孕晚期妊娠高血压孕妇和健康孕妇的凝血指标差异研究

Difference Research of Blood Coagulation Indicator Between Pregnant Women with Gestational Hypertension and Healthy Pregnant Women in the Third Trimester

摘要:

〔摘 要〕 目的：通过比较深圳地区孕晚期妊娠高血压孕妇和健康孕妇凝血指标的差异，探讨凝血检验指标在妊 娠期孕妇临床诊疗中的应用价值。 方法：选取 2021 年 4 月至 2021 年 12 月在深圳市妇幼保健院做产前检查的 393 例 健康孕妇，分为孕早期组 177 例，孕中期组 108 例，孕晚期组 108 例，另选取同期的 130 例健康未孕妇女作为对 照组，以及 160 例孕晚期妊娠高血压孕妇为病例组。检测并统计所有孕妇凝血酶原时间（PT）、活化部分凝血活 酶时间（APTT）、纤维蛋白原（Fib）、凝血酶时间（TT）、抗凝血酶 Ⅲ（AT–Ⅲ）和 D– 二聚体（DD）数据。 结果：病例组 PT、AT–Ⅲ 均低于正常早、中、晚孕期组，Fib、DD 高于正常早、中、晚孕期组，差异具有统计学意义 （P ＜ 0.05）；以孕晚期高血压为结局作二元 logistic 回归分析，Fib、DD 是孕晚期妊娠高血压的危险因素；在鉴别 诊断孕晚期妊娠高血压诊断效能时，其中 PT、Fib、AT–Ⅲ、DD、联合检测的曲线下面积（AUC）分别为 0.684、0.571、 0.646、0.688、0.790，P ＜ 0.05。 结论：检测孕晚期妊娠高血压凝血参数的变化，可为医生准确诊断和治疗妊娠期疾 病提供有效的依据。

Abstract:

〔Abstract〕 Objective To explore the application value of coagulation test index in clinical diagnosis and treatment of pregnant women with hypertension in the third trimester of pregnancy in Shenzhen by comparing the difference of coagulation indicator between pregnant women and healthy pregnant women. Methods A total of 393 pregnant women who underwent prenatal examination in Shenzhen Maternal and Child Health Hospital from April 2021 to December 2021 were selected and divided into the first trimester group (177 cases), the second trimester group (108 cases), and the third trimester group (108 cases). In addition, 130 healthy non_x0002_pregnant women in the same period were selected as the control group, and 160 pregnant women with gestational hypertension in the third trimester were selected as the case group. The prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib), thrombin time (TT), antithrombin Ⅲ (AT-Ⅲ) and D-dimer (DD) data of all pregnant women were detected and statistically analyzed. Results PT and AT-Ⅲ in case group were lower than those in the normal first, second and third trimester group, while Fib and DD were higher than those in the normal first, second and third trimester group, and the differences were statistically significant (P < 0.05). Binary logistic regression analysis showed that Fib and DD were risk factors for gestational hypertension in the third trimester. The area under curve (AUC) of PT, Fib, AT-Ⅲ, DD and combined detection were 0.684, 0.571, 0.646, 0.688, 0.790, respectively, P < 0.05. Conclusion Detection of the changes of coagulation parameters of gestational hypertension in the third trimester of pregnancy can provide effective basis for doctors to accurately diagnose and treat gestational diseases.