血凝及血常规指标对妊娠晚期子痫发生及妊娠结局的影响

Influence of the indexes of blood coagulation and blood routine during the third trimester of pregnancy on their eclampsia occurrence and pregnancy outcomes

目的:探讨血凝及血常规指标与妊娠晚期子痫患者发病的相关性及对妊娠结局的影响。方法:选取2015-2018年本院健康孕妇(对照组)和妊娠晚期子痫患者(子痫组)临床资料,对比两组血凝指标及血常规指标差异,分析这些指标与子痫发生的相关性;记录子痫患者不良妊娠,分析血凝和血常规指标与妊娠结局关系。结果:相较于对照组,子痫组血浆凝血酶时间(TT)、凝血酶原时间(PT)、活化凝血酶原时间(APTT)、抗凝血酶Ⅲ活性(AT-Ⅲ)和血小板计数(PLT)水平降低,D-二聚体、纤维蛋白原(FIB)和红细胞压积(HCT)升高(P<0.05);两组红细胞数(RBC)、白细胞数(WBC)、血小板平均体积(MPV)和血红蛋白浓度(Hb)水平无差异(P>0.05);行logistic多因素分析发现,子痫发生的风险因素包括D-二聚体(OR值=0.238)、FIB(OR值=0.368)和PLT(OR值=0.685)(均P<0.05);随血凝及血常规指标异常数目增多,子痫患者发生早产率、剖宫产率、低体重儿、新生儿窒息率和围生儿死亡率升高(P<0.05)。结论:血凝及血常规指标与子痫发生具有相关性,血凝及血常规指标异常导致不良妊娠结局增高,临床应加以重视。

Objective: To explore the influence of the indexes of blood coagulation and blood routine of pregnant women during the third trimester of pregnancy on their eclampsia occurrence and pregnancy outcomes. Methods: The clinical data of healthy pregnant women(in control group) and pregnant women patients with eclampsia(in study group) from 2015 to 2018 were selected as the research subjects. The differences of the indexes of blood coagulation and blood routine of the women were compared between the two groups. The correlation between the indexes of blood coagulation and blood routine of the women and their eclampsia occurrence was analyzed. The incidence of adverse pregnancy outcomes of the women with eclampsia was recorded. The relationship between the indexes of blood coagulation and blood routine of the women and their pregnancy outcomes was analyzed. Results: The values of plasma thrombin time(TT), prothrombin time(PT), activated prothrombin time(APTT), antithrombin Ⅲ(AT-Ⅲ) activity, and platelet(PLT) count of the women in the study group were significantly lower than those of the women in the control group, while the values of D-dimer, fibrinogen(FIB), and hematocrit(HCT) of the women in the study group were significantly higher(P<0.05). There were no significant differences in the values of red blood cell count(RBC), white cell count(WBC), mean platelet volume(MPV), and hemoglobin concentration(Hb) of the women between the two groups(P>0.05). Logistic multivariate analysis showed that the risk factors of eclampsia included D-dimer(OR=0.238), FIB(OR=0.368), and PLT count(OR=0.685)(all P<0.05). The incidences of premature delivery, cesarean section, low birth weight, neonatal asphyxia, and perinatal mortality of the women had increased with the increase of the abnormal iteams of the indexes of blood coagulation and abnormal blood routine(P<0.05). Conclusion: The indexes of blood coagulation and blood routine of the pregnant women are related to their eclampsia occurrence.The abnormal indexes of blood coagulation and blood routine of the pregnant women can lead to the adverse pregnancy outcomes,so which should be paid attention to in clinic.