早期妊娠妇女凝血、抗凝、纤溶与抗纤溶指标的测定

Indexes determination of coagulation, anticoagulation, fibrinolysis and antifibrinolytic in early pregnancy

目的了解早期妊娠凝血、抗凝、血栓形成、纤溶和抗纤溶状态的改变。方法选取105例妊娠10～12周孕妇为研究组,另选取82例正常未孕者为对照组。测定凝血状态指标,包括凝血常规即血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fg)以及凝血酶原片段1+2(F1+2)、凝血酶-抗凝血酶复合物(TAT),同时测定抗凝、纤溶与抗纤溶分子标志物,包括抗凝血酶-Ⅲ(AT-Ⅲ)、血小板颗粒糖蛋白140(GMP140)、血栓烷B2(TXB2)、D二聚体(D-Ⅱ)、纤溶酶原激活物抑制物(PAI-2)。结果研究组Fg、F1+2、TAT、D-Ⅱ、PAI-2分别为4.00、179.95、0.66、201.51、46.80,明显高于对照组的2.52、39.46、0.31、125.02、5.87,差异有统计学意义(P<0.008),而研究组反映血栓形成的指标GMP140为9.42,显著低于对照组的19.13,差异有统计学意义(P<0.008)。结论正常妊娠早期,血液凝血功能增强,抗凝状况无明显改变,纤溶活性及抗纤溶活性出现亢进,血栓形成减少,这样的改变可能有利于保持充足的胎盘子宫血流灌注量。

Objective To explore the changes in coagulation, anticoagulation, fibrinolysis and antifibrinolytic during early pregnancy. Methods 105 pregnant women who conceived from 10 to 12 weeks were enrolled as the study group, and 82 non- pregnant women were selected as the control group. Coagulation, anticoagulation, fibrinolysis and antifibrinolytic parameters were measured. Results Fg, Fl＋2, TAT, GMP140, D-dimer and PAI-2 in the study group were statistically different to the control group （P〈0.008）. Conclusion The coagulation, fibrinolytic, and the antifibrinolytic functions of healthy pregnant women are enhanced during early pregnancy. Such changes may help maintaining adequate placental uterine blood flow perfusion.