[1]郑少娟,李亮*.凝血指标测定对妊娠期高血压疾病诊断与鉴别诊断的应用效果分析[J].中国计划生育和妇产科,2018,(10):43-46.
　ZHENG Shao-juan,LI Liang*.Analysis of application of coagulation index determination in diagnosis and differential diagnosis of hypertensive disorder complicating pregnancy[J].Chinese Journal of Family Planning & Gynecotokology,2018,(10):43-46.
点击复制

凝血指标测定对妊娠期高血压疾病诊断与鉴别诊断的应用效果分析
分享到：

《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2018年10期
页码:
43-46
栏目:
论著与临床
出版日期:
2018-10-25

文章信息/Info

Title:
Analysis of application of coagulation index determination in diagnosis and differential diagnosis of hypertensive disorder complicating pregnancy
作者:
郑少娟; 李亮*
汕尾市人民医院妇产科
Author(s):
ZHENG Shao-juan; LI Liang*
Department of Gynecology and Obstetrics,People's Hospital of Shanwei,Shanwei Guangdong 516600,P.R.China
关键词:
凝血指标; 妊娠期高血压疾病; 子痫; 相关性
Keywords:
coagulation index; hypertensive disorder complicating pregnancy; eclampsia;  correlation
分类号:
R 713.4
摘要:
目的探究凝血指标的测定对妊娠期高血压疾病（hypertensive disorder complicating pregnancy,HDCP）的诊断和严重程度的评估价值。方法选取2016～2017年汕尾市人民医院收治的HDCP患者148例为研究对象，根据HDCP的分类诊断标准，将其分为妊娠期高血压组（38例）、轻度子痫前期组（44例）、重度子痫前期或子痫组（66例），选取同期入院的正常晚期妊娠妇女40例（正常晚孕组）为对照组。分析并观察凝血指标与HDCP及其严重程度的相关性。结果3个疾病组的凝血酶原时间（prothrombin time,PT）、凝血酶时间（thrombin time，TT）和活化部分凝血酶时间(activated partial thromboplastin time,APTT)较正常晚孕组明显降低，而纤维蛋白原(fibrinogen,FIB)明显升高（P均＜005）;PT随病情加重而下降，而FIB随病情加重逐渐升高（P均＜005）;3个疾病组血小板体积分布宽度（platelet distribution width,PDW）和血小板平均容积(mean platelet volume，MPV)较正常晚孕组明显升高，而血小板计数（platelet count, PLT）明显降低（P均＜005）；PDW和MPV也随病情加重而增加，而PLT随病情加重而降低、差异均有统计学意义（P均＜005）;3个疾病组的D-二聚体（D-Dimer,D-D）和纤维蛋白原降解产物（fibrinogen degradation products,FDP）均高于正常晚孕组（P均＜005）；D-D和 FDP两项指标随病情加重逐渐升高，而抗凝血酶Ⅲ低于正常晚孕组，且随病情加重而逐渐降低，差异均有统计学意义（P均＜005）。结论高凝血状态和血小板活化程度对HDCP的评估和治疗具有重要意义。
Abstract:
ObjectiveTo explore the value of coagulation markers in the diagnosis and severity assessment of hypertensive disorder complicating pregnancy(HDCP). Methods148 patients with HDCP in People's Hospital of Shanwei from 2016 to 2017 were selected as the study group, and the correlation between the coagulation index and the severity of HDCP was analyzed and observed. ResultsThe PT, TT and APTT in the three groups were significantly lower than those in the normal late pregnancy group, while the FIB was significantly higher(P<005). PT decreased with the aggravation of the disease,while FIB gradually increased with the aggravation of the disease(P<005); the PDW and MPV of the three disease groups showed a significant increase compared with the normal late pregnancy group, while the PLT decreased significantly (P<005).PDW and MAV also increased with the aggravation of the disease, while PLT decreased with the aggravation of the disease(P<005); the DD and FDP of the three disease groups were significantly higher than those of the normal late pregnancy group(P<005); the two indexes of DD and FDP gradually increased with the severity of the disease, while the AT-III was lower than the normal late pregnancy group. And gradually decreased with the severity of the disease, there were statistical differences(P<005).ConclusionThe high coagulation state and the degree of platelet activation may be of great significance for the evaluation and treatment of HDCP.

参考文献/References:

