity, age, and occupation （P〉 0.05）. ④ There were no significant difference between groups compared with volume of bleeding during caesarean section and vaginal delivery（P〉0.05）. Platelet transfusion could decrease bleeding volume during caesarean section. ⑤ There were no significant correlation between platelet count and perinatal outcomes（P〉0.05）. Conclusion The incidence of gestational thrombocytopenia is high. But there are no significant correlation between platelet count and perinatal outcomes. Platelet transfusion can reduce bleeding volume in caesarean section.