妊娠期高血压疾病患者血小板与凝血功能变化及其与平均动脉压的相关性

Changes of platelet and coagulation function in patients with hypertensive disorder complicating pregnancy and their correlation with mean arterial pressure

目的探讨妊娠期高血压患者血小板与凝血功能变化及其与发病早期平均动脉压的相关性。方法选择2021年3月至2022年4月杭州市富阳区妇幼保健院产科收治的40例妊娠期高血压疾病患者(观察组)及同期于本院规律孕检的40例正常妊娠孕妇(对照组)为研究对象。比较两组凝血功能相关参数指标和血小板相关参数指标变化,并分析其与平均动脉压的相关性。结果观察组凝血功能相关参数指标中凝血酶原时间(PT)为(9.8±1.4)s,凝血酶时间(TT)为(13.1±1.2)s,活化部分凝血活酶时间(APTT)为(27.5±4.4)s,均短于对照组的(13.5±1.7)、(15.9±1.8)、(36.5±5.8)s(P<0.05);观察组纤维蛋白原(FIB)为(4.5±1.2)g/L,高于对照组的(3.1±0.9)g/L(P<0.05)。观察组血小板相关参数指标中,血小板压积(PCT)为(0.23±0.02)%,小于对照组的(0.32±0.05)%(P<0.05);血小板平均体积(MPV)为(12.4±0.9)μm^(3),大于对照组的(10.1±0.6)μm^(3)(P<0.05);血小板体积分布宽度(PDW)为(15.2±1.5)%,高于对照组的(11.7±0.9)%(P<0.05);血小板计数(PLT)为(135.8±28.9)×109/L,低于对照组的(268.5±50.5)×109/L(P<0.05)。PT、TT、APTT、PCT及PLT与平均动脉压呈负相关性(P<0.05),FIB、MPV和PDW与平均动脉压呈正相关性(P<0.05)。结论妊娠期高血压疾病患者凝血功能被显著激活,血小板消耗增多,且随着平均动脉压增高,凝血功能异常越明显,血小板消耗越多。

Objective To explore the changes of platelet and coagulation function in patients with hypertensive disorder complicating pregnancy and their correlation with mean arterial pressure.Methods A total of 40 cases of hypertensive disorder complicating pregnancy(observation group)and 40 cases of normal pregnant women(control group)who had regular pregnancy examination in Department of Obstetrics,Hangzhou Fuyang Women and Children Hospital from March 2021 to April 2022 were selected as the research objects.Then the changes of parameters related to coagulation function and platelet were compared between the two groups,and the correlation between them and average arterial pressure was analyzed.Results Among the parameters related to coagulation function in the observation group,prothrombin time(PT)was(9.8±1.4)s,thrombin time(TT)was(13.1±1.2)s,and activated partial thromboplastin time(APTT)was(27.5±4.4)s,which were all shorter than(13.5±1.7),(15.9±1.8)and(36.5±5.8)s in the control group(P<0.05).The fibrinogen(FIB)in the observation group was(4.5±1.2)g/L,which was higher than(3.1±0.9)g/L in the control group(P<0.05).In the platelet related parameters of the observation group,plateletcrit(PCT)was(0.23±0.02)%,which was lower than(0.32±0.05)%of the control group(P<0.05).The mean platelet volume(MPV)was(12.4±0.9)μm^(3),which was higher than(10.1±0.6)μm^(3) of the control group(P<0.05).The platelet distribution width(PDW)was(15.2±1.5)%,higher than(11.7±0.9)%of the control group(P<0.05).The platelet count(PLT)was(135.8±28.9)×109/L,which was lower than(268.5±50.5)×109/L of the control group(P<0.05).The PT,TT,APTT,PCT and PLT levels were negatively correlated with the average arterial pressure(P<0.05),while FIB,MPV and PDW levels were positively correlated with average arterial pressure(P<0.05).Conclusion The coagulation function of hypertensive disorder complicating pregnancy is significantly activated,and the platelet consumption is increased.With the increase of mean arterial pressure,the more obvious the coagulation function and the more the platelet consumption.