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目的了解妊娠妇女凝血功能变化,探讨妊娠妇女凝血指标变化的规律及临床意义。方法对156例正常孕妇和20例健康非孕妇女的凝血酶原时间(PT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)及纤维蛋白原(Fg)、D-二聚体(D-D)、抗凝血酶Ⅲ(AT-Ⅲ)进行检测。结果妊娠组与对照组比较,PT、APTT指标差异无统计学意义(P>0.05),且PT、APTT在妊娠早、中、晚期组间差异也无统计学意义(P>0.05);TT值在对照组、早孕组、中孕组之间差异无统计学意义(P>0.05),而晚孕组的TT检测结果较前三组明显缩短(P<0.05);妊娠组与对照组比较,AT-Ⅲ活性显著下降,差异有统计学意义(P<0.01),且随孕期增加有不断下降的趋势(P<0.01);而妊娠组的D-D、Fg水平都显著高于对照组(P<0.01),Fg在孕早、中期无明显变化(P>0.05),孕晚期明显升高(P<0.01),D-二聚体在孕早、中、晚期不断升高(P<0.01)。结论正常孕妇处于高凝状态,孕期进行凝血指标的监测,可早期发现凝血功能的异常变化,对预防和抢救产科一些并发症有重要意义。
Objective To understand the changes of coagulation function in pregnant women and to explore the changes and clinical significance of coagulation indexes in pregnant women. Methods The prothrombin time (PT), partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fg) and D-dimer in 156 normal pregnant women and 20 healthy non- (DD), antithrombin Ⅲ (AT-Ⅲ) were detected. Results Compared with the control group, there was no significant difference in PT and APTT between pregnancy group and control group (P> 0.05). There was also no significant difference in PT, APTT between early, middle and late pregnancy groups (P> 0.05); TT There was no significant difference in the control group, the first trimester pregnancy group and the second trimester pregnancy group (P> 0.05), while the TT test results in the third trimester pregnancy group were significantly shorter than those in the third trimester group (P <0.05). Compared with the control group, (P <0.01), and decreased with the increase of pregnancy (P <0.01), while the levels of DD and Fg in pregnancy group were significantly higher than those in control group (P < 0.01). There was no significant difference in Fg between the first trimester and the second trimester (P> 0.05). The Fg increased significantly in the third trimester of pregnancy (P <0.01). Conclusion The normal pregnant women are in hypercoagulable state. The monitoring of coagulation index during pregnancy can detect the abnormal changes of coagulation function early, which is of great significance in preventing and salvage some complications of obstetrics.