贵州医科大学学报

2019, v.44;No.227(08) 955-959+964

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妊娠妇女出凝血相关指标的影响因素及参考范围
Factors and Range of Coagulation Related Indexes in Pregnant Women

徐殿琴,冉连会,杨元,谭玉洁
XU Dianqin,RAN Lianhui,YANG Yuan,TAN Yujie

摘要(Abstract):

目的:探讨孕周及年龄因素对妊娠妇女凝血相关指标的影响,建立正常孕妇不同孕周凝血指标的参考范围。方法:1 099例正常妊娠妇女根据孕周分为孕早期、孕中期和孕晚期组,再根据怀孕年龄分为适龄组(25~29岁)、中年组(29~35岁)和高龄组(≥35岁),选择347例正常非妊娠妇女作为对照组;检测各组被检者凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)、纤维蛋白降解产物(FDP)、D二聚体(D-Dimer)及抗凝血酶Ⅲ(ATⅢ),分析孕周及年龄对妊娠期凝血指标的影响,建立妊娠妇女不同孕周适宜的凝血指标的参考范围。结果:与对照组相比,孕妇PT和APTT值随妊娠进展呈下降趋势,而FIB,FDP和D-二聚体水平逐渐升高(P<0.05),ATⅢ变化不显著(P>0.05);与适龄组相比,高龄组孕早期孕妇的PT及APTT值变化显著(P<0.05),而各年龄组孕中期和孕晚期孕妇各凝血指标比较差异无统计学意义(P>0.05);与目前临床使用的参考范围比较,本研究中PT、APTT及TT参考值范围的波动较小,而FDP、FIB及D-二聚体上限值随妊娠进展逐渐增大。结论:妊娠妇女的凝血指标主要受孕周影响,年龄仅对妊娠早期妇女影响较大,有必要建立不同孕周孕妇的凝血指标的参考范围。
Objective: To explore the effect of gestational age and age factors on coagulation related indexes of pregnant women and establish the reference range of coagulation indexes of normal pregnant women at different gestational weeks.Methods: 1099 normal pregnant women were divided into early pregnancy,second trimester and third trimester groups according to gestational age.According to the age of pregnancy,women were divided into appropriate age group(25~29 years old),middle age group(29~35 years old) and older group(≥35),and 347 normal non-pregnant women were selected as control group.The prothrombin time(PT),activated partial thromboplastin time(APTT),fibrin(FIB),thrombin time(TT),fibrin degradation product(FDP),D dimer(D-Dimer) and antithrombin III(ATIII) were detected in the persons of every group.The effects of gestational age and age on coa-gulation indexes during pregnancy were analyzed,and the suitable reference range of coagulation indexes for pregnant women at different gestational weeks was established.Results: Compared with the control group,the PT and APTT values of pregnant women were decreased with the progress of pregnancy,while the levels of FIB,FDP and D-dimer were increased gradually(P<0.05)and the change of ATIII was not significant(P>0.05).Compared with the age group,the PT and APTT values of pregnant women in the elderly group changed significantly in the early stage of pregnancy(P<0.05).However,there was no significant difference in coagulation indexes between the second trimester and the third trimester of pregnancy(P>0.05).Compared with the reference range of current clinical use,the reference range of PT,APTT and TT fluctuated little in this study,while the upper limit values of FDP,FIB and D-dimer increased gradually with the progress of pregnancy.Conclusion: The coagulation index of pregnant women is mainly affected by gestational weeks,and age only has a great influence on early pregnant women.It is necessary to establish the reference range of coagulation indexes of pregnant women at different gestational weeks.

关键词(KeyWords): 妊娠;孕周;出血;止血;参考范围
gestation;gestational age;bleeding;hemostasis;reference range

Abstract:

Keywords:

基金项目(Foundation): 贵州省科技厅项目[黔科合基础(2016)1121]

作者(Author): 徐殿琴,冉连会,杨元,谭玉洁
XU Dianqin,RAN Lianhui,YANG Yuan,TAN Yujie

DOI: 10.19367/j.cnki.1000-2707.2019.08.018

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