妊娠期高血压疾病患者凝血功能及血栓前状态各指标的临床意义

目的: 探讨妊娠期高血压疾病(简称妊高病)患者凝血功能及血栓前状态指标的变化及其临床意义。方法: 检测正常晚期妊娠妇女(正常晚孕组)、正常非孕妇(正常非孕组)各30例及40例妊期高血压疾病(妊高病组)血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fbg)、血管性血友病因子(vWF)、血小板a-颗粒膜蛋白(GMP-140)、凝血酶抗凝血酶Ⅲ复合物(TAT)、D-二聚体(D-dimer)含量等指标。结果: 正常晚孕组及妊高病组PT值均明显低于正常非孕组(P<0.01),而APTT与正常非孕组差异无显著性(P>0.05);妊高病组中,中、重度妊高病患者vWF、GMP-140和TAT与正常非孕组及正常晚孕组比较均显著增高(P<0.01);妊高病组中,中、重度妊高病者与正常非孕组比较Fbg、D-dimer含量均显著增高(P<0.01),且随病情的发展而更加明显。结论: 正常晚期妊娠孕妇及妊高病患者处于高凝状态,且存在明显血栓前状态。产前测定凝血功能及血栓前状态指标,对妊高病的预防及治疗具有重要的意义。

Detection of the coagulation function and prethrombosis state in patients with pregnancy-induced hypertension and its clinical significance

Objective:To study the changes and diagnostic value of coagulation function and relative variables of pretherombosis state in patients with pregnancy-induced hyertension(PIH).Methods:The prothrombin time(PT),activated partial prothrombin time(APTT),fibrinogen(Fbg),vWF,GMP-140,TAT,and were examined in 30 normal late-pregnancy women,30 non-pregnancy women and 40 patients with PIH.Results:In the normal late-pregnancy women and patients with PIH,the levels of PT was obviously lower((P<0.01)),while the level of APTT had no significant change(P>0.05) compared with the non-pregnant women;the level of vWF,GMP-140 and TAT were obviously higher in PIH women(P<0.01)than in the non-pregnant and late-pregnant women;some variables,including Fbg and D-dimer were greatly higher in patients with PIH than in the non-pregnant women(P<0.01);further more,these changes became more apparent with the progression of the disease.Conclusions:The normal late-pregnant women and the PIH women are in the hypercoagulation and prethrombotic state.Antenatal examination of coagulation function and variables of prethrombosis state are important for the prevention and treatment of PIH.