［1］温海勋．研究血小板平均容积在疾病中的变化 ［J］．世界最新医学信息文摘，2017，17（1）：27-28． ［2］张春英，刘兰莲．责任制整体护理模式下应用护理程序存在的问题与改进对策 ［J］．齐鲁护理杂志，2016，22（14）：107-108． ［3］乐杰．妇产科学 ［M］．北京：人民卫生出版社，2008：72-74． ［4］冯燕，徐军娟．妊娠期高血压疾病患者凝血功能及血小板参数变化与疾病严重程度的相关性分析 ［J］．中国妇幼保健，2016，31（5）：947-948． ［5］李惠娟．妊娠期高血压孕妇妊娠晚期凝血功能变化分析 ［J］．中外医疗，2015，34（21）：8-9． ［6］史玉霞，杨一新，许倩，等．妊娠期高血压疾病患者血小板参数和凝血功能指标的变化及意义 ［J］．海南医学院学报，2015，21（10）：1384-1386． ［7］JAGROOP I A, MIKHAILIDIS D P. Mean platelet volume is a useful parameter: a reproducible routine method using a modified Coulter Thrombocytometer ［J］. Platelets, 2001, 12 (3): 171. ［8］陆奕华，吴星光，崔艳双．妊娠期高血压疾病患者凝血功能及血小板参数的变化 ［J］．海南医学，2014，25（12）：1805-1806． ［9］刘晓洁．合体滋养细胞微绒毛膜在子痫前期发病中作用的研究 ［D］．重庆：第三军医大学，2014． ［10］王晓岩，王青，熊祝嘉，等．凝血指标、免疫因子和综合征病情的关系观察 ［J］．标记免疫分析与临床，2017，24（4）：396-400． ［11］廖丹. D-二聚体、凝血指标、血小板参数检测对妊娠高血压疾病的应用价值 ［J］.2014,18（4）：621-623. ［12］王鲁霞，路海云，温春良．责任制整体护理在优质护理病房中的实施与成效 ［J］．齐鲁护理杂志，2013，19（4）：100-101． ［13］赵一兵．妊娠高血压孕妇血浆D-二聚体及凝血指标检测的临床意义 ［J］．现代医药卫生，2017，33（18）：2838-2839． ［14］童蓉．西宁地区正常孕妇与妊娠期高血压疾病孕妇凝血功能的对照研究 ［J］．青海医药杂志，2014，44（11）：18-19． ［15］KARPMAN D, LETHAGEN S, KRISTOFFERSSON A, et al. Von Willebrand factor mediates increased platelet retention in recurrent thrombotic thrombocytopenic purpura ［J］. Thrombosis and Haemostasis, 1997, 78 (1): 1456-1462.

相似文献/References:

[1]黄辉秀,谭毅.妊娠期高血压疾病预测和预防的研究现状[J].中国计划生育和妇产科,2009,(05):0.
　HUANG Hui-xiu,TAN Yi MCH Hospital of Fangcheng urban district,Fangchenggang city Guangxi automous region 80,et al.[J].Chinese Journal of Family Planning & Gynecotokology,2009,(10):0.
[2]张珺,仲红丽.妊娠期高血压疾病监测系统预测及早期干预520例临床分析[J].中国计划生育和妇产科,2009,(06):0.
[3]肖兵,高岩,熊庆,等.妊娠期高血压疾病的流行病学研究进展[J].中国计划生育和妇产科,2010,(01):0.
[4]何怡,赵可文,唐莉,等.卡孕栓防治妊娠期高血压疾病产后出血的疗效观察[J].中国计划生育和妇产科,2010,(02):0.
　HE Yi,ZHAO Ke-wen,TANG LiMCH hospital of Dongguan city,et al.[J].Chinese Journal of Family Planning & Gynecotokology,2010,(10):0.
[5]庞春蓉,傅晓冬.肾上腺髓质素与妊娠期高血压疾病[J].中国计划生育和妇产科,2010,(02):0.
[6]陈倩,段成城,傅晓冬,等.血清T辅助细胞比率与妊娠期高血压疾病的关系和意义[J].中国计划生育和妇产科,2010,(03):0.
　CHEN Qian,DUAN Cheng-cheng,FU Xiao-dong..[J].Chinese Journal of Family Planning & Gynecotokology,2010,(10):0.
[7]陈茜松,刘丽俊,季淑英,等.妊娠期高血压疾病患者血清抵抗素水平的变化及其临床意义[J].中国计划生育和妇产科,2011,(03):0.
　CHEN Qian-song,LIU Li-jun,JI Shu-ying.[J].Chinese Journal of Family Planning & Gynecotokology,2011,(10):0.
[8]侯卫萍,程兰,黄立,等.血清胱抑素C在妊娠期高血压疾病中的应用[J].中国计划生育和妇产科,2011,(06):0.
　HOU Wei-ping,CHENG Lan,HUANG Li.[J].Chinese Journal of Family Planning & Gynecotokology,2011,(10):0.
[9]刘圣英,杨建恩.孕期补钙预防高危孕妇妊娠期高血压疾病的临床观察[J].中国计划生育和妇产科,2012,(03):0.
　LIU Sheng-ying,YANG Jian-en.[J].Chinese Journal of Family Planning & Gynecotokology,2012,(10):0.
[10]金爽,尹春艳.IGF-Ⅰ、IGF-Ⅱ、IGFBP-1与妊娠期高血压疾病的相关性研究[J].中国计划生育和妇产科,2012,(05):0.
　JIN Shuang,YIN Chun-yan University of South China Teaching Hospital,the Second Peoples Hospital in Guangdong Province,et al.[J].Chinese Journal of Family Planning & Gynecotokology,2012,(10):0.
[11]李秀军,张轶岚*,叶兆兰.川芎嗪注射液联合阿司匹林对妊娠期高血压疾病患者凝血指标及母婴结局的影响[J].中国计划生育和妇产科,2018,(8):72.
　LI Xiu-jun,ZHANG Yi-lan*,YE Zhao-lan.Effect of ligustrazine injection combined with aspirin on blood coagulation index and maternal and infant outcome in patients with hypertensive disorder complicating pregnancy[J].Chinese Journal of Family Planning & Gynecotokology,2018,(10):72.

更新日期/Last Update: 2018-10-25