妊娠期高血压综合征孕妇凝血功能指标变化及其临床意义

Changes of coagulation function indicators and its clinical significance of women with pregnancy induce hypertension syndrome

目的:探究妊娠期高血压综合征(PIHS)孕妇凝血功能指标改变及其临床意义。方法:选取2019年1月-2020年12月本院收治的PIHS孕妇100例为观察组,其中妊娠期高血压45例、子痫前期30例、重度子痫前期25例;规律产前检查健康孕妇100例为对照组。分别在孕8~12周、20~27周、28~32周时检测并比较凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)指标变化,分析凝血功能指标与PIHS病情程度关系。结果:两组孕早期时PT、TT、APTT、FIB、D-D指标均无差异(P>0.05);观察组孕中期、孕晚期时PT、TT、APTT均低于孕早期及同期对照组,FIB、D-D均高于孕早期及同期对照组,孕晚期时PT、TT、APTT均低于孕中期,FIB、D-D均高于孕中期;孕中期与孕晚期时,妊娠期高血压、子痫前期组、重度子痫前期孕妇PT、TT、APTT水平均依次降低,FIB、D-D均依次升高(均P<0.05)。PT、TT、APTT与PIHS均呈负相关性,FIB、D-D与PIHS均正负相关性(均P<0.01)。结论:PIHS孕妇孕中、晚期凝血功能指标发生明显异常改变,且凝血功能指标与PIHS病情程度相关。

Objective:To explore the changes of coagulation function indicators and its clinical significance of pregnant women with pregnancy induce hypertension syndrome(PIHS).Methods:A total of 100 pregnant women with PIHS were selected in observation group,and another 100 healthy pregnant women were selected in control group from January 2019 to December 2019.The women in the observation group were divided into group A(45 cases with gestational hypertension),group B(30 cases with preeclampsia),and group C(25 cases with severe preeclampsia).The values of the prothrombin time(PT),thrombin time(TT),activated partial thrombin time(APTT),and the levels of fibrinogen(FIB),D-dimer(D-D)of the women during 8-12 gestational weeks,20-27 gestational weeks,28-32 gestational weeks were detected and were compared between the two groups.The correlation between the blood coagulation function index of the women and the severity of their PIHS was analyzed.Results:There were no significant differences in the values of PT,TT,APTT,FIB,and D-D of the women during the first trimester of pregnancy between the observation group and the control group(P>0.05).The values of PT,TT and APTT of the women in the observation group during the second and third trimester of pregnancy were significantly lower than those during the first trimester of pregnancy,and which of the women were significantly lower than those of the women in the control group during the second and third trimester of pregnancy.The FIB and D-D levels of the women in the observation group during the second and third trimester of pregnancy were significantly higher than those during the first trimester of pregnancy,and which of the women were significantly higher than those of the women in the control group during the second and third trimester of pregnancy.The values of PT,TT,and APTT of the women in the observation group during the third trimester of pregnancy were significantly lower than those during the second trimester of pregnancy,and the FIB and D-D levels of the women in the observation group during the third trimester of pregnancy were significantly higher.During the second and third trimester of pregnancy,the values of PT,TT,and APTT of the women in group A,B,and C had decreased gradually,while the FIB and D-D levels had increased gradually(all P<0.05).The values of PT,TT,and APTT of the women were negatively correlated with their PIHS,and the FIB and D-D levels of the women were positively correlated with their PIHS(all P<0.01).Conclusion:The coagulation function indexes of the women with PIHS during the second and third trimester of pregnancy change abnormally,and which of the women are correlated with the severity of their PIHS.