重度子痫产妇血栓弹力图参数变化分析及其早期诊断的价值探究

Changes of thromboelastography parameters and their early diagnostic value in women with severe preeclampsia

目的探讨重度子痫产妇血栓弹力图(TEG)参数变化及其早期诊断价值。方法选取2019年11月至2021年1月本院收治的97例重度子痫产妇作为观察组,另选取同期90名未孕健康女性作为对照组。两组均进行TEG检测及凝血功能检查,比较两组TEG参数、凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)];Pearson相关分析凝血指标与TEG检测结果的相关性。结果观察组反应时间(γ)、凝固时间(K)均短于对照组,最宽距离(MA)长于对照组,血块形成速度(α角)大于对照组,差异有统计学意义(P<0.05)。观察组PT、ATPP、TT均长于对照组,差异有统计学意义(P<0.05)。Pearson相关分析显示,PT与MA呈正相关(r>0,P<0.05);APTT与γ、K呈正相关(r>0,P<0.05),与α角、MA呈负相关(r<0,P<0.05);TT与MA呈正相关(r>0,P<0.05)。结论TEG应用于重度子痫产妇中能动态监测凝血动态变化,γ、K、MA、α角与正常孕妇存在一定差异,可作为早期诊断指标,并根据参数变化给予针对性治疗,在一定程度上缓解患者高凝状态,值得临床推广应用。

Objective To explore the changes of thromboelastography(TEG)parameters and their early diagnostic value in women with severe preeclampsia.Methods 97 women with severe preeclampsia admitted to our hospital from November 2019 to January 2021 were selected as the observation group,and 90 healthy non-pregnant women during the same period were selected as the control group.The TEG test and coagulation function test were performed in both groups,and TEG parameters,coagulation function indices(prothrombin time[PT],activated partial thromboplastin time[ATPP],and thrombin time[TT])were compared between the two groups;Pearson correlation analysis was used to investigate the correlation between coagulation indices and TEG test results.Results The reaction time(γ)and coagulation time(K)values in the observation group were shorter than the control group,while maximum width distance(MA)was longer and the blood clot formation speed(αangle)were larger than the control group,the differences were statistically significant(P<0.05).PT,ATPP,and TT in the observation group were longer than the control group,the differences were statistically significant(P<0.05).Pearson correlation analysis showed positive correlation between PT and MA(r>0,P<0.05);APTT showedpositive correlation withγand K(r>0,P<0.05),and negative correlation withαangle and MA(r<0,P<0.05);TT showed positive correlation with MA(r>0,P<0.05).Conclusion TEG can dynamically monitor the changes in coagulation in women with severe preeclampsia,the differences inγ,K,MA,andαangle between these women and normal pregnant women indicate its potential as an early diagnostic tool,treatment can be tailored based on the parameter changes,potentially alleviating the hypercoagulable state in patients,TEG deserves to be widely applied in clinical practice.