妊娠期糖尿病高龄产妇的凝血功能监测

Blood coagulation function monitoring in elderly pregnant women with gestational diabetes mellitus

目的探讨常规凝血功能检测和血栓弹力图(TEG)测定对妊娠期糖尿病(GDM)的高龄产妇凝血状态的评估。方法通过对2019年1~12月上海市普陀区妇婴保健院产检并分娩的88例妊娠期糖尿病的高龄产妇与250例无合并症的正常高龄产妇进行凝血常规和TEG测定,对各项结果比较分析。结果与正常高龄孕产妇组比较,妊娠期糖尿病高龄孕产妇组的INR值及K值稍低,R值及CI偏高,差异有统计学意义(P<0.05);凝血酶原时间(PT)、部分凝血酶原时间(APTT)、凝血时间(TT)、纤维蛋白原(FIB)、D-二聚体、Angle值和MA值差异均无统计学意义(P>0.05)。结论妊娠期糖尿病的高龄产妇凝血功能紊乱,凝血综合指数增高,可利用凝血常规和血栓弹力图筛选异常,及早发现产后出血及产后血栓性疾病。

Objective To investigate the assessment of coagulation status of elderly pregnant women with gestational diabetes mellitus(GDM)by routine coagulation function test and thromboelastography(TEG)measurement.Methods 88 elderly pregnant women with GDM(GDM group)and 250 normal elderly pregnant women without comorbidities(normal group)who implemented check-up and delivery from January to December 2019 in Shanghai Putuo District Maternal and Child Health Hospital were examined by blood coagulation routine and TEG.The results were compared and analyzed.Results Compared with the normal group,the international normalized ratio(INR)and K values of the GDM group were slightly lower,while the R value and CI were higher,and the differences were statistically significant(P<0.05).There was no statistical difference in prothrombin time(PT),active partial prothrombin time(APTT),thrombin time(TT),fibrinogen(FIB),D-D dimer,Angle value and MA value between the two groups(P>0.05).Conclusion The elderly pregnant women with GDM have coagulation dysfunction and an increase in coagulation comprehensive index.The coagulation routine and TEG can be used to screen for abnormalities to early detect postpartum hemorrhage and postpartum thrombotic diseases.