摘要
目的:分析子痫前期患者血栓弹力图特征及对血栓前状态的预测效能。方法:选取2017年1月-2020年10月本院收治的68例子痫前期患者为研究对象,根据子痫前期轻重程度分为轻度组(轻度子痫前期组,n=44)、重度组(重度子痫前期组,n=24),同时选取同期健康孕中期产妇作为健康组(n=30),对比三组血栓弹力图(TEG)特征、血栓前状态指标及分析TEG参数与血栓前状态指标的相关性。结果:与健康组、轻度组相比,重度组TEG参数反应时间(R值)、凝血时间(K值)明显增大,最大凝块强度(MA值)、凝血综合指数(CI值)显著较小,差异均有统计学意义(P<0.05);与轻度组、健康组比较,重度组PLT明显降低,纤维蛋白原(FIB)、D-二聚体(D-D)明显升高,活化部分凝血酶时间(APTT)明显延长,差异均有统计学意义(P<0.05);Pearson相关性分析显示,TEG参数中R值、K值与FIB、D-D、APTT呈明显正相关,与PLT呈明显负相关(P<0.05);MA值、CI值与PLT呈明显正相关,与FIB、D-D、APTT呈明显负相关(P<0.05)。结论:TEG能有效反映重度子痫前期产妇的凝血与纤溶功能、血小板聚集功能等,从而有效评估产妇血栓前状态,利于医生快速、准确、全面评估产妇综合凝血全貌及出血风险,并调整和制定后续治疗方案。
Objective:To analyze the characteristics of thromboelastography in patients with preeclampsia and its predictive effect on prethrombotic state.Method:A total of 68 patients with preeclampsia admitted our hospital from January 2017 to October 2020 were selected as the research objects.According to the severity of preeclampsia,they were divided into mild group (mild preeclampsia group,n=44) and severe group (severe preeclampsia group,n=24).Meanwhile,healthy pregnant women in the second trimester of pregnancy in the same period were selected as the healthy group (n=30).The characteristics of TEG and prethrombotic state indexes among the three groups were compared,the correlation between TEG parameters and prethrombotic state indexes was analyzed.Result:Compared with the healthy group and the mild group,TEG parameters reaction time (R value),coagulation time (K value) of severe group were significantly increased,the maximum clot strength (MA value) and coagulation comprehensive index (CI value) were significantly smaller,the differences were statistically significant (P<0.05).Compared with the mild group and the healthy group,PLT of the severe group was significantly decreased,and the fibrinogen (FIB),D-Dimer (D-D) were significantly increased in the severe group,the differences were statistically significant (P<0.05).Pearson correlation analysis showed that R value and K value of TEG parameters were significantly positively correlated with FIB,D-D and APTT,but negatively correlated with PLT (P<0.05).MA value and CI value were significantly positively correlated with PLT,and negatively correlated with FIB,D-D and APTT (P<0.05).Conclusion:TEG can effectively reflect the coagulation and fibrinolysis function and platelet aggregation function of severe preeclampsia women,so as to effectively evaluate the prethrombotic state of pregnant women,which is conducive to doctors’ rapid,accurate and comprehensive assessment of the overall picture of maternal coagulation and bleeding risk,and adjust and formulate the follow-up treatment plan.
作者
黄雅
彭静
金松敏
朱丽仙
HUANG Ya;PENG Jing;JIN Songmin;ZHU Lixian(Kunming First People’s Hospital,Kunming 650011,China;不详)
出处
《中国医学创新》
CAS
2020年第33期30-34,共5页
Medical Innovation of China
关键词
子痫前期
血栓弹力图
血栓
凝血指标
Preeclampsia
Thromboelastography
Thrombus
Coagulation indexes
