妊娠糖尿病(GDM)患者妊娠期间凝血功能各指标的动态变化及临床意义

 目的    探讨妊娠糖尿病(gestational diabetes mellitus,GDM)患者孕期凝血功能各参数指标的动态变化及意义。方法    回顾性研究16例GDM患者和16例正常对照(C)组孕妇,记录分析孕12～16周和孕36～40周的凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、国际标准化比值(international normalized ratio,INR)、凝血酶时间(thrombin time,TT)、纤维蛋白原(fibrinogen,FIB)等指标。结果    孕12～16周GDM组的PT、APTT、INR水平显著低于C组(P＜0.05);孕36～40周GDM组的FIB显著高于C组(P＜0.05)。多元线性逐步回归显示:孕36～40周凝血功能与孕24～28周口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)中1 h血糖(1 h blood glucose,1HBG)呈独立负相关(P＜0.05)。结论    孕期凝血功能处于动态变化过程,相比于正常妊娠女性,GDM孕妇处于高凝状态,这种状态可能与其餐后1HBG有关。

Dynamic changes and clinical significance of the blood coagulation indices in gestational diabetes mellitus (GDM) patients

ObjectiveTo explore the dynamic changes and its influences of blood coagulation indices during the pregnancy in gestational diabetes mellitus (GDM) patients.MethodsSixteen pregnant women with GDM and 16 time-matched normal pregnant subjects (control group) were included in this study.All the pregnant women were followed the level of prothrombin time (PT),activated partial thromboplastin time (APTT),international normalized ratio (INR),thrombin time (TT),fibrinogen (FIB) in the 12-16 and 36-40 gestational week.ResultsThe values of PT,APTT and INR were significantly lower in GDM group compared with control group (P＜0.05) in the 12-16 gestational week,and the FIB value was significantly higher (P＜0.05) in GDM group compared with control group in 36-40 gestational week.Multiple linear regression showed that 1 h blood glucose (1HBG) concentration of oral glucose tolerance test (OGTT) in 24-28 gestional week had a negative correlation with the blood coagulation in 36-40 gestional week (P＜0.05).ConclusionsThe blood coagulation is in a dynamic change during pregnancy,and GDM pregnant women were in a higher hypercoagulable state compared with the normal pregnant women,which maybe associated with 1HBG.