妊娠期妇女凝血功能指标变化及其临床意义

目的研究妊娠期妇女凝血功能的动态变化及其提示的临床意义。方法选取2010～2011年间150例住院治疗的妊娠期妇女为研究对象,其中妊娠早期、妊娠中期、妊娠晚期的妇女各50例,将她们定为观察组;选取同期正常非孕期妇女50例,定为对照组。采用RT-2204C半自动四通道血凝分析仪对两组患者在妊娠不同时期的凝血功能指标血浆凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、血浆凝血酶时间(TT)、国际标准化比值(INR)、纤维蛋白原(FIB)进行动态的检测。结果妊娠早期的比较上观察组与对照组经统计学处理,P>0.05,提示无明显差异;而在妊娠中、晚期的比较上两组有明显差异,经统计学处理,P<0.05,提示妊娠中、晚期妇女的PT、APTT、INR等指标较非妊娠妇女明显缩短而TT、FIB明显增加,并且随着临产期的靠近变化逐渐增大。结论在妇女的不同孕期凝血功能处于一个动态的平衡状态,这时动态监测凝血功能的变化,对预防孕期及术后弥散性血管内凝血等一系列并发症的发生有着积极的作用和临床指导意义。

Study on clinical significance of changes in blood coagulation function in pregnant women

Objective To study the clinical significance of dynamic changes in blood coagulation function of pregnant women during preg- nancy. Methods One hundred and fifty pregnant women admitted in this hospital during 2010 to 2011 were enrolled for this study. Among them, 50 with early pregnancy, 50 with pregnancy of second trimester and 50 with prenancy of third trimester were allocated in observation group ; and 50 normal non - pregnant women at the same period were selected as control group. Blood samples were examined by RT - 2204Csemi - automatic four- channel coagulation analyzer for coagulation parameters including prothrombin time （PT）, activated partial thromboplastin time （APTI）, plasma thrombin time （Tr）, international normalized ratio （INR） and fibrinogen （FIB） at two different periods of pregnancy in patients for dy- namic testing. Results There was no difference at early period of pregnancy between observation group and control group by statistical analysis （ P 〉 0.05 ）. The difference in coagulation parameters in mid and late stages of pregnancy between observation group and control group was statistically significant （ P 〈 0.05 ）. PT, APTT and INR in pregnant women in late pregnancy period were significantly decreased compared with non - pregnant women and their TT and FIB were significantly longer than those of control group, and their amplitude of increment was closely proportion- al to the approaching of labor. Conclusion The maternal blood coagulation function is keeping a dynamic equilibrium during different stages of gestation, and it is important to monitor the dynamic changes in blood coagulation function in mothers during pregnancy in order to prevent the occurrence of a series of thrombotic complications during pregnancy and DIC after operation.