凝血功能指标及血小板参数与子痫前期的相关性研究

Correlation between coagulation function,platelet parameters and preeclampsia

目的:分析病人凝血功能指标及血小板参数,探讨其对子痫前期(PE)的临床意义。方法:选取符合PE诊断的孕妇78例为观察组,并按照发病时间分为观察组1(早发型PE组,孕周20~<34周)和观察组2(晚发型PE组,孕周≥34周)。同时选取产检的健康孕妇80例作为对照组,对照组同样按照孕周分为对照组1(孕周20~<34周)和对照组2(孕周≥34周)。所有受试者采血和测血压,检测凝血功能指标、血小板参数。采用Pearson相关分析验证D-二聚体(D-D)与凝血功能指标之间的关系。结果:观察组1的体质量指数(BMI)、D-D、收缩压(SBP)、舒张压(DBP)、平均血小板体积(MPV)、血小板分布宽度(PDW)值高于对照组1(P<0.01)。观察组2 BMI、SBP、DBP值高于对照组2(P<0.01)。观察组1 D-D值高于观察组2(P<0.01)。对照组2 BMI、D-D、DBP、MPV水平高于对照组1(P<0.05~P<0.01)。观察组BMI、D-D、SBP、DBP、MPV水平高于对照组(P<0.01)。观察组1凝血酶原时间(PT)、国际标准化比值(INR)、活化部分凝血酶原时间(APTT)、血浆纤维蛋白原(FIB)、凝血酶时间(TT)水平与对照组1比较差异有统计学意义(P<0.05~P<0.01)。观察组2 PT、INR、FIB、TT水平与对照组2比较差异有统计学意义(P<0.01)。观察组1 TT与观察组2比较差异有统计学意义(P<0.05)。对照组1 FIB、TT与对照组2比较差异有统计学意义(P<0.01)。观察组PT、INR、APTT、FIB、TT水平与对照组比较差异有统计学意义(P<0.01)。PE病人D-D与孕周、PT、INR、APTT、TT、PLT均呈负相关关系(r=-0.289、-0.235、-0.247、-0.236、-0.351、-0.286,P<0.05~P<0.01)。PE病人D-D与FIB、MPV、PDW无明显相关性(P>0.05)。结论:早发型PE病人高凝血状态较晚发型PE病人更为明显,PE病人D-D与凝血功能密切相关,D-D可以作为预测PE发病的生物学标志物。

Objective:To analyze the coagulation function index and platelet parameters of patients,and explore their clinical significance in preeclampsia(PE).Methods:Seventy-eight pregnant women with PE were set as the observation group,and subdivided into the observation group 1(early PE group,20 weeks≤gestational weeks<34 weeks)and observation group 2(late PE group,onset≥34 weeks).At the same time,80 healthy pregnant women were set as the control group,and subdivided into the control group 1(20 weeks≤gestational weeks<34 weeks)and control group 2(onset≥34 weeks).The blood of all cases was collected,and the blood pressure was measured.The indicators of coagulation function and platelet parameters were detected.The correlation between D-dimer(D-D)and coagulation function indexes were analyzed using the Pearson test.Results:The body mass index(BMI),D-D,systolic pressure(SBP),diastolic pressure(DBP),mean platelet volume(MPV)and platelet distribution width(PDW)in observation group 1 were higher than those in control group 1(P<0.01).The BMI,SBP and DBP in observation group 2 were higher than those in control group 2(P<0.01).The D-D in observation 1 group was higher than that in observation group 2(P<0.01).The levels of BMI,D-D,DBP and MPV in control group 2 were higher than those in control group 1(P<0.05 to P<0.01).The levels of BMI,D-D,SBP,DBP and MPV in observation group were higher than those in control group(P<0.01).The differences of the levels of PT,INR,APTT,FIB and TT between the observation group 1 and control group 1 were statistically significant(P<0.05 to P<0.01).The differences of the levels of PT,INR,FIB and TT between the observation group 2 and control group 2 were statistically significant(P<0.01).The difference of the level of TT between the observation group 1 and observation group 2 was statistically significant(P<0.05).The differences of the levels of FIB and TT between the control group 1 and control group 2 were statistically significant(P<0.01).The differences of the levels of PT,INR,APTT,FIB and TT between the observation group and control group were statistically significant(P<0.01).The D-D in PE patients was negatively correlated with the levels of gestational weeks,PT,INR,APTT,and TT(r=-0.289,-0.235,-0.247,-0.236,-0.351,-0.286,P<0.05 to P<0.01),and the D-D was not correlated with the levels of FIB,MPV,and PDW in PE patients(P>0.05).Conclusions:The high coagulation status in early PE patients is more obvious than that in late PE patients.The D-D in PE patients is closely related to coagulation function,and the D-D can be used as a biological marker to predict the incidence of PE.