哈萨克族妇女分娩前后凝血、抗凝血及纤维蛋白溶解功能指标的检测及意义

目的探讨哈萨克族妇女分娩前后凝血、抗凝血及纤维蛋白溶解功能部分指标的变化及其对易发深静脉血栓的意义。方法检测比较36例哈萨克族妇女和39例汉族妇女分娩前后的凝血酶原时间(PT)、凝血酶原活动度(PTA)、活化部分凝血活酶时间(APTT)、国际标准化比值(INR)、纤维蛋白原定量(Fbg)、D-二聚体(D-D)、蛋白C(PC)、蛋白S(PS)、抗凝血酶Ⅲ(AT-Ⅲ)活性、活化蛋白C抵抗(APCR)比值。结果分娩前哈萨克族妇女与汉族妇女相关指标比较,D-D差别有统计学意义(P<0.05),PT、PTA、INR、APTT、Fbg差别无统计学意义(P>0.05)。哈萨克族组分娩后PS较分娩前明显增高,差别有统计学意义(P<0.01)。哈萨克族组分娩后PC、PS低于汉族组分娩后,差别有统计学意义(P<0.01,P<0.05)。汉族组分娩后与哈萨克族组分娩前比较,PC、APCR值差别有统计学意义(P<0.05),PS值差别有统计学意义(P<0.01)。结论哈萨克族妇女分娩前后存在明显的血栓前状态;PC、PS活性较汉族妇女低可能是其分娩前后易发深静脉血栓的重要因素;分娩前后进行凝血、抗凝血与纤维蛋白溶解功能的检查对预防哈萨克族妇女深静脉血栓的形成有一定临床意义。

Changes of coagulation,anti-coagulation and fibrinolysis system in Kazakh women before and after delivery

Objective To investigate the changes of relative variables about coagulation,anti-coagulation and fibrinolysis system and its significance that Kazakh women prone to deep vein thrombosis before or after delivery.Methods The prothrombin time（PT）,prothrombin activity（PTA）,activated partial thromboplastin time（APTT）,international normalized ratio（INR）,fibrinogen（Fbg）,D-dimer（D-D）,protein C（PC）,protein S（PS）,antithrombin Ⅲ（AT-Ⅲ） and activated protein C resistance ratio（APCR） of 36 cases of Kazakh women and 39 cases of Han women were detected before and after delivery,and the results were compared.Results The detection value of PT,PTA,INR,APTT and Fbg had no statistical significance（P0.05） and the D-D had statistical significance（P0.05）between the Kazakh women and the Han women before delivery.The PS after delivery was significantly higher than before delivery of Kazakh women（P0.01）.The PC and PS of Kazakh women were significantly lower than those of Han women after delivery（P0.01,P0.05）.There were statistic difference of PC,APCR and PS between Han women after delivery and Kazakh women before delivery（P0.05,P0.01）.Conclusion The Kazakh women exist clear prothrombotic state before and after delivery.The lower activity of PC and PS than the Han women may be the important factor of deep vein thrombosis-prone before and after delivery.The detection of coagulation,anti-coagulation and fibrinolysis system have some clinical significance on the prevention of the deep vein thrombosis in Kazakh women before and after delivery.