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目的:探讨促血小板生成素(TPO)和平均血小板体积(MPV)在评价孕妇高凝状态中的应用价值。方法:检测41例健康孕妇在早孕期、中孕期和晚孕期的TPO、MPV、抗凝血酶-3(AT-3)、纤维蛋白原(FIB)、D-二聚体(D-D)和血小板聚集率(PAR)水平,计算孕妇各指标的阳性率,并分析TPO、MPV和其余指标间的相关性;同时选取30例健康非孕妇女为正常对照组。结果:妊娠组中孕期TPO和MPV显著高于早孕期和对照组,晚孕期二者水平显著高于中孕期(P<0.01);中孕期AT-Ⅲ、FIB、D-D和PAR水平与早孕期比较无统计学差异(P>0.05),晚孕期FIB、D-D和PAR水平显著高于中孕期,AT-Ⅲ水平显著低于中孕期(P<0.001)。TPO与MPV呈显著正相关;TPO和MPV与AT-Ⅲ呈显著负相关,与FIB、D-D和PAR呈显著正相关(P<0.01)。中孕期TPO、MPV、AT-Ⅲ、FIB、D-D、PAR和TPO+MPV阳性率显著高于早孕期,晚孕期各指标阳性率均显著高于中孕期(P<0.01)。中孕期和晚孕期TPO、MPV的阳性率均显著高于AT-Ⅲ、D-D和PAR阳性率,不同孕期TPO+MPV的阳性率均显著高于其余4个指标的阳性率(P<0.01)。结论:TPO和MPV可能是导致孕妇血液高凝状态的更重要因素,联合测定TPO和MPV在监测孕妇围产期高凝状态的发展和预防血栓形成中具有重要的价值。
Objective: To investigate the value of thrombopoietin (TPO) and mean platelet volume (MPV) in evaluating hypercoagulability in pregnant women. Methods: The serum levels of TPO, MPV, AT-3, fibrinogen (FIB), D-dimer and platelet in 41 healthy pregnant women were measured in the first trimester of pregnancy, (PAR), calculate the positive rate of each index of pregnant women, and analyze the correlation between TPO, MPV and other indicators; At the same time select 30 healthy non-pregnant women as the normal control group. Results: The levels of TPO and MPV in pregnancy group were significantly higher than those in first trimester and control group, while the levels in late pregnancy were significantly higher than those in middle trimester (P <0.01). The levels of AT-Ⅲ, FIB, DD and PAR in middle trimester were significantly higher than those in early trimester There was no significant difference (P> 0.05). The levels of FIB, DD and PAR in the second trimester were significantly higher than those in the second trimester. The AT-III level was significantly lower than that in the second trimester (P <0.001). There was a significant positive correlation between TPO and MPV. TPO and MPV were negatively correlated with AT-Ⅲ and positively correlated with FIB, D-D and PAR (P <0.01). The positive rates of TPO, MPV, AT-III, FIB, D-D, PAR and TPO + MPV in the first trimester were significantly higher than those in the first trimester and the second trimester respectively (P <0.01). The positive rates of TPO and MPV in middle and pre-pregnancy were significantly higher than that in AT-Ⅲ, D-D and PAR. The positive rates of TPO + MPV in different pregnancy were significantly higher than those in the other four indicators (P <0.01). CONCLUSION: TPO and MPV may be the more important factors leading to hypercoagulability in pregnant women. The combined determination of TPO and MPV is of great value in monitoring the development of perinatal hypercoagulability and preventing thrombosis in pregnant women.