妊高征患者凝血和纤溶系统的变化及其临床意义

Changes and Clinical value in coagulation and fibrinnolytic system of patients with pregnancy induced hypertension

目的 :探讨妊高征患者凝血和纤溶系统的变化及其临床意义。方法 :检测 35例妊高征患者的凝血酶原时间 (PT)、活化部分凝血活酶时间 (APTT)、组织型纤溶酶原激活物活性 (t PA)、D 二聚体 (D D)、纤维蛋白原 (Fbg)及纤维蛋白降解产物 (FDP)的含量并与 2 0例正常孕妇及 2 0例育龄健康非孕妇比较分析。结果 :妊娠期PT、APTT均缩短 ,且妊高征患者与非孕妇比较差异有统计学意义 (P <0 .0 5 ) ;妊高征患者与正常孕妇t PA均明显升高 (P <0 .0 0 1) ,但二组间无统计学意义 (P >0 .0 5 ) ;非孕妇与正常孕妇、正常孕妇与妊高征患者之间D D有明显差异 (P <0 .0 1、P <0 .0 0 1) ;妊娠期Fbg明显升高 (P <0 .0 1) ;非孕妇与正常孕妇、正常孕妇与妊高征患者之间FDP有明显差异 (P <0 .0 1、P <0 .0 0 1)。结论 :正常孕妇处于高凝状态 ,妊高征患者有血栓形成倾向。

Objective To evaluate changes and clinical value in coagulation and fibrinolytic system of patients with pregnancy induced hypertension(PIH).Methods the value of prothrombin time(PT), partial thromboplastintime(APTT), tissueplasminogen activator(t PA), D dimer(D D), fibrinogen(Fbg) and fibrin degradation products(FDP) were determined in 20 normal pregnant women, 20 nomal nonpregnant women and 35 patients with PIH. Results PT and APTT were shorted in pregnant women, they showed significant difference between nonprgnant women and patients with PIH (P<0.05). t PA improved in normal pegnant women and patients with PIH(P<0.01),There are no significant difference between the two group(P>0.05) .The value of D D showed significant difference between nonpregnant and normal pregnant women(P<0.01)and very significant difference between normal pregnant women and PIH(P<0.001).Fbg was higher in pregnant women (P<0.01). The value of FDP showed significant difference between nonpregnant and normal pregnant women (P<0.01) and very signifinant difference between normal pregnant women and PIH(P<0.001). Conclusion Normal pregnant women are in a hypercoagulable state and the PIH patients show a tendency to develop thrombosis and predispose to spontaneous intravascular coagulation. To detect coagulation and fibrinolytic system can be applied to monitor the changes in fibriolysis and thrombosis in PIH patients.