不同孕期孕妇凝血四项、血浆纤维蛋白(原)降解产物、D-二聚体、血小板水平的变化及临床意义

Changes and clinical significance of four items of blood coagulation,fibrinogen degradation products,D-dimer and platelet indexes in pregnant women of different pregnancies

目的探讨不同孕期(早、中、晚)孕妇凝血四项、血浆纤维蛋白(原)降解产物(FDP)、D-二聚体和血小板水平的变化及其临床意义。方法回顾性分析2019年1月至2021年1月于锡山人民医院鹅湖分院接受产检的200名孕妇的临床资料,孕早期65名,孕中期78名,孕晚期57名,比较不同孕期孕妇纤维蛋白原(FIB)、凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)和FDP、D-二聚体及血小板水平。结果不同孕期孕妇PT、APTT、FIB水平比较差异有统计学意义(P<0.05),不同孕期孕妇TT比较差异无统计学意义;随着孕龄增加,孕妇PT、APTT逐渐缩短,FIB水平逐渐升高,差异有统计学意义(P<0.05),不同孕期TT两两比较差异无统计学意义。不同孕期孕妇的FDP、D-二聚体及血小板计数水平比较差异有统计学意义(P<0.05);随着孕龄增加,孕妇FDP和D-二聚体的表达水平逐渐升高,血小板计数逐渐减少,差异有统计学意义(P<0.05)。结论对不同孕期产妇进行凝血四项、FDP、D-二聚体及血小板水平检测,可评估患者的凝血功能,以及时对异常情况采取干预措施,预防患者产后出血与血栓的发生。

Objective To explore the changes of four items of blood coagulation,fibrinogen degradation products(FDP),D-dimer and platelet in pregnant women at different stages of pregnancy(early pregnancy,middle pregnancy and late pregnancy).Methods The clinical date of 200 pregnant women in Ehu Branch,Xishan People's Hospital from January 2019 to January 2021 were retrospectively analyzed,including 65 cases in the early pregnancy,78 cases in the middle pregnancy and 57 cases in the late pregnancy,the levels of fibrinogen(FIB),prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT)and plasma fibrinogen degradation products(FDP),D-dimer and platele at different stages of pregnancy were compared.Results There were statistically significant differences in PT,APTT and FIB levels among pregnant women of different pregnancies(P<0.05);there was no statistically significant difference in TT levels among pregnant women of different pregnancies,with the increase of gestational age,PT and APTT of pregnant women were gradually shortened,and FIB level was gradually increased,the difference was statistically significant(P<0.05),but there was no statistically significant difference in TT pairwise among different pregnancies.There were significant differences in the levels of FDP,D-dimer and platelet count among pregnant women(P<0.05);with the increase of gestational age,the expression levels of fdp and d-dimer were gradually increased,and the platelet count was gradually decreased,and the difference was statistically significant(P<0.05).Conclusion The blood clotting function of the patients can be evaluated by testing the blood clotting four items,FDP,D-dimer and platelet levels of the women in different pregnancies,and timely intervention measures can be taken to prevent postpartum hemorrhage and thrombosis of the patients.