正常孕妇妊娠各期凝血指标变化检测

Investigation on the changes of blood coagulation index in normal pregnant women during different periods of gestation

目的探讨凝血功能指标在孕妇各妊娠期的动态变化。方法检测160例孕妇(实验组)妊娠各期的凝血功能指标:凝血酶原时间(PT)、国际标准化比值(INR)、活化部分凝血酶时间(APTT)、凝血酶时间(TT)及纤维蛋白原(Fib)和D-二聚体(D-D),与同期160例正常非妊娠妇女(对照组)的凝血指标进行对比分析。结果实验组在整个妊娠期PT、PT-INR水平与对照组相比,差异无统计学意义(P>0.05);APTT、TT水平在孕中期出现较正常组及孕早期显著的下降,差异具有统计学意义(P<0.05);APTT、TT水平在孕中期、孕晚期及临产期差异无统计学意义(P>0.05);Fib、D-D从孕早期开始,与对照组相比明显升高,差异具有统计学意义(P<0.05);Fib、D-D自孕中期开始进一步增高,较孕早期比较差异具有统计学意义(P<0.05);Fib、D-D水平在临产期与中期比较,差异具有统计学意义(P<0.05);孕妇在产后一周,各凝血指标均恢复至产前水平,与对照组比较,差异无统计学意义(P>0.05)。结论定期检测凝血指标,对预防和治疗产中、产后异常出血及其他产科并发症具有重要的临床意义。

Objective To investigate the dynamic changes of the coagulation function index in pregnant women. Methods The coagulation indexes[prothrombin time（ PT）, international normalized ratio（ INR）, activated partial thromboplastin time（ APTT）,thrombin time（ TT） and fibrin original（ FIB） and D dimer（ D- D） ]of 160 cases pregnant women in different periods of gestation were detected,which were compared and analyzed with the coagulation indexes of the 160 cases of normal non pregnant women in the same period. Results The changes of PT and PT- INR in the experimental group were compared with the control group,and the differences were not statistically significant（ P〈0. 05）; the reduction of TT and APTT in the early pregnancy was obvious,compared with the normal group and the early pregnancy,and the differences were statistically significant（ P〈0. 05）; the differences of TT and APTT among the second trimester,the third trimester,and parturient period had no statistical significance（ P〈0. 05）. The D- D and Fib in the beginning of the early pregnancy was compared with the control group,and the difference was statistically significant（ P〈0. 05）; from the second trimester,the Fib and D- D increased further,compared with the first trimester,and the difference was statistically significant（ P〈0. 05）,to the perinatal period,there were still statistical significance on the differences compared with the second trimester（ P〈0. 05）. After one week of the postpartum,all the blood coagulation indexes of the pregnant women recovered to the level of prenatal,and compared with the control group,the differences were statistically significant（ P〈0. 05）. Conclusion Regular detection of coagulation index has an important clinical significance in the prevention and treatment of abnormal bleeding or other obstetric complications during or after delivery.