论文部分内容阅读
目的了解早期妊娠凝血、抗凝、血栓形成、纤溶和抗纤溶状态的改变。方法选取105例妊娠10～12周孕妇为研究组,另选取82例正常未孕者为对照组。测定凝血状态指标,包括凝血常规即血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fg)以及凝血酶原片段1+2(F1+2)、凝血酶-抗凝血酶复合物(TAT),同时测定抗凝、纤溶与抗纤溶分子标志物,包括抗凝血酶-Ⅲ(AT-Ⅲ)、血小板颗粒糖蛋白140(GMP140)、血栓烷B2(TXB2)、D二聚体(D-Ⅱ)、纤溶酶原激活物抑制物(PAI-2)。结果研究组Fg、F1+2、TAT、D-Ⅱ、PAI-2分别为4.00、179.95、0.66、201.51、46.80,明显高于对照组的2.52、39.46、0.31、125.02、5.87,差异有统计学意义(P<0.008),而研究组反映血栓形成的指标GMP140为9.42,显著低于对照组的19.13,差异有统计学意义(P<0.008)。结论正常妊娠早期,血液凝血功能增强,抗凝状况无明显改变,纤溶活性及抗纤溶活性出现亢进,血栓形成减少,这样的改变可能有利于保持充足的胎盘子宫血流灌注量。
Objective To understand the changes of coagulation, anticoagulation, thrombosis, fibrinolysis and antifibrinolytic status in early pregnancy. Methods 105 pregnant women from 10 to 12 weeks of gestation were selected as the study group, and 82 normal pregnant women were selected as the control group. The indexes of coagulation state were determined, including coagulation routine, namely prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fg) and prothrombin fragment 1 + 2 F1 + 2), thrombin-antithrombin complex (TAT), and simultaneously determine anticoagulant, fibrinolysis and antifibrinolytic molecular markers including antithrombin-Ⅲ (AT-Ⅲ), platelet granulocyte glycoprotein 140 (GMP140), thromboxane B2 (TXB2), D dimer (D-II) and plasminogen activator inhibitor (PAI-2). Results The levels of Fg, F1 + 2, TAT, D-Ⅱ and PAI-2 in the study group were 4.00,179.95,0.66 and 201.51 and 46.80 respectively, which were significantly higher than those in the control group (2.52,39.46,0.31,125.02,5.87) (P <0.008). However, the GMP140, a measure of thrombosis, was 9.42 in the study group, which was significantly lower than that of the control group (19.13) (P <0.008). Conclusion In the early stage of normal pregnancy, blood coagulation function is enhanced, anticoagulation status is not changed, fibrinolytic activity and anti-fibrinolytic activity are hyperthyroidism, and thrombus formation is reduced. Such changes may be helpful to maintain sufficient placental uterine blood perfusion.