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目的检测妊娠晚期女性凝血四项、纤维蛋白(原)降解产物(FDP)及D-二聚体(DD)水平,分析其变化及临床意义,为临床提供参考依据。方法选取2016年1月-12月就诊的9 200例妊娠晚期女性为妊娠晚期组,选取同期的1 200例健康非妊娠女性为健康对照组。采集两组女性清晨空腹静脉血,检测凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、纤维蛋白(原)降解产物(FDP)及D-二聚体(DD)水平。根据孕周将妊娠晚期组分为Ⅰ组(31~37孕周)、Ⅱ组(38~40孕周)、Ⅲ组(41~42孕周),比较不同孕周女性PT、TT、APTT、FIB、FDP及DD水平。结果与健康对照组比较,妊娠晚期组女性PT、TT、APTT均明显缩短,FIB、FDP及DD水平均明显升高,差异均有统计学意义(均P<0.05)。Ⅰ组与Ⅱ组PT、TT、APTT、FIB、FDP、DD比较,差异均有统计学意义(均P<0.05);Ⅰ组与Ⅲ组PT、TT、APTT、FIB、FDP、DD比较,差异均有统计学意义(均P<0.05);Ⅱ组与Ⅲ组PT、TT、APTT、FIB、FDP、DD比较,差异均无统计学意义(均P>0.05)。结论妊娠晚期女性机体处于高凝状态,动态监测凝血功能指标可指导临床合理治疗及用药。
Objective To detect the levels of coagulation, fibrinogen (FDP) and D-dimer (DD) in third trimester of pregnancy, and to analyze the changes and clinical significance of these indexes for clinical application. Methods A total of 9 200 pregnant women in the third trimester of pregnancy who were seen from January to December in 2016 were selected as the third trimester of pregnancy. One hundred and two healthy nonpregnant women of the same period were selected as the healthy control group. Fasting venous blood samples were collected from two groups of women in the morning. Prothrombin time, PT, APTT, fibrinogen (FIB) FDP) and D-dimer (DD) levels. According to gestational age, the third trimester of pregnancy was divided into group Ⅰ (31-37 gestational weeks), group Ⅱ (38- 40 gestational weeks) and group Ⅲ (41-42 weeks gestation). PT, TT, APTT, FIB, FDP and DD levels. Results Compared with the healthy control group, the levels of PT, TT and APTT were significantly shortened and the levels of FIB, FDP and DD were significantly increased in the third trimester of pregnancy (all P <0.05). The differences of PT, TT, APTT, FIB, FDP and DD between group Ⅰ and group Ⅱ were statistically significant (all P <0.05) (All P <0.05). There was no significant difference in PT, TT, APTT, FIB, FDP and DD between group Ⅱ and group Ⅲ (all P> 0.05). Conclusions In the third trimester of pregnancy, the female body is in hypercoagulable state. The dynamic monitoring of coagulation function can guide clinical rational treatment and medication.