健康孕妇血浆D-二聚体浓度与妊娠进展关系的研究

The study for the correlation between D-dimer concentrations and gestation in normal uncomplicated pregnancy

目的研究不同妊娠期正常健康孕妇血浆D-二聚体的水平，探讨以D-二聚体浓度作为监测指标评估妊娠期血栓形成风险的意义。方法收集380例健康孕妇和150例健康未孕女性静脉血，分别进行D-二聚体浓度、凝血时间（PT）、活化部分凝血活酶时间（APTT）、血小板计数等测定。结果妊娠组血浆D-二聚体、血小板计数与对照组比较差异均有统计学意义（P〈0.05）。但两组受试对象的PT、APTT结果差异均无统计学意义（P〉0.05）。D-二聚体水平与孕程成明显的正相关性。妊娠组约有9.2％孕妇的血浆D-二聚体浓度高于血栓形成风险的限值（500ng／mL）。结论9.2％孕妇血浆D-二聚体浓度大于500ng／mL，具有较高的血栓形成风险；鉴于D-二聚体检测方法的特异性一般，后续研究需要同时对其他血液凝固系统和纤溶系统的分子标志进行测定，精确评估正常健康妇女在孕期是否存在血栓形成的风险。

Objective As D-dimer levels have been reported to increase progressively during pregnancy, this study aims to determine the D-dimer concentration and its relationship with other coagulation parameters in normal uncomplicated pregnant women. Methods Venous blood samples collected from 380 normal pregnant women and 150 health nonpregnant women controls were assessed using the standard procedures for the following parameters： D-di- mer concentration, prothrombin time （PT）,activated partial thromboplastin time （APTT） and platelet count. Results The D-dimer concentration and platelet count in the pregnant group was found to be significantly different when compared with the control group. There was no statistically significant difference in the values for the PT and APTT between pregnant and nonpregnant women. A liner relationship was found to exist between D-dimer and gestation. A- bout 9.2% of the pregnant women were found to be at risk of thrombosis （D-dimer level 〉 500 ng/mL）. Conclusion About 9.2% of the pregnant women in this study population had elevated D-dimer levels over 500 ng/mL,there is the possibility that this group may be at risk of thrombosis. Since the D-dimer is not a very specific test, further stud- y, incorporating other diagnostic parameters, about pre-pregnancy, gestation, postnatal and pregnancy outcome of sin- gle study object may be needed before a more logical conclusion can be draw.