凝血功能检测在妊娠期糖尿病孕妇中的意义

Significance of blood coagulation function in patients with gestational diabetes mellitus

目的比较妊娠期糖尿病(GDM)患者与健康孕妇实验室凝血指标和血栓弹力图(TEG)参数的差异。方法回顾分析2013年6月至2014年7月在重庆医科大学附属第二医院产科住院的GDM患者46例,健康孕妇49例,比较其血栓弹力图、血图及凝血检测结果。结果 GDM组和对照组的传统凝血项目比较,国际标准化比值、凝血酶原时间差异具有统计学意义(P<0.05),而活化部分凝血活酶时间、纤维蛋白原、血小板计数差异无统计学意义(P>0.05),GDM组和对照组的TEG常用指标比较,发现R、K、Angle角、MA、CI值差异均有统计学意义(P<0.05)。结论 TEG较传统凝血功能检查监测GDM患者的血栓前状态的进展更敏感,对指导临床早期干预、缓解或延迟并发症,改善母婴结局具有一定意义。

Objective To compare the differences of clotting laboratory indices and thromboelastogram（TEG）parameters between pregnant women with gestational diabetes mellitus（GDM）and healthy pregnant women.Methods The detection results of clotting laboratory indices and TEG in 46 pregnant women with GDM and 49 healthy pregnant women in our hospital from June2013 to July 2014 were retrospectively analyzed and compared.Results In the comparison of the GDM group and the control group,the traditional clotting laboratory indices,INR and PT had statistically significant differences（P〈0.05）.However,other traditional clotting laboratory indices,like APTT,FIB,PLT showed no statistically significant differences（P〉0.05）.The common TEG indices of R value,K value,Angle,MA value and CI value were statistically different between the GDM group and control group（P〈0.05）.Conclusion TEG is more sensitive than traditional clotting detection in monitoring the prethrombotic state of pregnant women with GDM and has certain significance for guiding early clinical intervention,alleviating or delaying complications and improving the maternal and infantile outcome.