摘要
目的探讨凝血功能4项、纤维蛋白原降解产物(FDP)、D-二聚体(D-Dimer)检测在产后出血诊断中的临床应用。方法将46例产后出血(出血量大于或等于500mL)孕妇作为产后出血组,另外50例出血量正常(出血量小于500mL)孕妇作为对照组,分别采用Sysmex CA-1500全自动血凝分析仪和Beckman AU640全自动生化分析仪检测此两组产前产后的凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)4项指标和D-Dimer、FDP的值并进行比较分析。结果产后出血组凝血功能4项及D-Dimer,FDP检测值异常率产前及产后均高于同期对照组(P<0.01);产后出血组PT、APTT、D-Dimer、FDP在产前及产后两个时期均高于同期对照组(P<0.01);产后出血组PT、APTT、D-Dimer、FDP产后高于产前(P<0.01),但是FIB产后低于产前(P<0.05),TT产前、产后差异无统计学意义(P>0.05)。结论及时积极对孕产妇进行产前凝血功能4项、FDP、D-Dimer检测有助于提前预防产后大出血的发生及降低孕妇产后出血的病死率,产前和产后血浆FDP、DDimer水平变化对产后出血更具有临床预警价值。
Objective To investigate the clinic value of the 4 parameters of coagulation funetion,FDP and D-Dimer in dissem- inated intravascular coagulation caused by postpartum hemorrhage. Methods 4 parameters of the prothrombin time （PT） ,activated partial prothrombin time （APTT）, thrombin time （TT）, fibrinogen （FIB） and D-Dimer, fibrinogen degradation products （FDP） were measured in 96 women who were divided into 2 groups according to the quality of hemorrhage. 46 pregnant women underwent postpartum hemorrhage were in postpartum hemorrhage group （intrapartum hemorrhage more than 500 mL） and 50 normal pregnant women （intrapartum hemorrhage less than 500 mL）were chose as control group. Results The abnormal rate of the postpartum hemorrhage group was higher than that of control group in antepartum and postpartum（P〈0.01）. The results of PT,APTT, D-Dimer and FDP of postpartum hemorrhage group were higher than those of the control group both in antepartum and postpartum （P〈0.01）. The results of PT,APTT,D-Dimer and FDP of postpartum hemorrhage group in postpartum were higher than those in antepartum （P〈0. 01） ,but the results of FIB in postpartum were lower than those in antepartum （P〈0.01）, the results of TT had no significant difference between antepartum and postpartum （P〉0.05）. Conclusion The timely detecting of the 4 parameters of coagulation function,FDP and D-Dimer for pregnant women will be helpful to prevent postpartum haemorrhage and reduce the mortality of postpartum hemorrhage. The change of plasma FDP and D-Dimer from antepartum to postpartum has more clinical value.
出处
《重庆医学》
CAS
北大核心
2015年第17期2384-2385,2388,共3页
Chongqing medicine
关键词
凝血功能4项
纤维蛋白纤维蛋白原降解物
D-二聚体
产后出血
the 4 parameters of coagulation {unction
{ibrin {ibrinogen degradation products, D-Dimer, postpartum hemor-rhage
