不同孕期孕妇凝血四项的变化及临床意义

目的探讨不同孕期妇女凝血酶原时间（PT）、部分活化凝血酶时间（APTT）、凝血酶时间（TT）和纤维蛋白原（Fib）四项凝血指标的变化及临床意义。方法采用法国Stago Compact全自动血凝分析仪检测201例正常妊娠早期、197例正常妊娠中期、199例正常妊娠晚期和100例非孕正常妇女的PT、APTT、TT和Fib,并对检测结果进行比较和分析。结果正常非孕对照组与早孕组比较,PT、APTT、TT及Fib差异均无统计学意义（P〉0.05）;中、晚孕组与早孕组和对照组比较,PT、APTT时间明显缩短,Fib含量明显增高,差异有统计学意义（P〈0.05或P〈0.01）;早孕组与中孕组比较,TT时间缩短,差异具有统计学意义（P〈0.05）,早孕组与晚孕组比较,TT的差异无统计学意义（P〉0.05）。结论随着孕期的延长,妊娠妇女的血液中凝血因子处于一定程度的活化状态,凝血功能增强、抗凝及纤溶功能减弱,血浆处于高凝状态,这一妊娠期生理变化为产后快速止血提供物质基础,同时也易形成血栓,并引起其他产科疾患。定期动态监测凝血功能,了解其凝血功能状态,对预防产科并发症、及时进行抗凝治疗和保护母婴健康有着极其重要的意义。

Changes in pregnant women four items of blood coagulation and its clinical significance

Objective To investigate the change of the four coagulation indexes and clinical significanceamongwomen during different pregnancy prothrombin time（PT）.Activated partial thromboplastin time（APTT）,thrombin time（TT） and fibrinogen（Fib）.Methods Detected the PT,APTT,TT and Fib for 201 cases of normal first trimester of pregnancy,197 cases of normal second trimester of pregnancy,199 cases of normal third trimester of pregnancy,and 100 cases of non-pregnant women by using the automatic blood coagulation analyzer of Stago Compact（France）,and compared and analyzed the detected results.Results Compared the non-pregnancy group with the first trimester group,no significant difference in PT,APTT,TT and Fib（P0.05）.Compared the second/third trimester group with the first trimester group,the PT,APTT time was obviously reduced,Fib content distinctly increased,and with significant difference（P0.05 or P0.01）.Compared the first trimester group with the second trimester group,TT time is shortened,the difference was statistically significant（P0.05）.Compared the first trimester group with the third trimester group,no statistically significance in TT（P0.05）.Conclusion Along with the prolonged pregnancy,the coagulation factors in the blood of pregnant women will be in state of activation,coagulation function enhanced,anticoagulation and fibrinolysis function will be abated,blood plasma is in hypercoagulable state,the pregnancy physiological changes provide quick hemostatic basis in postpartum,but also easy to thrombose,and cause other gynecology disease.Regular monitoring of coagulation function,investigate the coagulation status,will be with very important significance for the prevention of obstetric complications,timely treatment for anticoagulation and protection of maternal and child health.