凝血四项在不同孕期妇女中的变化趋势和临床意义

张景

（眉县人民医院检验科，陕西 宝鸡，722300）

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摘要：

目的 探讨不同孕期妇女中凝血四项凝血酶原时间（PT）、部分活化凝血酶时间（APTT）、凝血酶时间（TT）和纤维蛋白原 （Fib）的变化趋势以及检测的应用价值。方法 选取于2015年8月至2016年8月来我院就诊的不同妊娠期（早期、中期、晚期）120例妊娠妇女作为试验组，选取2015年8月至2016年8月来我院进行健康体检的非孕妇女80例作为对照组，应用全自动血凝仪检测两组受检者的PT、APTT、TT 和Fib。结果 试验组早期组凝血四项检测结果与对照组比较，差异不具有统计学意义（P>0.05）；和对照组以及早期组妇女相比，妊娠中、晚期组妇女的PT、APTT、TT 时间明显更少，而Fib 含量则明显更高，差异具有统计学意义（P<0.05）。结论 凝血指标变化趋势既是产妇产后短时间内迅速止血的物质基础，同时也是诱发妊娠期血栓性疾病的重要诱因，加强对凝血四项指标的检测，有助于减少妊娠期血栓的发生。

关键词：凝血四项；妊娠期；检测价值

中图分类号：R446.11文献标志码：A文章编号：2096-1413(2017)20-0112-02

Changes and clinical significance of four items of blood coagulation in different period of pregnant women
ZHANG Jing
(Department of Laboratory, People``s Hospital of Mei County, Baoji 722300, China)

ABSTRACT: Objective To study and explore the change trend of blood prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and fibrinogen (Fib) in the different period of pregnant women and the detection application value. Methods One hundred and twenty cases of different period of pregnancy women (early, middle and late pregnancy) in our hospital for treatment from August 2015 to August 2016 were selected as the experimental group, another 80 cases of non pregnant healthy women conducting physical examination in our hospital from August 2015 to August 2016 were set as the control group. The PT, APTT, TT and Fib were detected with full automatic blood coagulation in the two groups. Results In early pregnancy, the four items of blood coagulation test results in the experimental group had no statistically significant difference compared with those of the control group (P>0.05); compared with early pregnant women and control group, PT APTT TT in the middle and late pregnancy were significantly lower, but the Fib content was significantly higher (P<0.05). Conclusion The change trend of blood clotting is not only the material basis for rapid hemostasis in seconds, but also an important cause of thrombotic disease in pregnancy. It helps to reduce incidence of thrombosis during pregnancy to strengthen the inspection of the four indexes of blood coagulation.

KEYWORDS: coagulation four term; gestational period; detection value

参考文献：
[1] 吴杰,曾海燕.不同妊娠时期孕妇血浆D-二聚体及凝血四项变化分析[J].中国医药科学,2014,4(19):103-108.
[2] 王福义.正常孕妇不同孕期血浆D-二聚体的水平变化及临床意义[J].中国现代药物应用,2016,10(2):31-32.
[3] 林少荣,陈曼娜,周蓉,等.正常孕妇血浆D-二聚体的检测的临床分析[J].齐齐哈尔医学院学报,2015,36(12):1743-1744.
[4] 王峰,李美红,李春仙,等.宁波地区妊娠妇女血浆D-二聚体水平变化及静脉血栓栓塞性疾病的研究[J].中国妇幼保健,2016,31(4):705-707.
[5] 孔莹,刘泽金,刘世国.不同孕期妇女部分纤溶指标和C 反应蛋白水平变化[J].微循环学杂志,2013,23(3):33-34.
[6] 袁恩武,张玉瑢,娄小风,等.正常孕妇不同孕期D-二聚体和纤维蛋白降解产物参考区间调查[J].中国妇幼保健,2015,30(18):2934-2936.
[7] 周卫萍,顾桂兰.产前孕妇凝血四项联合抗凝血酶、D 二聚体检测的意义[J].血栓与止血学,2012,18(5):229-230.
[8] QUAH C,SYME G,SWAMY GN,et al.Obesity and recurrent intervertebral disc prolapse after lumbar microdiscectomy [J].Ann R Coll Surg Engl,2014,96(2):140-143.
[9] 田宇,马梦影,徐妍妍,等.孕产妇产前凝血四项、D-二聚体和血小板的检测分析[J].国际检验医学杂志,2014,8(16):2156-2158.
[10] BALAJI VR,CHIN KF,TUCKER S,et al.Recovery of severe motor deficit secondary to herniated lumbar disc prolapse: is surgical intervention important a systematic review [J].Eur Spine J,2014,23 (9):1968 -1977.
[11] 吴世园.孕中期、临产期凝血四项与D 二聚体的变化和临床意义 [J].国际检验医学杂志,2015,37(12):1713-1714,1717.
[12] 邹庆红.D-二聚体和凝血4 项检测在孕妇产前检查中的临床价值分析[J].四川医学,2013,34(2):284-286.
[13] 杨军,李彬.凝血功能4 项、FDP、D-Dimer检测在诊断产后出血中的临床应用[J].重庆医学,2015,44(17):2384-2385,2388.
[14] 梁月连,梁汝忠,黄兰祝.高血压脑出血偏瘫患者护理及早期肢体康复训练的意义[J].辽宁医学院学报,2013,34(3):89-90.