不同妊娠时期孕妇血浆D-二聚体及凝血四项变化分析

目的探讨孕妇在不同妊娠时期的血浆D-二聚体及凝血四项的变化规律,分析监测D-二聚体及凝血四项的变化的临床意义。方法选取我院妇产科自2012年10月-2013年10月定时进行常规体检的孕妇260例,按照孕期阶段分别于妊娠早期、妊娠中期、妊娠后期、临产前进行血浆D-二聚体以及凝血四项的检测,并对所得结果用统计学软件进行分析。结果 D-二聚体（D-Dimer）在孕妇整个妊娠过程中呈进行性升高（P〈0.05）;凝血酶原时间（PT）在妊娠早期、妊娠中期、妊娠后期过程中呈进行性缩短（P〈0.05）,妊娠后期至临产期之间PT的变化无统计学意义（P〉0.05）;凝血酶时间（TT）在孕妇妊娠整个过程中的变化无统计学意义（P〉0.05）;活化部分凝血活酶时间（APTT）在孕妇妊娠过程中呈逐渐缩短趋势,在妊娠早期至妊娠中期有明显的缩短趋势（P〈0.01）,妊娠中期至妊娠后期之间变化无统计学意义（P〉0.05）,妊娠后期至临产期阶段明显缩短（P〈0.05）;纤维蛋白原含量（FIB）在妊娠早期至妊娠中期明显增高（P〈0.01）,妊娠中期到妊娠后期之间变化无统计学意义（P〉0.05）,妊娠后期至临产期阶段急剧升高（P〈0.01）。结论对孕妇妊娠过程中血浆D-二聚体和凝血四项指标的变化进行动态监测,有助于预防分娩过程中和产后的异常出血,弥漫性血管内凝血以及动静脉血栓疾病等分娩并发症,有重要的临床指导意义。

Analysis of maternal plasma D-dimer and coagulation changes during different periods of pregnancy

Objective To investigate the maternal plasma D-dimerand coagulation changes of different periods of pregnanc, and to analyze and monitor clinical significance of changes of D-dimer and coagulation. Methods 260 cases of pregnant women with regular routine examination of Obstetrics and Gynecology in our hospital from October 2012 to October 2013 were seleted for the study, according to the trimester of pregnancy, at an early stage, mid-pregnancy, late pregnancy, before labor plasma D-direct and coagulation were detected and the results were analyzed using statistical software. （P 〈 0.05） in pregnant women throughout pregnancy Results D-dimer （D-Dimer） was progressively increased process： prothrombin time （PT） in early pregnancy, second trimester, the latter process was progressively shortened pregnancy （P 〈 0.05）, late pregnancy to the perinatal period had no significant changes in PT（P 〉 0.05）; thrombin time （TT） changes throughout the course of pregnancy in pregnant women was not statistically significant （P - 0.05）; activated partial thromboplastin time （APTT） was gradually shortened trend among pregnant women during pregnancy in the early second trimester of pregnancy to significantly shorten the trend （P 〈 0.01）; changes between the late second trimester of pregnancy was not statistically significant （P - 0.05）, the latter stages of pregnancy to the perinatal period was significantly shorter （P 〈 0.05）; fibrinogen （FIB） to mid-pregnancy was significantly higher （P 〈 0.01） in early pregnancy; second trimester of pregnancy to the late had no significant change （P 〉 0.05）. There was a sharp increase in the late stages of pregnancy to the perinatal period （P 〈 0.01）. Conclusion Dynamic monitoring the changes of plasma D-dimer and coagulation during pregnancy can help prevent birth complications during childbirth and postpartum abnormal bleeding, disseminated intravascular coagulation, and arterial and venous thrombosis diseases, which ha