血栓弹力图、凝血功能4项及D-二聚体在不同孕期孕妇凝血功能评估中的临床应用价值

Clinical application value of thrombelastogram,four blood coagulation indexes and D-dimer in coagulation function of pregnant women in different pregnancy periods

目的探讨血栓弹力图(TEG)、凝血功能4项及D-二聚体(D-D)在不同孕期孕妇凝血功能评估中的临床应用价值。方法选取2018-2019年该院120例产前检查孕妇作为观察组,另选取健康非孕妇50例作为对照组。分别测定各组TEG参数[凝血反应时间(R值)、血凝块形成时间(K值)、凝血形成速率(Angle角)、最大振幅(MA值)、凝血指数(CI值)]、凝血功能4项[凝血酶原时间(PT)、纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)]及D-D水平,统计分析上述各指标在不同孕期孕妇中的变化情况。结果与对照组比较,孕早、中、晚期TEG的R值和K值均降低,且随孕期进程增加有明显降低趋势;Angle角、MA值和CI值均升高,且随孕期进程增加逐渐升高,APTT、PT、TT均短于对照组,且随孕期进程增加逐渐降低;FIB、D-D水平均高于对照组,且随孕期进程增加逐渐升高。以上各项与对照组比较,差异均有统计学意义(P<0.05)。结论随着孕期增加,孕妇处于高凝状态,对孕妇进行血栓弹力图、凝血4项及D-D检测,能有效反映孕妇机体凝血和纤溶变化情况,可有效预防产后出血、血栓及多种相关并发症,为妊娠与临产提供参考和保证。

Objective To investigate the clinical application value of thrombelastogram(TEG)combined with four blood coagulation indexes and D-dimer(D-D)detection in the evaluation of coagulation function in pregnant women in different pregnancy periods.Methods A total of 120 women who had physical examination in the hospital from 2018 to 2019 were selected as the observation group,and 50 healthy non-pregnant women were taken as the control group.The TEG parameters of each group,including the coagulation reaction time(R),coagulation formation time(K),coagulation formation rate(Angle),maximum amplitude(MA),coagulation index(CI)were measured,also four blood coagulation indexes,including prothrombin time(PT),fibrinogen(FIB),activated partial thromboplastin time(APTT),thrombin time(TT)and D-D levels were analyzed in pregnant women in different pregnancy periods.Results Compared with the control group,the R and K values of TEG in the early,middle and late pregnancy decreased obviously,and with the increase of pregnancy,there was a significant downward trend.The Angle,MA and CI values were significantly increased,and with the increase of pregnancy,there was a significant upward trend.APTT,PT,TT in the observation group were lower than those in the control group,and gradually decreased with the increase of pregnancy.FIB,D-D levels in the observation group were higher than those in the control group,and gradually increased with the increase of pregnancy,the differences of the above items compared with the control group were statistically significant(P<0.05).Conclusion With the increase of pregnancy,pregnant women are in a state of high coagulation.TEG,four blood coagulation indexes and D-D detection in pregnant women can effectively reflect the changes of coagulation and fibrinolysis in pregnant women,effectively prevent postpartum hemorrhage,thrombosis and a variety of related complications,and can provide reference and guarantee for pregnancy and labor.