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目的:探讨妊娠高血压综合征(妊高征)患者凝血、抗凝、纤溶功能指标的改变及其在妊高征血栓前状态(PTS)中的诊断意义。方法:应用ELISA法测定85例妊高征患者血中凝血酶原片段F1+2、凝血酶-抗凝血酶复合物(TAT)、可溶性纤维蛋白单体复合物(SFMC)、D-二聚体(D-Dimer),并在ACL-200全自动血凝仪上同时测定纤维蛋白原(Fbg),抗凝血酶Ⅲ(AT-Ⅲ)、蛋白C(PC)、纤溶酶原(PLG)及α2-纤溶抑制物(α2-PI)。结果:妊高征患者F1+2、TAT、SFMC含量均明显升高,差异有统计学意义(P<0.05或P<0.01),且随病情加重含量有升高趋势;而AT-Ⅲ、PC活性均显著下降(P<0.05或P<0.01),病情越重降低越明显;妊高征组与对照组比较,除PLG外,Fbg、α2-PI、D-dimer显著性增高(P<0.05或P<0.01),中度及重度妊高征组增高更明显。结论:妊高征患者凝血功能增强,抗凝及纤溶功能减弱,处于明显的血栓前状态。
Objective: To investigate the changes of coagulation, anticoagulation and fibrinolysis in patients with pregnancy induced hypertension (PIH) and their diagnostic significance in preeclamptic prothrombotic state (PTS). Methods: Serum prothrombin fragment F1 + 2, thrombin-antithrombin complex (TAT), soluble fibrin monomer complex (SFMC), D-dimer (D-Dimer), and the simultaneous determination of fibrinogen (Fbg), antithrombin Ⅲ (AT-Ⅲ), protein C (PC), plasminogen (PLG ) And α2-fibrinolysis inhibitor (α2-PI). Results: The levels of F1 + 2, TAT and SFMC in PIH patients were significantly higher than those in PIH patients (P <0.05 or P <0.01) (P <0.05 or P <0.01), and the more severe the disease was, the more obvious the decrease was. Compared with the control group, the levels of Fbg, α2-PI and D-dimer in PIH group were significantly increased Or P <0.01), moderate and severe pregnancy-induced hypertension increased more significantly. Conclusion: The coagulation function of patients with PIH is enhanced, and the anticoagulant and fibrinolytic functions are weakened, which is in obvious prothrombotic state.