对重度子痫前期患者凝血功能的研究

Study on Coagulation Function in Patients With Severe Preeclampsia

目的研究重度子痫前期患者和同期正常孕妇的凝血四项指标、D-二聚体和血小板参数,比较两者之间的差异,及时发现重度子痫前期患者凝血的变化,指导临床诊疗。方法将2018年3月—2020年3月来本院住院的150例重度子痫患者作为试验组,同期150例来院检查的正常孕妇作为对照组。两组分别测定凝血酶原时间(prothrombin time,PT)、国际标准化比值(international normalized ratio,INR)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶时间(thrombin time,TT)、纤维蛋白原(fibrinogen,Fib)、血小板(platelet,PLT)、血小板分布宽度(platelet distribution width,PDW)、D-二聚体,对数据进行比较分析。结果试验组中PT、INR、Fib低于对照组,TT、D-二聚体高于对照组,差异有统计学意义(P<0.05)。两组APTT、PLT、PDW的差异无统计学意义(P>0.05)。ROC曲线分析得出D-二聚体、PT、INR、APTT、TT、Fib、PLT、PDW值对应的曲线下面积0.312(P=0.000)、0.607(P=0.001)、0.549(P=0.144)、0.557(P=0.090)、0.391(P=0.001)、0.600(P=0.003)、0.527(P=0.423)、0.502(P=0.943)。结论及时检测重度子痫前期患者的凝血状态,可以及时评估患者情况,及早预防和治疗。

Objective To study the four indexes of coagulation,Ddimer and platelet parameters of patients with severe preeclampsia and normal pregnant women in the same period,and compare the differences between them,so as to find the changes of coagulation in patients with severe preeclampsia in time and guide clinical diagnosis and treatment.Methods A total of 150 patients with severe eclampsia hospitalized in our hospital from March 2018 to March 2020 were taken as the experimental group,and 150 normal pregnant women in the same period were taken as the control group.The prothrombin time(PT),international standardized ratio(INR),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(Fib),platelet(PLT),platelet distribution width(PDW)and D-dimer in the two groups were measured respectively.Results In the experimental group,PT,INR and Fib were lower than those in the control group,while TT and D-dimer were higher than those in the control group,with statistical significance(P<0.05).There were no significant differences in APTT,PLT and PDW between the two groups(P>0.05).ROC curve analysis showed that the areas under the curve corresponding to D-dimer,PT,INR,APTT,TT,Fib,PLT and PDW were 0.312(P=0.000),0.607(P=0.001),0.549(P=0.144),0.557(P=0.090),0.391(P=0.001),0.600(P=0.003),0.527(P=0.423),0.502(P=0.943).Conclusion Detecting the coagulation state of severe preeclampsia patients in time can evaluate the patients’condition in time and prevent and treat them as soon as possible.