妊娠期高血压疾病及妊娠糖尿病孕妇凝血指标的研究

摘要

Objective To study the changes of coagulation indexes in patients with hypertensive disorders complicating pregnancy (HDCP) or gestational diabetes mellitus ( GDM) and make comparison with healthy pregnancy.Methods All pregnant woman were divided into four groups, healthy non-pregnant group (women taking physical examination), healthy pregnant group, HDCP group and GDM group by clinical diagnosis.Prothrombin time ( PT) , activated partial thromboplastin time ( APTT) , antithrombin Ⅲ activity ( AT-Ⅲ) , fibrinogen ( FIB) and D-dimer ( D-D) were measured in four groups.Results Compared with healthy non-pregnant group, healthy pregnant group was not significantly different in APTT, PT, AT-Ⅲ and FIB at 12 and 22 gestational week (all P>0.05), but D-D increased obviously (at 12 gestational week t=15.387,P<0.05;at 22 gestational week t=35.270, P<0.05).And APTT, PT, AT-Ⅲand FIB in healthy pregnant group at 32 gestational week were significantly lower than in the healthy non-pregnant group ( tPT =5.124, tAPTT =6.424,tAT-Ⅲ =5.548, respectively, all P<0.05), but the FIB and D-D were significantly higher (tFIB =58.996, tD-D =19.087, respectively, both P<0.05).The PT, APTT and AT-Ⅲin HDCP group and GDM group were significantly decreased than in the healthy pregnant group (HDCP:tPT =5.402, tAPTT =4.950, tAT-Ⅲ =5.602, respectively, all P<0.05;GDM:tPT =5.069, tAPTT =6.406, tAT-Ⅲ =5.145, respectively, all P<0.05), but the FIB and D-D were significant higher (HDCP:tFIB =5.218, tD-D =5.508, respectively, both P<0.05;GDM:tFIB =6.137, tD-D =4.789, respectively, both P <0.05).The difference in coagulation indexes was not significant between HDCP group and GDM group.Conclusion For HDCP and GDM, detecting coagulation indexes plays an important role in preventing the incidence of DIC.%目的：探讨妊娠期高血压疾病及妊娠糖尿病孕妇凝血指标的变化及与正常对照的比较。方法根据临床诊断将研究对象分为健康非孕组（健康体检的非孕期妇女）、健康孕妇组、妊娠期高血压疾病组（HDCP）、妊娠期糖尿病组（GDM），对各组凝血酶原时间（ PT）、部分活化凝血酶原时间（ APTT）、抗凝血酶（ AT-Ⅲ）、纤维蛋白原（ FIB）和D－二聚体（ D-D）进行检测和比较。结果健康孕妇组孕12周、孕22周的PT、APTT、AT-Ⅲ、FIB与健康非孕组比较均无明显差异（均P＞0．05），D-D指标均有显著性升高（孕12周：t＝15．387，P＜0．05；孕22周：t＝35．270，P＜0．05）；而健康孕妇组孕32周的PT、APTT、AT-Ⅲ与健康非孕组比较有显著性降低（tPT ＝5．124、tAPTT ＝6．424、tAT-Ⅲ＝5．548，均P＜0．05），FIB、D-D指标与健康非孕组比较均有显著性升高（tFIB ＝58．996、tD-D ＝19．087，均P＜0．05）。与健康孕妇组（孕32周）比较，HDCP组和GDM组的PT、APTT、AT-Ⅲ指标均有显著性的降低（HDCP：tPT ＝5．402、tAPTT ＝4．950、tAT-Ⅲ＝5．602，均P＜0．05；GDM：tPT ＝5．069、tAPTT ＝6．406、tAT-Ⅲ＝5．145，均P＜0．05），FIB、D-D指标均有显著性升高（HDCP：tFIB ＝5．218、tD-D ＝5．508，均P＜0．05；GDM：tFIB ＝6．137、tD-D ＝4．789，均P＜0．05）。而HDCP组与GDM组之间，各项凝血指标比较无明显差异（均P＞0．05）。结论对于HDCP及GDM孕妇，检测凝血指标，有助于预防弥漫性血管内凝血的发生。