妊娠妇女凝血及纤溶系统的变化

目的探讨妊娠期妇女的凝血及纤溶系统变化及意义。方法选取120例妊娠妇女和60名健康育龄非妊娠妇女作为实验组和对照组。检测其血浆中凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（FIB）、D-二聚体（D-Dimer）的水平及抗凝血酶Ⅲ（AT-Ⅲ）的活性。结果妊娠组与非妊娠组相比PT、APTT缩短（P〈0．05）此两指标在妊娠早、中、晚期组间差异无统计学意义（P〉0．05）；TT指标差异无统计学意义（P〉0．05），且在妊娠早、中、晚期组间差异也无统计学意义（P〉0．05）FIB、D-二聚体两者水平都显著升高（P〈0．01），FIB在妊娠晚期明显高于妊娠早、中期（P〈0．01）D-二聚体随孕期增加而不断升高（P〈0．01）AT-Ⅲ活性显著下降（P〈0．01），随孕期增加呈现下降的趋势（P〈0．01）。结论正常孕妇处于高凝状态，妊娠期进行凝血指标的监测，对预防血栓栓塞性疾病的发生有重要意义。

The Changes in Coagulation and Fibrinolytic System of Pregnant Women

Objective To investigate the changes of coagulation and fibrinolysis system during pregnancy and their clinical significance.Methods 120 pregnant women and 60 non-pregnant women at child-bearing age were studied.Blood plasma were collected.And the concentrations of Prothrombin Time（PT）,Activated Partial Thromboplastin Time （APTT）,Fibrinogen（FIB）,D-Dimer and activity of Antithrombin Ⅲ （AT- Ⅲ）were determined. Results PT and APTT shortened during pregnancy,with significant difference between pregnant women and nonspregnant women（P〈0.05）.No significant difference was found of PT or APTT among different pregnant periods. No difference of TT was found between pregnant group and non-pregnant group or among three periods of pregnancy（P〉0.05）. The values of FIB and D-Dimer were higher in pregnant women than the control non-pregnant women with significant difference（P〈0.01）. FIB was higher in the terminal pregnant women than women in early or mid stage of pregnancy. D-Dimer was increasing with the growing pregnancy（P〈0.01）.Activity of Antithrombin Ⅲ （AT- Ⅲ） of pregnant women was lower than the control group with great significance（P〈0.01）. A downward tendency was found when determining the changes of Antithrombin Ⅲ （AT- Ⅲ） in pregnant group.Conclusion Pregnant women are in hypercoagulable state. The coagulation and fibrinolytic system can be of great significance when applied to monitor thrombosis in pregnant women.