妊高征孕妇凝血功能、血流动力学、血液流变学的变化及意义

Changes and significance of coagulation function,hemodynamics and blood rheology in women with pregnancy induced hypertension

目的：观察妊高征孕妇凝血功能、血流动力学、血液流变学的变化,并探讨其临床意义。方法：选择2011年7月~2016年2月我院收治的88例妊娠期高血压患者为研究对象,同时选择入院的90例正常妊娠孕妇为正常晚孕组,检测两组各凝血参数、血流动力学、血液流变学指标。结果：分娩前,妊高征组的凝血酶原时间（PT）、抗凝血酶Ⅲ（AT-Ⅲ）值明显低于正常晚孕组,差异有统计学意义（P〈0.05）、D-D、血浆纤维蛋白原（FIB）值明显高于正常晚孕组,差异有统计学意义（P〈0.05）。分娩后,妊高征组的PT、AT-Ⅲ值明显升高,FIB值明显降低,差异均有统计学意义（P〈0.05）,且与正常晚孕组无显著差异。但D-D值仍然明显高于正常晚孕组,差异有统计学意义（P〈0.05）。妊高征组的各血流动力学参数明显高于正常晚孕组,差异有统计学意义（P〈0.05）。妊高征组的全血高低切黏度、血浆黏度、高低切还原黏度、红细胞压积、红细胞变形指数、红细胞电泳时间及纤维蛋白原值均明显高于正常晚孕组（P〈0.05）。结论：妊高征患者的血液各项指标相对于正常妊娠孕晚期孕妇呈现高凝状态。适时检测患者的各项凝血功能、血流动力学、血液流变学指标,对于监测病情,辅助诊断及预防有重要意义。

Objective： To observe the changes of coagulation function,hemodynamics and blood rheology in patients with pregnancy induced hypertension,and to explore its clinical significance. Methods： A total of 88 cases of patients with pregnancy induced hypertension admitted in our hospital from July 2011 to February 2016 were selected as the research objects,at the same time,90 normal pregnant women were selected as normal late pregnancy group. The coagulation parameters,hemodynamics,blood rheology indexes were detected in the two groups. Results： Before delivery,values of the PT and AT-Ⅲ in pregnancy induced hypertension group were significantly lower than those in the normal late pregnancy group（ P〈0. 05）,and the values of D-D and FIB were significantly higher than those in the normal late pregnancy group（ P〈0. 05）. After delivery,values of the PT and AT-Ⅲ in pregnancy induced hypertension group were significantly higher（ P〈0. 05）,and the FIB value was significantly lower（ P〈0. 05）,there were no significant differences between the two group. But the D-D value was still significantly higher than that in the normal late pregnancy group（ P〈0. 05）. The blood flow dynamics parameter in pregnancy induced hypertension group were significantly higher than that in the normal late pregnant group,the differences were statistically significant（ P〈0. 05）. The whole blood high and low shear viscosity,plasma viscosity,low shear reduction viscosity,hematocrit,erythrocyte deformation index,erythrocyte electrophoresis time and fibrinogen in pregnancy induced hypertension group were significantly higher than those in normal late pregnancy group（ P〈0. 05）.Conclusions： The blood indexes in patients with pregnancy induced hypertension showed a high coagulation state compared with the normal late pregnancy women. Timely detection of patients＇ coagulation function,hemodynamics,and blood rheology indexes has important significance for the detection,auxiliary diagnosis and prevention of the disease.