摘要
目的探讨妊娠晚期糖尿病孕妇的血小板活化状态、血管内皮损伤、抗凝及纤溶系统部分功能指标的变化及其临床意义。方法检测了正常非孕妇女、正常晚期妊娠妇女各20例和46例妊娠晚期糖尿病孕妇的血管性血友病因子、血小板α-颗粒膜蛋白、抗凝血酶-Ⅲ、蛋白C系统筛选、纤溶酶原、组织纤溶酶原激活物及其抑制物、D-二聚体等指标的含量。结果与正常非孕组及正常晚期妊娠组比较,妊娠晚期糖尿病孕妇组血管性血友病因子、血小板α-颗粒膜蛋白、组织纤溶酶原抑制物水平均显著增高(P<0.01),组织纤溶酶原激活物活性明显低于正常晚期妊娠组(P<0.01);与正常非孕组比较,正常晚期妊娠组和妊娠期糖尿病组空腹血糖、纤溶酶原、D-二聚体等指标均显著增高(P<0.01)。与正常晚期妊娠组比较,妊娠期糖尿病组空腹血糖、纤溶酶原、D-二聚体均显著增高(P<0.01),抗凝血酶-Ⅲ、蛋白C活性依赖凝固时间在正常晚期妊娠组较非孕组呈下降趋势,妊娠期糖尿病患者AT-III水平与正常晚期妊娠组无显著差异。结论正常晚期妊娠妇女血液处于血栓前状态,而糖尿病孕妇存在着明显的血栓前状态,因此,糖尿病孕妇产前测定凝血和纤溶功能指标,对监测病情、指导治疗、改善预后具有一定的价值。
Objective To study the clinical implications of changes of coagulation function and fibrinolytic system in patients with gestational diabetes mellitus （GDM）. Methods Twenty non-pregnant women, 20 with normal pregnancy and 46 with GDM were enrolled in this study for examinations ofplatelet alpha-granule membrane protein （GMP-140）, Von Willebrand factor （vWF）, antithrombin Ⅲ activity （AT-Ⅲ ）, plasminogen activity （PLG）, activity of tissue-type plasminogen activator （t-PA） and plasminogen activator inhibitor （PAI）. Results vWF, GMP-140, PLG, D-dimer, PAI were obviously elevated while t-PA was lower in GDM patients as compared with the measurement in non-pregnant women and women with normal pregnancy （P〈0.01）. AT-Ⅲ and ProC measurement showed no significant differences between GDM patients and women of the other two groups. Conclusion GDM patients may have elevated platelet activation and fibrinolyic activity as well as vascular endothelial injuries, and antenatal assessment of the coagulation function can be of value for prevention and treatment of GDM.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2007年第1期35-37,共3页
Journal of Southern Medical University
基金
广东省重大社会问题攻关项目(2KB04701S)~~
关键词
妊娠期糖尿病
血管内皮细胞
血小板活化
抗凝系统
纤溶系统
gestational diabetes mellitus
vascular endothelium
platelet activation
antithrombotic system
fibrinolyic system
