早产孕妇血小板参数、纤维蛋白原及D-二聚体水平的变化

Changes of platelet parameters,fibrinogen and D-dimer in premature pregnant women

目的探讨早产孕妇血小板计数(PLT)、血小板分布宽度(PDW)、血小板平均体积(MPV)、血小板压积(PCT)、纤维蛋白原(FIB)和D-二聚体(D-D)水平变化及其临床意义。方法对173例早产孕妇(早产孕妇组)产前和产后(24h内)标本进行PLT、PDW、MPV、PCT、FIB和D-D检测及分析,选择50例无早产的健康孕妇为对照组A;50例非孕健康育龄妇女为对照组B。结果早产孕妇组产前的PLT、PDW和PCT高于对照组B,差异有统计学意义(P<0.05);早产孕妇组产前D-D高于对照组A,差异有统计学意义(P<0.05)。早产孕妇组产前FIB、D-D显著高于对照组B,差异有统计学意义(P<0.05);与产前比较,产后24h内FIB降低,D-D显著增高,差异有统计学意义(P<0.05)。结论早产孕妇血液处于高凝状态,早产前后监测PLT、PDW、PCT、FIB和D-D水平对预防产后异常出血和弥散性血管内凝血等血栓性并发症有重要的临床意义。

Objective To investigate the changes of platelet count（PLT）,platelet distribution width（PDW）,mean platelet vol-ume（MPV） ,platelet hematocrit（PCT） ,fibrinogen （FIB） and D-dimer（D-D） in premature pregnant women and their clinical signifi-cance. Methods PLT,PDW, MPV,PCT,FIB and D-D before and after delivery （within 24 h） were detected and analyzed in 173 ca-ses of premature pregnant women （premature pregnant woman group）. 50 healthy pregnant women without premature were select-ed as the control group A and 50 non-pregnant women were selected as the control group B. Results PLT,PDW and PCT before delivery in the premature pregnant women group were higher than those in the control group B,the difference was statistically sig-nificant （P〈0.05）;The D-D level before delivery in the premature pregnant women group was higher than that in the control group A, the difference was statistically significant （P〈0. 05）. FIB and D-D before delivery in the premature pregnant women group were significantly higher than those in the control group B,the difference was statistically significant （P〈0.05） ;Compared with before delivery,the FIB level within postnatal 24 h was decreased and the D-D level was increased significantly,the difference was statistically significant （P〈0. 05）. Conclusion Blood of premature pregnant women is in hypereoagulative state, monitoring PLT, PDW, PCT, FIB and D-D before and after delivery has important clinical significance in preventing the thrombus complications of abnormal postpartum bleeding and disseminated intravascular coagulation （DIC）.