摘要
目的探讨妊娠期高血压疾病(HDP)患者应用血浆凝血酶生成活性,判断HDP患者病情发展及预后。方法 2004年1月至2009年12月对上海市长宁区妇幼保健院、上海市宝山区罗店医院住院的妊娠妇女应用荧光发色底物分析方法,对妊娠期高血压疾病患者32例、轻度子痫前期35例、重度子痫前期38例(其中4例围产期发生急性D IC)和正常晚期孕妇50例血浆凝血酶生成活性进行检测,测定分析各组研究对象凝血酶生成的量和速度,并进行比较研究。结果正常孕妇凝血酶生成峰值为(362.0±29.6)nmol/L,妊娠期高血压疾病为(385.0±33.5)nmol/L,轻度子痫前期为(412.0±41.5)nmol/L,重度子痫前期为(624.0±67.6)nmol/L。轻、重度子痫前期患者较正常孕妇有显著增高(P<0.05),同时有纤维蛋白原及纤维蛋白降解产物D-二聚体(D-D)的明显改变,重度子痫前期凝血酶生成峰值与纤维蛋白原含量呈正相关关系(r=0.894,P<0.05)。结论轻、重度子痫前期患者存在不同程度的血栓前状态,重度子痫前期尤为明显。HDP患者血浆凝血酶生成活性检测可作为预测HDP患者血栓形成及D IC发生的实验室检查方法。
Objective To approach a method of evaluating and predicting the severity and the prognosis of HDP cases by detecting the plasma thrombin formation. Methods Automated fluorogenic substrate analysis was used to analyze thrombin formation rate and amount in 32 cases of gestational hypertension, 35 cases of moderate pre-eclampsia, 38 cases of severe pre-eelampsia, and 50 cases of midterm or late-term normal pregnancy in the Shanghai Changning Miaternity ＆ Infant Health Hospital between January 2004 and December 2009. Results Normal pregnancy thrombin peaked at （362.0 ± 29. 6） nmol/L, in HDP was （ 385.0 ± 33.5 ） nmol/L, in mild pre-eclampsia thrombin was （412. 0 ± 41.5 ） nmol/L, severe pre-eclampsia thrombin was （624. 0 ± 67. 6） nmoL/L, mild and severe pre-eclampsia thrombin was substantially elevated when compared with normal pregnancy （P 〈 0. 05 ,P 〈0. 01 ）. Thrombin elevation also accompanied with fibrinogen and decomposed D-dimer（D-D） change, in severe pre-eclampsia thrombin formation amount peaked and fibrinogen showed significant correlation （ r = 0. 894, P 〈 0. 05 ）. Conclusion Mild and severe pre-eclampsia patients showed different degree of Prethrombotic state, especially in severe pre-eclampsia. Special precaution should be taken for these patients to prevent DIC occurrence.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2011年第1期60-62,共3页
Chinese Journal of Practical Gynecology and Obstetrics
