孕晚期高龄孕妇凝血参数与血小板指标间的相关性

The correlation between coagulation parameters and platelet indexes in advanced pregnant women in the third trimester

目的研究孕晚期高龄孕妇凝血参数与血小板指标间的相关性。方法收集孕晚期孕妇251例,包括高龄孕妇121例(高龄孕妇组)、适龄孕妇130例(适龄孕妇组),另取同期体检的高龄非妊娠女性90例和适龄非妊娠女性85例为高龄对照组和适龄对照组。比较孕妇凝血参数与血小板指标间的变化。Spearman相关性分析孕晚期孕妇凝血参数与血小板指标间的相关性。结果分别与高龄对照组、适龄对照组相比,孕晚期高龄孕妇组、适龄孕妇组的凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶时间(thrombin time,TT)均缩短,纤维蛋白原(fibrinogen,FIB)、D-二聚体(D-dimer,D-D)、纤维蛋白和纤维蛋白原降解产物(fibrinogen degradation products,FDP)均升高,血小板计数(platelet,PLT)、血小板压积(thrombocytocrit,PCT)降低,血小板分布宽度(platelet distribution width,PDW)增加(P<0.05)。与适龄孕妇组相比,高龄孕妇组的PDW升高(P<0.05)。Spearman相关性分析提示孕晚期适龄、高龄孕妇FIB与FDP呈正相关,高龄孕妇APTT与PLT呈负相关(P<0.05)。结论孕晚期孕妇血液凝固性相对增强,PLT数量相对降低。高龄孕妇PLT减少时,APTT可能存在相对延长趋势,孕晚期高龄孕妇较适龄孕妇更易发生产后出血等并发症。

Objective To study the correlation between coagulation parameters and platelet index in advanced pregnant women in the third trimester.Methods A total of 251 pregnant women in the third trimester of pregnancy were collected,including 121 pregnant women of advanced age and 130 pregnant women of appropriate age,and 90 non-pregnant women of advanced age and 85 non-pregnant women of appropriate age who underwent physical examination during the same period were selected as controls.The changes of coagulation parameters and platelet index in advanced pregnant women were compared.The correlation between coagulation function and platelet index in advanced pregnant women was analyzed by Spearman correlation analysis.Results As compared with the elderly and age-appropriate controls,the prothrombin time(PT),activated partial thromboplastin time(APTT)and thrombin time(TT)of pregnant women in the third trimester of pregnancy were significantly shortened;fibrinogen(FIB),D-dimer(D-D),fibrin and fibrinogen degradation products(FDP)were significantly increased;platelet(PLT)count and thrombocytocrit(PCT)were significantly reduced;and platelet distribution width(PDW)was significantly increased(P<0.05).As compared with pregnant women of appropriate age,PDW of elderly pregnant women was significantly increased(P<0.05).Spearman correlation analysis showed that FIB was positively correlated with FDP in the third trimester pregnant women,and APTT was negatively correlated with PLT in elderly pregnant women(P<0.05).Conclusion The blood coagulation ability of pregnant women in the third trimester is relatively enhanced,and the amount of PLT is relatively reduced.The homogeneity of PLT in elderly pregnant women is worse than that in age-appropriate women,and there are more naive PLTs.When the PLT of elderly pregnant women decreases,there may be a relative prolongation of APTT.Elderly pregnant women in the third trimester are more prone to complications such as postpartum hemorrhage than suitable-age pregnant women.