妊娠高血压综合征患者凝血四项指标和血小板计数的临床意义

Clinical significance of four blood coagulation parameters and platelet count in patients with pregnancy induced hypertension syndrome

目的:探讨妊娠期高血压综合征(妊高征)患者凝血四项指标及血小板(PLT)计数的变化及其临床意义。方法:检测120名正常非孕期妇女、120名中后期妊娠妇女和360例妊高征患者的血浆凝血酶原时间(PT)、国际标准化比值(INR)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fbg)、凝血酶时间(TT)和PLT,并进行统计学分析。结果:妊高征患者的凝血四项指标及PLT水平与正常非孕期妇女、正常妊娠妇女比较,差异有统计学意义,其PT、APTT、TT缩短,PLT减少尤为明显,且随着病情的加重而递减,Fbg含量则逐渐升高,使其处于严重的血栓前状态。结论:妊高征患者体内存在着凝血和纤溶系统的平衡紊乱,有血栓形成的趋向和危险,产前进行凝血四项和PLT检测可指导产科医师采取相应措施,在防治出血、避免弥散性血管内凝血(DIC)的发生和保障母婴安全等中具有重要的临床意义。

Objective： To study the changes and clinical significance of four blood coagulation parameters and platelet count in patients with pregnancy-induced hypertension syndrome Methods： Levels of prothrombin time （PT： INR）, activated partial thromboplastin time （AFFF）, fibrinogen （Fbg）, thrombin time （TF） and platelet count （PLT） were deter mined in 120 normal non-pregnant women, 120 mid- and late- term pregnant women, and 360 patients with pregnancy in duced hypertension syndrome. Statistical analysis was then performed. Results： Statistically significant differences in the four blood coagulation parameters and platelets count were existed between patients with pregnancy-induced hypertension syndrome, non-pregnancy women, and normal pregnant women. Prothrombin time （PT： INR）, activated partial thromboplas- tin time （AFFF）, thrombin time （TI＇） and platelet count in patients with pregnancy induced hypertension syndrome were shortened or decreased significantly, and were shortened or decreased further with the progress of disease. In contrast, fib- rinogen （Fbg） content was increased. The patients with pregnancy-induced hypertension syndrome were in a state of severe prethrombotic state. Conclusions： Disturbance in balance between coagulation and fibrinolysis system occurs in patients with pregnancy induced hypertension syndrome, and there is a trend and risk of thrombosis. Prenatal determination of four blood coagulation parameters and platelet count has important clinical significance for the obstetrician to take appropriate measures to prevent bleeding and to avoid the occurrence of DIC and to protect the pregnant mother and infant.