妊娠高血压疾病患者血小板参数和凝血指标的改变及临床意义

Changes and clinical significance of platelet parameters and coagulation indicators of patients with gestational hypertension

目的通过对妊娠高血压疾病(HDCP)患者与健康妊娠晚期孕妇血小板参数与凝血功能指标的检测及统计学分析比较,探讨血小板相关参数和凝血指标的改变与易栓症发生的相关性。方法采用Beckman 5 diff AL全血细胞分析仪、Sysmex CA7000全自动血凝分析仪分别对42例HDCP患者(HDCP组)与98例健康妊娠晚期孕妇(妊晚组)以及110例健康非孕妇女(对照组)的血液标本进行血小板计数(PLT)、血小板压积(PCT)、平均血小板体积(MPV)、血小板体积分布宽度(PDW)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶凝结时间(TT)、纤维蛋白原(FIB)的检测和统计分析。结果 HDCP组的PT、FIB、PLT、MPV、PCT、PDW分别为(11.7±1.40)s、(4.2±0.84)g/L、(197.7±71.8)×109/L、(11.0±1.9)fL、(0.11±0.45)%、(20.7±1.3)%,与对照组的(13.0±0.92)s、(2.7±0.65)g/L、(208±69.4)×109/L、(10.0±1.8)fL、(0.14±0.29)%、(18.5±1.2)%比较,差异有统计学意义(P<0.05或0.01);妊晚组PT、APTT、FIB、PLT为(12.0±0.95)s、(25.5±4.4)s、(3.6±0.71)g/L、(198.4±70.1)×109/L,与对照组比较差异有统计学意义(P<0.05或0.01);HDCP组PT、APTT、FIB、MPV、PDW为(11.7±1.40)s、(26.0±4.3)s、(4.2±0.84)g/L、(11.0±1.9)fL、(20.7±1.3)%,与妊晚组的(12.0±0.95)s、(25.5±4.4)s、(3.6±0.71)g/L、(10.1±1.6)fL、(19.4±1.5)%比较,差异有统计学意义(P<0.05或0.01)。结论妊娠高血压疾病患者应对其血小板参数和凝血指标进行动态监测,及时发现血栓前状态,有效预防易栓症的发生,提高产科的安全性,保障母婴健康。

Objective To discuss the correlation between the changes of platelet parameters and coagulation indicators and the occurrence of thrombophilia through detecting and analyzing the platelet parameters and coagulation indicators of patients with hypertensive disorder complicating pregnancy （HDCP） and healthy pregnant women in late pregnancy. Methods The platelet count （PLT）, platelet-pressure product （PCT）, mean platelet volume （MPV）, platelet distribution width （PDW）, prothrombin time （PT）, activated partial thromboplastin thromboplastin time （APTT）, thrombin condensation time 033 and fibrinogen content （FIB） of 42 patients with HDCP （HDCP group）, 98 healthy pregnant women in late pregnancy （late pregnancy group） and 110 health non-pregnant women （control group） were detected and analyzed statistically using the Beckman 5 diff AL whole blood cell analyzer and Sysmex CA7000 automated coagulation analyzer. Results The PT, FIB, PLT, MPV, PCT and PDW of the HDCP group were （11.7±1.40）s, （4.2±0.84）g/L, （197.7± 71.8）×10^9/L, （11.0±1.9）fL, （0.11±0.45）% and （20.7±1.3）% respectively, which were significantly different from the （13.0_0.92）s, （2.7±0,65）g/L, （208±69.4）×10^9/L, （10.0±1.8）fL, （0.14±0.29）% and （18.5±1.2）% of the control group （P 〈 0.05 or 0.01）; The PT, APTT, FIB and PLT of the late pregnancy group were （12.0±-0.95）s, （25.5±4.4）s, （3.6±0.71）g/L and （198.4±70.1）×10^9/L, which were significantly different from those of the control group （P 〈 0.05 or 0.01）; The PT, APTT, FIB, MPV and PDW of the HDCP group were （11.7±1.40）s, （26.0±4.3）s, （4.2±0.84）g/L, （11.0±l.9）fL and （20.7±1.3）%, which were significantly different from the （12.0±0.95）s, （25.5±4.4）s, （3.6±0.71）g/L, （10.1±l.6）fL and （19.4± 1.5）% of the late pregnancy group （P 〈 0.05 or 0.01）. Conclusion The platelet parameters and coagulation markers of patients with gestational hypertension should be monitored dynamically in order to detect the prothrombotic state timely, prevent the occurrence of thrombophilia effectively, improve the obstetric security and guarantee the maternal and child health.