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目的探讨外源性促性腺激素行控制性超促排卵后行体外受精-胚胎移植术前患者血液凝血状态及血栓形成风险。方法 103名应用促排卵药物促性腺激素释放激素激动剂(GnRHa)后拟行体外受精-胚胎移植患者,按GnRHa用量分为:观察1组(GnRHa 1.25 mg,n=35)、观察2组(GnRHa 1.875 mg,n=35)及观察3组(GnRHa3.75 mg,n=33);以56名健康非妊娠妇女作为对照组。对4个组作产前凝血4项(PT、APTT、TT、Fib)检测,同时作血栓弹力图(TEG)检测,比较分析2种检测结果。结果凝血4项试验检测中,观察1、2、3组及对照组的PT(s)分别为9.1±1.6、7.2±1.2、6.2±0.9和12.2±1.2(P<0.05)。TEG检测,观察1、2、3组及对照组的R值(min)分别为4.6±1.8、4.2±3.2、3.2±3.2和6.2±1.2;CI值分别为1.2±0.7、1.6±0.2、3.6±2.7和-0.85±0.8(P<0.05);TEG检测参数K值与PT呈正相关,Angle角、MA值、G值及CI值与PT呈副相关;TEG检测参数Angle角与Fib呈正相关;观察1、2、3组用药前R值(min)分别为8.2±1.1、7.6±1.2、7.9±2.2,用药后R值(min)分别为4.6±1.8、4.2±3.2、3.2±3.2,(P<0.05)。结论 TEG可动态观察应用促排卵药物行体外受精-胚胎移植术前患者体内凝血状态,能及时了解体内凝血状况,对预防应用促排卵药物引起的卵巢过度刺激综合征的并发症血栓栓塞具有一定临床意义。
Objective To investigate the blood coagulation status and thrombosis risk in patients undergoing IVF-ET before controlled ovulation (ESOP) with exogenous gonadotropin. Methods One hundred and three patients with in vitro fertilization and embryo transfer after ovulation induction with GnRHa were divided into observation group 1 (GnRHa 1.25 mg, n = 35) and observation group 2 GnRHa 1.875 mg, n = 35) and observation group 3 (GnRHa3.75 mg, n = 33). Fifty-six healthy non-pregnant women served as the control group. Four prenatal coagulation tests (PT, APTT, TT, Fib) were performed on the four groups. TEG tests were also performed on the four groups to compare the results of the two tests. Results In the four tests of coagulation, PT (s) of observation group 1,2,3 and control group were 9.1 ± 1.6,7.2 ± 1.2,6.2 ± 0.9 and 12.2 ± 1.2 respectively (P <0.05). TEG, the R values (min) of observation group 1, 2, 3 and control group were 4.6 ± 1.8, 4.2 ± 3.2, 3.2 ± 3.2 and 6.2 ± 1.2 respectively; the CI values were 1.2 ± 0.7, 1.6 ± 0.2 and 3.6 ± 2.7 and -0.85 ± 0.8 respectively (P <0.05). The K value of TEG was positively correlated with PT, while Angle, MA, G and CI were correlated with PT. The Angle of TEG was positively correlated with Fib. The R values (min) before treatment in groups 1,2,3 were 8.2 ± 1.1, 7.6 ± 1.2 and 7.9 ± 2.2, respectively, and the values of R after treatment were 4.6 ± 1.8, 4.2 ± 3.2 and 3.2 ± 3.2, respectively P <0.05). Conclusion TEG can dynamically observe the blood coagulation status of patients before IVF-ET with in vitro fertilization and embryo transfer, and can know the coagulation status in vivo in time. It is of clinical significance to prevent thromboembolism of complications of ovarian hyperstimulation syndrome caused by ovulation induction. significance.