正常孕产妇凝血四项水平分析及参考区间的建立

Reference intervals of common coagulation tests during the pregnancy and puerperium period

目的建立河南地区汉族正常孕产妇凝血四项参考区间。方法采用凝固法在Stago STA-R全自动血凝分析仪上检测2 008例健康非孕妇女、6 354例健康孕妇和1 987例健康产妇血浆凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血酶时间(APTT)及纤维蛋白原(Fib)水平。健康孕妇按孕周分为早孕组、中孕组及晚孕组。采用非参数方法建立凝血四项参考区间。结果早孕组、中孕组、晚孕组、产妇组的PT值分别为11.8 s～14.2 s、10.4 s～12.8 s、9.8 s～12.5 s、12.1 s～14.7 s;TT值分别为14.1 s～16.6 s、13.0 s～15.5 s、11.1 s～15.0 s、14.5 s～17.7 s;APTT值分别为29.6 s～40.9 s、28.9 s～39.2 s、28.4 s～38.1 s、30.3 s～43.0 s;Fib值分别为248 mg/dl～486 mg/dl、286 mg/dl～515 mg/dl、293 mg/dl～558 mg/dl、172 mg/dl～482 mg/dl。结论本研究建立了河南地区汉族正常孕产妇血浆凝血四项参考区间,有望提高凝血四项在孕产妇人群中的应用价值。

Objective To establish the reference intervals of common coagulation tests during the pregnancy and puerperium period in Han population in Henan Province. Methods The prothrombin time(PT), thrombin time(TT), activated partial thromboplastin time(APTT), and fibrinogen(Fib) of 2 008 healthy non-pregnant women, 6 354 healthy pregnant women and 1 987 healthy postpartum women were measured by Stago STA-R automatic coagulation analyzer using clotting time method. And they were divided into early-pregnancy group(2 087), mid-pregnancy group(2 108), and late-pregnancy group(2 159). Reference intervals were constructed using the nonparametric method. Results The reference intervals of PT for the early-pregnancy, mid-pregnancy, late-pregnancy, and postpartum women were respectively 11.8 s-14.2 s, 10.4 s-12.8 s, 9.8 s-12.5 s, 12.1 s-14.7 s, that of TT were 14.1 s-16.6 s, 13.0 s-15.5 s, 11.1 s-15.0 s, 14.5 s-17.7 s, that of APTT were 29.6 s-40.9 s, 28.9 s-39.2 s, 28.4 s-38.1 s, 30.3 s-43.0 s, and that of Fib were 248 mg/dl-486 mg/dl, 286 mg/dl-515 mg/dl, 293 mg/dl-558 mg/dl, 172 mg/dl-482 mg/dl. Conclusion Reference intervals of common coagulation tests during the pregnancy and puerperium period were established. Those reference intervals may improve the application values of the routine coagulation tests in the pregnant and postpartum population.