血栓弹力图在妊娠期肝内胆汁淤积症中的变化及意义

Changes and significance of thrombelastogram in intrahepatic cholestasis of pregnancy

目的探讨血栓弹力图(TEG)在妊娠期肝内胆汁淤积症(ICP)的变化及意义。方法回顾性收集2018年1月至2020年8月安徽医科大学附属巢湖医院妇产科确诊的87例ICP患者的病例资料作为ICP组,并将其进一步分为轻度ICP组和重度ICP组,另收集同期健康孕妇100例作为健康对照组,比较各组间的TEG指标。结果ICP组TEG指标中反应时间(R)、最大振幅(MA)均高于对照组,差异有统计学意义(P<0.05),两组其他TEG指标比较,差异无统计学意义(P>0.05)。重度ICP组TEG指标中的R高于轻度ICP组,差异有统计学意义(P<0.05),两组其他TEG指标间比较,差异无统计学意义(P>0.05)。重度ICP组TEG指标中R和MA均高于对照组,差异有统计学意义(P<0.05),两组其他TEG指标比较,差异无统计学意义(P>0.05)。轻度ICP组TEG指标与对照组比较,差异均无统计学意义(P>0.05)。结论TEG指标能全面反映ICP患者凝血状态的变化,一定程度上也可反映其病情的严重性,从而为病情评估及治疗提供重要的依据。

Objective To investigate the changes and significance of thrombelastogram(TEG)in intrahepatic cholestasis of pregnancy(ICP).Methods A total of 87 cases of ICP diagnosed in the Department of Obstetrics and Gynecology of Chaohu Hospital Affiliated to Anhui Medical University from January 2018 to August 2020 were retrospectively collected as the ICP group,and further divided into the mild ICP group and the severe ICP group.Another 100 healthy pregnant women during the same period were collected as the healthy control group,and the TEG indicators among the groups were compared.Results The reaction time(R)and maximum amplitude(MA)of TEG indexes in ICP group were higher than those in control group,the differences were statistical significance(P<0.05),but there were no statistical significances in other TEG indexes between the two groups(P>0.05).The R of TEG indexes in severe ICP group was higher than that in mild ICP group,and the difference was statistically significant(P<0.05),but there were no significant differences in other TEG indexes between the two groups(P>0.05).The R and MA of TEG indexes in severe ICP group were higher than those in control group,and the differences were statistically significant(P<0.05),but there were no significant differences in other TEG indexes between the two groups(P>0.05).There were no significant differences in TEG indexes between mild ICP group and control group(P>0.05).Conclusion TEG index can fully reflect the changes of coagulation status of ICP patients and reflect the severity of their disease to a certain extent,thus providing an important basis for the evaluation and treatment of the disease.