妊娠期糖尿病患者血小板、凝血功能及纤溶参数变化的临床价值

Clinical value of platelet,coagulation function and fibrinolytic parameters in patients with gestational diabetes mellitus

目的:探讨妊娠期糖尿病(GDM)患者血小板、凝血功能及纤溶参数变化的临床价值。方法:选取2019年1月至2022年1月于焦作市人民医院门诊产检的70例健康孕妇作为对照组,选取同期同院就诊的80例GDM患者作为观察组。检测并比较不同时期(孕早期、孕中期、孕晚期)血小板、凝血功能及纤溶参数。结果:两组血小板计数(PLT)、血小板分布宽度(PDW)和血小板压积(PCT)组间比较、时间点比较及交互作用差异均有统计学意义(P<0.05)。组内比较:两组PLT和PCT均随孕期时间增加逐渐降低,PDW随孕期时间增加逐渐升高(P<0.05);组间比较:观察组孕早、中期PLT、PDW和PCT均高于对照组,孕晚期PDW高于对照组、PLT和PCT均低于对照组(P<0.05)。两组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)凝血酶时间(TT)和D-二聚体(D-D)组间比较、时间点比较及交互作用差异均有统计学意义(P<0.05)。组内比较:两组PT、APTT、TT均随孕期时间增加逐渐降低,D-D随孕期时间增加逐渐升高(P<0.05);观察组FIB随孕期时间增加逐渐升高(P<0.05)。组间比较:两组孕早、中、晚期PT、APTT和D-D同期比较差异均有统计学意义(P<0.05);观察组孕晚期FIB高于对照组同期,TT短于对照组同期(P<0.05)。结论:GDM患者妊娠不同时期的血小板、凝血功能及纤溶参数均存在异常情况,临床上除控制血糖外,应及时干预血小板及凝血、纤溶参数的变化,预防相关疾病的发生,提高产妇生产质量。

Objective:To investigate clinical value of platelet,coagulation function and fibrinolytic parameters in patients with gestational diabetes mellitus(GDM).Methods:A total of 70 healthy pregnant women underwent prenatal checkups at Outpatient Department of Jiaozuo People’s Hospital from January 2019 to January 2022 were selected as control group,and 80 GDM patients in the same hospital during the same period were selected as observation group.Platelet count,coagulation function and fibrinolytic parameters were detected and compared in different periods(early,mid and late pregnancy).Results:Comparison of the blood platelet count(PLT),platelet distribution width(PDW),and plateletcrit(PCT)values between the two groups,as well as comparisons of time points and interactive effects showed statistically significant differences(P<0.05).Within-group comparisons revealed that both PLT and PCT gradually decreased with increasing gestational age in both groups,while PDW gradually increased(P<0.05).Between-group comparisons showed that in the early and midgestation period,PLT,PDW,and PCT values in the observation group were higher than those in the control group.In the late-gestation period,PDW remained higher in the observation group,but PLT and PCT were lower than those in the control group(P<0.05).Comparisons of prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),thrombin time(TT)and D-dimer(D-D)values between the two groups,as well as comparisons of time points and interactive effects,exhibited statistically significant differences(P<0.05).Within-group comparisons indicated that PT,APTT,and TT in both groups gradually decreased with increasing gestational age,while D-D gradually increased(P<0.05).In the observation group,FIB gradually increased with gestational age(P<0.05).Between-group comparisons showed statistically significant differences in PT,APTT,and D-D values during all gestational periods(P<0.05).In the late-gestation period,FIB in the observation group was higher than that in the control group,while TT was shorter than that in the control group(P<0.05).Conclusions:GDM patients have abnormal platelet,coagulation function and fibrinolytic parameters at different stages of pregnancy.In clinical practice,in addition to controlling blood sugar,timely intervention of platelet,coagulation and fibrinolytic parameter changes should be carried out to prevent occurrence of related diseases,and improve the quality of maternal production.