正常妊娠妇女不同时期凝血四项、D-二聚体及抗凝血酶Ⅲ的变化及临床意义

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摘要目的探讨正常妊娠妇女不同时期凝血四项、D-二聚体（D-D）及抗凝血酶Ⅲ（AT-Ⅲ）的变化及临床意义。方法选取2018年3月～2019年3月于柳州市妇幼保健院行产前检查的556 例无分娩史单胎妊娠妇女（孕早期135例，孕中期145 例，孕晚期140 例，待产期136 例）及150 例非孕妇作为研究对象，检测其凝血四项[凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（FIB）]、D-D 及AT-Ⅲ水平的差异。结果孕早期、孕中期、孕晚期及待产期妇女的PT、APTT、TT 均短于非孕妇，FIB、D-D 均高于非孕妇，差异有统计学意义（P＜0.05）。孕中期、孕晚期、待产期妇女的FIB、D-D 均高于孕早期妇女，孕晚期、待产期妇女的D-D 均高于孕中期妇女，差异有统计学意义（P＜0.05）。孕中期、孕晚期、待产期妇女的AT-Ⅲ均低于非孕妇，孕晚期、待产期妇女的AT-Ⅲ均低于孕早期、孕中期妇女，差异有统计学意义（P＜0.05）。孕早期妇女的AT-Ⅲ与非孕妇比较，孕晚期妇女FIB、D-D、AT-Ⅲ与待产期妇女比较，差异无统计学意义（P＞0.05）。结论正常妊娠妇女不同孕期凝血功能的变化可提示机体处于高凝状态，纤溶功能不断增强。

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	冼肖英
	陈华干

关键词 ：孕妇, 凝血功能, D-二聚体, 抗凝血酶Ⅲ

Abstract：Objective To explore the changes and clinical significance of blood coagulation four items, D-dimer (D-D)and antithrombin Ⅲ (AT-Ⅲ) in normal pregnant women at different stages. Methods A total of 556 single pregnant women without childbirth history (135 cases in the early pregnancy, 145 cases in the second trimester, 140 cases in the third trimester, and 136 cases in the expectant period) undergoing the prenatal examination in Liuzhou Maternal and Child Health Hospital from March 2018 to March 2019 and 150 non-pregnant women were selected as the research objects. The differences of blood coagulation four items (prothrombin time [PT], activated partial thromboplastin time[APTT], thrombin time [TT], fibrinogen [FIB]), D-D and AT-Ⅲwere detected among them. Results The PT, APTT and TT of women in the early pregnancy, the second trimester, the third trimester and the expectant period were shorter than those of non-pregnant women, FIB and D-D were higher than those of non-pregnant women, and the differences were statistically significant (P＜0.05). The FIB and D-D of women in the second trimester, the third trimester and expectant period were higher than those of women in the early pregnancy, and the D-D levels of women in the third trimester and expectant period were higher than those of women in the second trimester, with statistically significant differences (P＜0.05). The AT-Ⅲof women in the second trimester, third trimester and expectant period was lower than that of the non-pregnant women, the AT-Ⅲof women in the third trimester and expectant period was lower than that of women in the early pregnancy and in the second trimester, statistically significant differences (P＜0.05). There was no significant difference in AT-Ⅲbetween the women in the early pregnancy and non-pregnant women, and there were no significant differences in FIB, D-D, AT-Ⅲbetween the women in the third trimester and in the expectant period(P＞0.05). Conclusion Changes of blood coagulation function in normal pregnant women during different periods of pregnancy may indicate that the body is in a hypercoagulable state, and the fibrinolytic function is enhanced.

Key words： Pregnant woman Blood coagulation function D-dimer Antithrombin Ⅲ

基金资助:广西壮族自治区卫生和计划生育委员会自筹经费科研课题（Z2016539）

作者简介: 冼肖英，女，技师，主要从事孕产妇凝血研究

引用本文:

冼肖英；陈华干. 正常妊娠妇女不同时期凝血四项、D-二聚体及抗凝血酶Ⅲ的变化及临床意义[J]. 中国当代医药, 2020, 27(6): 170-173.
XIAN Xiao-ying； CHEN Hua-gan. Changes and clinical significance of blood coagulation four items, Ddimer and antithrombin Ⅲin normal pregnant women at different stages. 中国当代医药, 2020, 27(6): 170-173.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2020/V27/I6/170

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