妊娠期糖尿病孕妇血栓弹力图和传统凝血功能指标结果比较

目的分析血栓弹力图和传统凝血功能指标在妊娠期糖尿病(GDM)孕妇凝血功能中的评估价值。方法选取该院2017年10月至2018年12月收治的60例GDM孕妇纳入研究组,选取60例健康孕妇纳入对照组。使用全自动血凝仪对所有研究对象的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)和纤维蛋白原(FIB)指标进行测定,根据PT计算国际标准化比值(INR);使用血栓弹力图仪检测两组R值、K值、α角、MA和CI值。采用全自动血细胞分析仪进行血小板计数(PLT)检测。比较两组传统凝血功能指标和血栓弹力图指标的差异。结果除APTT外,研究组PT、FIB及INR均明显高于对照组,差异有统计学意义(P<0.05)。研究组R值、K值明显高于对照组,α角、MA和CI值明显低于对照组,差异均有统计学意义(P<0.05)。研究组、对照组的PLT、妊娠不良结局发生率比较,差异无统计学意义(P>0.05)。结论使用血栓弹力图对GDM孕妇的凝血功能异常状态进行观察是对传统凝血功能指标的补充,对于预测GDM孕妇是否有存在凝血功能异常,以及是否有血栓形成倾向有重要意义,值得临床推广。

Comparison of the results of thrombotic elasmogram and traditional coagulation indicators in pregnant women with gestational diabetes mellitus

Objective To analyze the value of thrombotic elasmogram and traditional coagulation indicators in the evaluation of coagulation function in pregnant women with gestational diabetes mellitus(GDM).Methods A total of 60 pregnant women with GDM admitted to Shanghai Changning District Maternal and Child Health Hospital from October 2017 to December 2018 were selected as the study group,and 60 normal pregnant women were recruited as the control group.The prethrombin time(PT),partial thrombin time(APTT)and fibrinogen(FIB)indexes of all subjects were measured by fully automatic hemagglutination apparatus,and the international standardized ratio(INR)was calculated based on PT.Thrombus elastic graph instrument was used to detect R value,K value,αAngle,MA and CI value in the two groups.The differences of traditional coagulation function and thrombotic elasmogram between the two groups were compared.Results Except for APTT,thetraditional coagulation indicators including PT,FIB and INR values in the study group were significantly higher than those in the control group(P<0.05).The R value,K value in the study group were significantly higher than those in the control group,αAngle,MA and CI value in the study group were significantly lower than those of the control group(P<0.05).There were no significant differences on the PLT and incidence of adverse pregnancy outcomes between the study group and the control group(P>0.05).Conclusion The use of thrombelastogram to observe the abnormal state of coagulation function in GDM patients is a supplement to the traditional indexes of coagulation,and it is important to predict whether the GDM patients have abnormal coagulation function and whether there is a tendency of thrombosis,worthy of clinical promotion.