孕妇妊娠不同时期凝血功能四项、D-二聚体、FDP指标检测的临床意义

目的:探讨孕妇妊娠不同时期凝血功能四项、D-二聚体(D-D)、纤维蛋白原降解产物(FDP)检测的临床意义。方法:选取不同妊娠时期孕妇130例为观察组,其中妊娠中期48例,妊娠后期45例,临产期37例;另选同期健康非妊娠妇女45例为对照组。比较两组及不同妊娠时期孕妇的活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)、D-D及FDP水平。结果:与对照组比较,妊娠后期及临产期孕妇APTT、PT、TT明显缩短,FIB水平明显升高。妊娠中期至妊娠后期,APTT、TT、FIB水平未见明显变化(P>0.05),PT明显缩短(P<0.05);妊娠后期至临产期,APTT明显缩短,FIB水平明显升高(P<0.05),而PT、TT未见明显变化(P>0.05)。D-D、FDP水平在妊娠中、后期及临产期呈进行性升高,且均显著高于对照组(P<0.01);产后出血组产后APTT、PT、D-D、FDP水平均明显高于产前,FIB水平明显高于产前(P<0.05);产后出血组产前APTT、PT、D-D、FDP水平明显高于产后未出血组产前水平(P<0.05)。结论:在孕妇妊娠过程中,动态监测凝血功能四项、D-D、FDP水平对预防产中及产后异常出血具有重要临床意义。

Clinical value of four programs of coagulation function,D-dimer and FDP indexes in different pregnant periods in pregnant women

Objective:To explore the clinical value and significance of detecting four programs of coagulation function,D-dimer (D-D) and fibrinogen degradation product (FDP) indexes indifferent pregnant periods in pregnant women.Methods:A total of 130 pregnant women in different pregnant periods were selected as observation group,among whom 48 were in mid trimester of pregnancy,45 in late trimester of pregnancy and 37 in parturient period.Another 45 healthy non-pregnant women served as control group.Activated partial thromboplastin time (APTT),prothrombin time (PT),thrombin time (TT),fibrinogen (FIB),D-D and FDP levels were com-pared between two groups in different period periods.Results:Compared with control group,APTT,PT and TT were shortened evidently while FIB was increased notably in pregnant women in late trimester of pregnancy and parturient period.There was insignificant differ-ence in APTT,TT and FIB levels(P>0.05) while PT was markedly shortened(P<0.05) in pregnant women from mid to late trimes-ter of pregnancy.APTT level was prominently shortened and FIB level was obviously increased(P<0.05),whereas PT and TT had no significant change (P>0.05) in pregnant women from the late trimester of pregnancy to parturient period.Both D-D and FDP levels increased progressively in pregnant women in mid trimester,late trimester of pregnancy and parturient period,which were markedly higher than those in control group(P<0.01),the levels of APTT,PT,DD and FDP in postpartum hemorrhage group were significantly higher than those in prenatal period,and the level of FIB was significantly higher than that in the prenatal period (P<0.05).APTT, PT,DD and FDP levels in postpartum hemorrhage group were significantly higher than those in postpartum non-hemorrhage group(P<0.05).Conclusions:During pregnant period,dynamic monitoring the four programs of coagulation function and the levels of D-D and FDP is of great significance in monitoring the abnormal intra-and post-delivery hemorrhage.