妊娠期高血压疾病患者凝血指标的变化及临床意义

Change and clinical significance of blood coagulation index in patients with hypertensive disorder complicating pregnancy

目的探讨妊娠期高血压疾病患者血凝指标的变化情况。方法选取本院2011年2月~2013年10月诊治的114例妊娠期高血压疾病患者作为观察组,根据子痫程度将观察组分为轻度子痫前期组（A组）和重度子痫前期组（B组）,根据发病孕周将观察组分为早发型子痫前期组（C组）和晚发型子痫前期组（D组）。选取同期本院的111例正常妊娠孕妇作为对照组。所有人员均行血凝指标（凝血酶时间、凝血酶原时间、活化部分凝血活酶时间、纤维蛋白原）检测。结果观察组的凝血酶时间、凝血酶原时间、活化部分凝血活酶时间显著短于对照组,纤维蛋白原水平显著低于对照组,差异有统计学意义（P〈0.05）。B组的凝血酶时间、凝血酶原时间、活化部分凝血活酶时间显著短于A组,纤维蛋白原水平显著低于A组,差异有统计学意义（P〈0.05）。C组的凝血酶时间、凝血酶原时间、活化部分凝血活酶时间显著短于D组,纤维蛋白原水平显著低于D组,差异有统计学意义（P〈0.05）。结论妊娠期高血压疾病患者伴有不同程度的凝血功能障碍,子痫程度越严重,凝血功能障碍越明显。与晚发型子痫前期相比,早发型子痫前期的凝血功能障碍更为明显。

Objective To explore the change situation of blood coagulation index in patients with hypertensive disorder complicating pregnancy. Methods 114 patients with hypertensive disorder complicating pregnancy in our hospital from February 2011 to October 2013 were selected as the observation group.According to degree of preeclampsia,the observation group was divided into the mild preeclampsia group（group A） and the severe preeclampsia group（group B）.According to the gestational week,the observation group was divided into the early onset preeclampsia group（group C） and the late onset preeclampsia group（group D）.111 normal pregnant women in our hospital at the same period were selected as the control group.All staff were performed on blood coagulation index（thrombin time,prothrombin time,activated partial thromboplastin time,fibrinogen） detection. Results Thrombin time,prothrombin time,activated partial thromboplastin time in the observation group was shorter than that in the control group,the level of fibrinogen in the observation group was lower than that in the control group,with significant difference（P〈0.05）.Thrombin time,prothrombin time,activated partial thromboplastin time in group B was shorter than that in group A,the level of fibrinogen in group B was lower than that in group A,with significant difference（P〈0.05）.Thrombin time,prothrombin time,activated partial thromboplastin time in group C was shorter than that in group D,the level of fibrinogen in group C was lower than that in group D,with significant difference（P〈 0.05）. Conclusion Patients with hypertensive disorder complicating pregnancy have coagulation dysfunction in different degree.Degree of preeclampsia is more serious,while coagulation dysfunction is more obvious.Compared with late onset preeclampsia,early onset preeclampsia has more obvious coagulation dysfunction.