妊娠期高血压疾病凝血和纤溶实验室指标变化的临床意义

Clinical significance of coagulation and fibrinolysis indexes in patients with pregnancy-induced hypertension

目的检测凝血与纤溶实验室指标,探讨其在妊娠期高血压疾病(简称妊高征)诊断和预防中的价值。方法采用凝固法测定血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)和纤维蛋白原(FIB)含量;采用酶联免疫吸附试验(ELIsA)检测D-D二聚体(DD),采用发色底物法检测组织纤溶酶原激活物(tPA)、纤溶酶原激活抑制物-1(PAI-1)活性,共检测158例标本(其中重度子痫前期组44例,轻度子痫前期组32例,妊娠期高血压组30例,正常妊娠组52例),并进行比较分析。结果与正常妊娠组比较,妊娠期高血压组的PT、APTT明显降低(P<0.01),FIB、DD、PAI-1明显升高(P<0.01或P<0.05),tPA无显著差异;妊娠期高血压各组间除tPA无显著差异外,其余参数各组间差异均有统计学意义,随着疾病的加重,参数变化越显著。结论检测妊娠期高血压患者PT、APTT、FIB、DD和PAI-1等指标,对预防和治疗妊娠期高血压疾病的发生、发展有重要临床意义。

Objective To investigate the value of coagulation and fibrinolysis indexes in the diagnosis and prevention of pregnancy-induced hypertension（ PIH）. Methods The level of prothrombin time（ PT）,activated partial thromboplastin time（ APTT） and fibrinogen（ FIB） were tested with clotting time method,D-dimer（ D-D） with ELISA,tissue-type plasminogen activator（ tPA） and plasminogen activator inhibitor-1（ PAI-1） with chromogenic assay. The blood samples from44 women with severe preeclampsia,32 women with mild preeclampsia,30 women with pregnancy-induced hypertension,and 52 normal pregnant women were detected and compared. Results Compared with normal pregnancy group,the levels of PT and APTT of PIH group decreased obviously（ P〈0. 01）,the levels of FIB,DD and PAI-1 increased obviously（ P〈0. 01 or P〈0. 05）,the level of tPA was not obvious. There were obvious difference in PT,APTT,DD and PAI-1 among each PIH group,and the parameters changed more significantly with the deterioration of the disease. Conclusion To monitor the changes of PT,APTT,FIB,DD and PAI-1 in patients with pregnancy induced hypertension is very important in the prevention and treatment of PIH.