不同孕期女性血浆D-二聚体水平的比较与临床意义

Comparison and clinical significance of plasma D-dimer levels in women with different gestation weeks

目的比较妊娠结局为正常分娩的孕妇在不同孕期和非妊娠健康女性血浆D-二聚体和凝血4项指标的水平,评价这些指标对正常妊娠期女性的临床意义。方法选择2016年1月至2018年2月在舟山市妇幼保健院进行孕期检查并正常分娩的126例孕妇(孕妇组)和75例非妊娠健康女性(对照组)为研究对象,分别采集孕妇组早期、中期和晚期孕妇与对照组健康女性的血液标本,检测D-二聚体(D-D)、凝血酶原时间(PT)、活化凝血酶时间(APTT)、凝血活酶时间(TT)、纤维蛋白原(FIB)水平并进行比较。采用SPSS 22.0软件对相关数据进行统计分析。结果孕妇组不同孕期孕妇与对照组健康女性的血浆D-D水平比较,其差异均具有统计学意义(均P<0.05),且血浆D-D水平有随孕期的延长而增加的趋势;孕妇组不同孕期孕妇与对照组健康女性的PT、APTT、TT和FIB水平比较,其差异均具有统计学意义(均P<0.05)。总体而言,PT、APTT和TT有随孕期的延长而降低的趋势,FIB有随孕期的延长而增加的趋势。结论对早期、中期和晚期孕妇进行血浆D-D和凝血4项指标实施监测分析,有助于及时了解和掌握正常孕妇的凝血和止血功能变化。

Objective To compare the levels of plasma D-dimer and 4 coagulation indicators in pregnant women with normal pregnancy outcome during different pregnancy duration and non-pregnant healthy women, and to evaluate the clinical significance of these indicators for normal pregnant women. Methods From January 2016 to February 2018, 126 pregnant women(pregnant women group) with normal pregnancy outcome who underwent pregnant examination and 75 non-pregnant healthy women(control group) were investigated in Zhoushan Maternal and Child Health Hospital. Blood samples of pregnant women in early, middle and late pregnancy duration and control group were collected respectively. D-dimer(D-D), prothrombin time(PT), activated thrombin time(APTT), thromboplastin time(TT), fibrinogen(FIB) levels were detected and compared. SPSS22.0 statistical software was used for statistical analysis. Results There were statistically significant differences in plasma D-D levels among the control group and the pregnant women in different pregnancy duration(all P<0.05). The plasma D-D levels increased with the prolongation of pregnancy. There were statistically significant differences in PT, APTT, TT and FIB among the control group and the pregnant women in different pregnancy duration(all P<0.05). Overall, PT, APTT and TT decreased with the prolongation of pregnancy, while FIB increased with the prolongation of pregnancy. Conclusions Monitoring and analysis of D-D and four coagulation indicators in early, middle and late pregnancy is helpful to timely understand and master the coagulation and hemostasis function of normal pregnant women.