临产孕妇凝血及血细胞常规分析结果的意义

目的了解临产孕妇凝血常规4项指标及全血细胞发生生理性变化的状态，探讨其对分娩过程和产后发生凝血功能障碍的关联及影响。方法采用日本Sysmex CA-50自动血凝仪及迈瑞BC-3000plus自动血细胞分析仪对316例临产孕妇和130例健康非妊娠妇女进行凝血常规4项及全血细胞检测和分析。结果1）临产孕妇的凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）低于健康对照组（P〈0．05）；纤维蛋白原（Fbg）明显高于健康对照组（P〈0．01），凝血酶时间（TT）差异无统计学意义（P〉0．05）；2）临产孕妇的血红蛋白、红细胞计数及红细胞参数低于健康对照组（P〈0．01）；白细胞总数高于健康对照组，且以中性粒细胞为主（P〈0．01）；血小板计数低于健康对照组，平均血小板体积（MPV）及血小板分布宽度（PDW）高于健康对照组（P〈0．05）。结论临产孕妇血液处于高凝状态，动态监测凝血及血细胞指标，对预防和诊断分娩过程或产后发生的DIC及异常出血有重要意义。

Clinical significance of routine analysis on blood coagulation function and blood cells

Objective To explore the four indices of blood coagulation function and the physiological change of complete blood cells in parturient women,and to investigate their effect on coagulation disorders occurring during and after parturition.Methods 316 cases of parturient women(partudent group)and 130 cases of non-pregnant women(control group)were detected with Sysmex CA-50 automated blood coagulation analyzer for detection of four indices of blood coagulation function and Mayrui BC-3000 plus automated hematology analyzer for measurement of complete blood cells.Results The levels of two blood coagulation indices[prothrombin time(PT)and activated partial thromboplastin time(APTT)]and partial brood cell parameters(hemoglobin,red brood cell count,RBC parameters and platelet count)were significantly lower in parturient group than those in control group (P<0.05 or<0.01).In contrast,the levels of fibrinogen(Fbg),white cell count(mainly neutrophils),mean platelet volume(MPV,)and platelet distribution width(PDW)were markedly higher in parturient group than those in control group(P<0.05 or<0.01).There wasn't statistical difference of thrombin time(TT)between the two groups(P>0.05).Conclusion As the blood of parturient women is in hypercoagulable state,the dynamic detection of brood coagulation indices and blood cell parameters contributes to the diagnosis and prevention of DIC and the abnormal bleeding during and after parturition.