不同孕期孕妇凝血指标和血脂及脂蛋白水平观察

Observation of blood coagulation indicators and lipids as well as lipoproteins level during different stages of gestation in pregnant women

目的观察不同孕期孕妇凝血指标和血脂及脂蛋白水平并探讨其临床意义。方法应用日立生化分析仪分别检测106例不同孕期的孕妇和30例健康非孕女性凝血指标和血脂及脂蛋白水平,测定计算体质量指数(BMI)。结果中孕、晚孕组血浆纤维蛋白(FIB)、D-二聚体(D-D)、三酰甘油(TG)、总胆固醇(TC)、血清载脂蛋白B(ApoB)、BMI水平显著高于早孕组,差异有统计学意义(P<0.01),晚孕组仅D-D水平显著高于中孕组(P<0.01)。妊娠各组指标阳性率显著高于对照组,差异有统计学意义(P<0.01),阳性率高低依次为FIB、高密度脂蛋白胆固醇(HDL-C)和TG,早孕期TC和HDL-C敏感性最高,中孕期FIB和TG最高,晚孕期FIB、D-D和血小板聚焦率(PAgT)最高。各种联合检测对判断高凝状态的敏感性增加,敏感性可高达100%。结论凝血指标和血脂及脂蛋白水平可以有效辅助判断孕妇体内高凝状态的程度,对监测血栓发生具有非常重要的意义。

Objective To observe the blood coagulation indicators and lipids as well as lipoproteins level during different stages of gestation in pregnant women.Methods Samples were obtained from 106 pregnant women with different stages of gestation for detecting the levels of fibrinogen（FIB）,d-dimer（D-D）,blood lipids as well as lipoproteins by chemistry analyzer（Hitachi）,and the body mass index（BMI）was calculated.30 healthy females were collected as the control group.Results Levels of FIB,D-D,TG,TC,ApoB and BMI in pregnant women during intermediate and last stages were much higher than those during early stage（P〈0.01）,the level of D-D in pregnant women during last stage was much higher than that during intermediate stage（P〈0.01）.There were higher positive rates of all indicators in pregnant women than that in controls（P〈0.01）.The positive rates ranking was in turn FIB,HDL-C and TG.TC and HDL-C had the highest sensitivity in early stage of pregnancy,but FIB and TG in intermediate stage,FIB and D-D in last stage.The combination detection of indicators could elevate the sensitivity judging hypercoagulable state,its sensitivity could reach 100%.Conclusion It is efficient for the levels of blood lipids as well as lipoproteins and coagulation indicators to judge the degree of hypercoagulable state and prognose thrombosis in pregnant women.