不同病情程度妊娠期高血压疾病患者的凝血功能指标和血小板参数分析

Analysis of Coagulation Function and Platelet Parameters in Patients with Hypertensive Disorder Complicating Pregnancy in Different Severity

目的:探究不同病情严重程度妊娠期高血压疾病患者的凝血功能指标和血小板参数差异。方法:回顾性分析2019年1月—2021年1月江苏大学附属医院收治150例妊娠期高血压疾病患者的临床资料并将其设为病例组,根据病情程度分成妊娠期高血压亚组(n=55)、妊娠合并慢性高血压亚组(n=15)、轻度子痫前期亚组(n=20)、重度子痫前期亚组(n=35)、子痫期亚组(n=25);另选同期50例正常妊娠孕妇设成对照组。各组均测定其凝血功能、血小板参数,比较各组检测结果。结果:病例组的活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT)、血小板计数(PLT)、纤维蛋白原(FIB)、D-二聚体(D-D)、血小板分布宽度(PDW)、平均血小板体积(MPV)数值均优于对照组,差异有统计学意义(P<0.05)。子痫期亚组、重度子痫前期亚组的APTT、TT、PT、PLT水平显著低于其他亚组,而FIB、D-D、PDW、MPV显著高于其他亚组,差异有统计学意义(P<0.05)。经Spearman分析显示,妊娠高血压病变程度与APTT、TT、PT、PLT呈负相关(P<0.05),与PDW、MPV、FIB、D-D呈正相关(P<0.05)。结论:妊娠期高血压疾病患者普遍存有凝血功能障碍、血小板活化等异常情况,且与病情严重程度直接相关,故监测妊娠期高血压疾病患者凝血功能、血小板参数,能够预估患者病情严重程度,为临床诊治提供依据。

Objective:To explore the differences of coagulation function and platelet parameters in patients with hypertensive disorder complicating pregnancy in different severity.Method:The clinical data of 150 patients with hypertensive disorder complicating pregnancy admitted to the Affiliated Hospital of Jiangsu University from January 2019 to January 2021 were retrospectively analyzed and divided into case groups,and they were divided into gestational hypertension subgroup(n=55),pregnancy complicated with chronic hypertension subgroup(n=15),mild pre-eclampsia subgroup(n=20),severe pre-eclampsia subgroup(n=35),eclampsia subgroup(n=25)according to the degree of illness.Another 50 normal pregnant women in the same period were selected as the control group.The blood coagulation function and platelet parameters were measured in each group,and the results of each group were compared.Result:The activated partial thromboplastin time(APTT),thrombin time(TT),prothrombin time(PT),platelet count(PLT),fibrinogen(FIB),D-dimer(D-D),platelet distribution width(PDW)and mean platelet volume(MPV)of the case group were significantly better than those of the control group,the differences were statistically significant(P<0.05).The levels of APTT,TT,PT and PLT in eclampsia subgroup and severe preeclampsia subgroup were significantly lower than those in other subgroups,and FIB,D-D,PDW and MPV were significantly higher than those in other subgroups,the differences were statistically significant(P<0.05).Spearman analysis showed that the degree of pregnancy induced hypertension was negatively correlated with APTT,TT,PT and PLT(P<0.05),and positively correlated with PDW,MPV,FIB and D-D(P<0.05).Conclusion:Patients with hypertensive disorder complicating pregnancy generally have abnormal conditions such as coagulation dysfunction and platelet activation,which are directly related to the severity of the disease.Therefore,monitoring the coagulation function and platelet parameters of patients with hypertensive disorder complicating pregnancy can predict the severity of the disease and provide basis for clinical diagnosis and treatment.