胎盘早剥孕妇血液中凝血因子等参数的变化研究

Changes of coagulation factors in pregnant women with placental abruption

目的 研究胎盘早剥孕妇血液中凝血因子、血小板参数、胎盘生长因子等的变化及临床意义。方法 选择2018年5月至2021年5月住院的胎盘早剥孕妇78例(观察组),对其血液中凝血因子、血小板、胎盘生长因子、肌酐、尿素氮等参数进行检测,并选择同期住院的正常孕妇78例(正常孕妇组)以及妊娠高血压综合征孕妇78例(妊娠期高血压孕妇组)作为对照,观察3组孕妇的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、血纤维蛋白原(FIB)、血二聚体-D(D-D)、血小板计数(PLT)、血小板体积分布宽度(PDW)、平均血小板体积(MPV)、胎盘生长因子(PLGF)、不对称二甲基精氨酸(ADMA)、游离雌三醇(uE3)、一氧化氮(NO)、肌酐(Cr)、尿素氮(BUN)、尿酸(UA)、并进行对比分析。结果 3组孕妇PT、APTT、FIB、D-D、PLT、PDW、MPV、ADMA、uE3、NO、Cr、BUN间差异,有统计学意义(P<0.05)。其中,PT、APTT妊娠期高血压孕妇组最短、胎盘早剥孕妇组最长(P<0.05);D-D中妊娠期高血压孕妇组最高,正常孕妇组最低(P<0.05);血浆FIB水平中妊娠期高血压孕妇组最高,胎盘早剥孕妇组最低(P<0.05);PDW、MPV妊娠期高血压孕妇组最高,正常孕妇组最低(P<0.05);PLT水平妊娠期高血压孕妇最低,正常孕妇组最高(P<0.05)。ADMA、uE3、NO、Cr、BUN,胎盘早剥孕妇组最高,正常孕妇组最低(P<0.05);3组孕妇TT、PLGF、UA间差异无统计学意义(P>0.05)。结论 在产前进行凝血因子、血小板参数、PLGF、ADMA、uE3、NO、Cr、BUN、UA,对及时发现胎盘早剥及保障孕妇、胎儿生命健康有重要意义。

Objective To investigate the changes and clinical significance of coagulation factors, platelet and placental growth factor(PLGF) in pregnant women with placental abruption.Methods A total of 78 pregnant women with placental abruption who were treated in our hospital from May 2018 to may 2021 were enrolled as observation group, and blood coagulation factors and platelet parameters, placental growth factor, creatinine, blood urea nitrogen were detected.At the same time, the other 78 normal pregnant women were enrolled as control group 1 and 78 pregnant women with gestational hypertension were enrolled as control group 2.The activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB),blood dimer-d(D-D),platelet count(PLT),platelet volume distribution width(PDW),mean platelet volume(MPV),placental growth factor(PLGF),Asymmetric dimethyl arginine(ADMA),Free estriol(uE3),Nitric oxide(NO),Creatinine(Cr),Blood urea nitrogen(BUN),Uric acid(UA) were observed and compared among the three groups.Results There were significant differences in Pt, APTT,FIB,D-D,PLT,PDW and MPV among the three groups(P<0.05).The plasma PT and APTT were the shortest in control group 2,which were the longest in observation group(P<0.05).The levels of D-Dimer(D-D) were the highest in control group 2,which were the lowest in control group 1(P<0.05),and the plasma fibrinogen(FIB) levels were the highest in control group 2,which were the lowest in observation group(P<0.05).Moreover the levels of platelet volume distribution width(PDW) and MPV were the highest in control group 2,which were the lowest in control group 1(P<0.05),and the levels of platelet(PLT) the lowest in control group 2,which were the highest in control group 1(P<0.05),and the levels of placental growth factor(PLGF),free estriol(uE3),nitric oxide(NO),creatinine(Cr),blood urea nitrogen(BUN) were the lowest in control group 2, which were the highest in observation group(P<0.05).There were no significant differences in the levels of TT,PLGF,UA among the three groups(P>0.05).Conclusion It is quite significant to detect the coagulation indexes and platelet parameters before delivery, so as to timely find the placental abruption to protect the life and health of pregnant women and fetuses.