APTT、PT等凝血相关指标变化与孕妇妊娠期血栓前状态发生的相关性分析

Correlation Analysis of APTT,PT and Other Coagulation Related Indicators with the Occurrence of Prethrombus in Pregnant Women

目的分析孕妇发生妊娠期血栓前状态时体内的活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)等凝血相关指标变化,并探究二者的相关性。方法将我院妇产科于2017年1月至2018年10月期间收治的60例妊娠期血栓前状态孕妇(经超声诊断)及100例同期在我院进行健康体检的正常孕妇纳为研究对象,分别为血栓前状态组和正常妊娠组;采用酶联免疫吸附双抗体夹心法(ELISA)法检测两组孕妇的血栓前状态指标:D-二聚体(D-D);采用免疫比浊法检测PT、APTT、凝血酶时间(TT)、纤维蛋白原(FBG)及抗凝血酶Ⅲ(AT-Ⅲ)等凝血功能指标;对比分析两组孕妇的以上指标并进行相关性法分析,为阐述凝血功能指标变化与血栓前状态发生的相关性提供依据。结果血栓前状态组与正常妊娠组的TT、PT、FBG差异无统计学意义(P>0.05);血栓前状态组的APTT、AT-Ⅲ分别为(22.4±3.3)s、(76.3±5.7)%,较正常妊娠组的(26.4±2.1)s、(92.3±6.4)%低,与血栓前状态发生呈负相关,差异有统计学意义(P<0.05);血栓前状态组D-D水平高于正常妊娠组,与血栓前状态发生呈正相关,差异有统计学意义(P<0.05)。结论APTT、AT-Ⅲ、D-D的异常是提示血清前状态发生的重要指标,孕期积极检查其水平变化对临床医师提前预知妊娠期血栓以及合理制定分娩方案具有重大意义。

Objective To analyze the changes of activated partial thromboplastin time(APTT),prothrombin time(PT)and other coagulation related indexes in pregnant women with prethrombus state during pregnancy,and to explore the correlation between them.Methods 60 pregnant women with prethrombotic condition(diagnosed by ultrasound)and 100 normal pregnant women who underwent physical examination in the Department of Obstetrics and Gynecology of our hospital from January 2017 to October 2018 were enrolled as study subjects.They were divided into the prethrombotic condition group and the normal pregnancy group.The prethrombotic status indicators of pregnant women in the two groups were detected by ELISA:d-dimer(D-D).Immunoturbidimetry method was used to detect coagulant function indexes,such as prothrombin time(PT),activated partial clotting enzyme live time(APTT),thrombin time(TT),fibrinogen(FBG)and antithrombinⅢ(AT-Ⅲ).These indexes of the two groups of pregnant women were compared and analyzed by correlation method,which provided the basis for expounding the correlation between the changes of coagulation function indexes and the occurrence of prethrombus state.Results There was no significant difference in TT,PT and FBG between prethrombus state group and normal pregnancy group(P>0.05).APTT and AT-III in the prethrombus state group was(22.4±3.3)s and(76.3±5.7)%,which was lower than those in the normal pregnancy group(26.4±2.1)s and(92.3±6.4)%,which was negatively correlated with the occurrence of prethrombus state,with statistically significant difference(P<0.05).The D-D level in the prethrombotic condition group was higher than that in the normal pregnancy group,which was positively correlated with the occurrence of prethrombotic state,and the difference was statistically significant(P<0.05).Conclusion The anomaly of APTT,AT-Ⅲand D-D is an important index to suggest the occurrence of prethrombotic state,and thus checking for changes of their levels is of great significance for predicting early pregnancy thrombosis and making reasonable delivery plan.