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目的:总结分析妊娠晚期导致孕妇血小板及凝血检测结果异常的原因、发生频率以及检测方法上要注意的问题。方法:以2008年9月～2009年8月间的住院孕妇作为研究对象,按妊娠并发症分类,以正常晚期妊娠妇女作为对照,分析血小板参数、凝血常规四项(PT、APTT、TT、FIB)。结果:①妊娠高血压综合征(PIH)组和妊娠糖尿病(GDM)组的血小板平均体积(MPV)值高于对照组;②妊高征组血小板降低、MPV升高、凝血指标未见明显异常。③妊娠糖尿病组的PT、APTT、FIB与对照组比较有显著性差异。④妊娠晚期孕妇发生血小板减少的原因以妊娠生理性原因和重度妊高征为主(58.4%和20.7%),其他原因还包括:双胎妊娠、母儿血型不合、EDTA依赖性假性PLT减少。结论:多种妊娠相关性疾病可引起妊娠晚期孕妇的血小板减少,血小板参数异常,同时需要注意鉴别EDTA依赖性假性PLT减少,避免误诊。
OBJECTIVE: To summarize the causes, frequency of occurrence and frequency of detection of abnormal platelet and coagulation in pregnant women during the third trimester of pregnancy and to pay attention to the detection methods. Methods: The hospitalized pregnant women from September 2008 to August 2009 were selected as research objects. According to the classification of pregnancy complications, normal pregnant women were used as control. The platelet parameters, routine coagulation parameters (PT, APTT, TT, FIB ). Results: ① The mean platelet volume (MPV) in PIH group and GDM group was higher than that in control group. ②The platelets in PIH group were decreased, MPV was elevated, and no significant abnormality was found in coagulation index . ③ gestational diabetes mellitus group PT, APTT, FIB compared with the control group were significantly different. (4) The causes of thrombocytopenia in pregnant women in the third trimester were mainly physiological causes of pregnancy and severe pregnancy-induced hypertension (58.4% and 20.7%). Other reasons included twin pregnancy, maternal and child type incompatibility and EDTA-dependent reduction of pseudo PLT . CONCLUSIONS: A variety of pregnancy-related diseases can cause thrombocytopenia and abnormal platelet parameters in pregnant women of the third trimester. At the same time, it is necessary to pay attention to the identification of EDTA-dependent pseudo-PLT reduction and avoid misdiagnosis.