子痫前期与血小板及凝血功能改变的相关性研究

发布时间：2018-03-23 14:35

本文选题：子痫前期　切入点：血小板参数　出处：《新疆医科大学》2014年硕士论文

【摘要】：目的：比较正常妊娠、轻度子痫前期、重度子痫前期分娩前血小板参数、凝血相关指标的变化情况,为确立治疗方案或及时终止妊娠提供决策依据。方法：采用回顾性分析、分层抽样的方法,将晚期妊娠分为正常妊娠组、轻度子痫前期组、重度子痫前期组。根据NCSS-PASS2011软件算出每组需要样本量最低30例,再随机选取我院2012年12月到2013年11月期间每组各40名患者,进行的血小板及凝血功能分析。结果：1.轻度子痫前期的血小板计数与正常妊娠组之间无统计学差异(P0.05),重度子痫前期血小板计数下降明显。2.子痫前期的血小板平均体积、血小板平均分布宽度高于正常妊娠,重度子痫前期的血小板平均体积、血小板平均分布宽度也高于轻度子痫前期,差异均有统计学意义(P0.05)。3.血小板平均分布压积在三组之间的差异无统计学意义(P0.05)。4.重度子痫前期的凝血酶原时间低于轻度子痫前期和正常妊娠组,并且轻度子痫前期的凝血酶原时间低于正常妊娠组,差异均有统计学意义(P0.05)。5.纤维蛋白原、凝血酶时间、D-二聚体在三组间的结果均是重度子痫前期与轻度子痫前期的差异无统计学意义(P0.05),但子痫前期的测量值高于正常妊娠。6.活化部分凝血酶原时间在三组之间的差异无统计学意义(P0.05)。结论：1.轻度子痫前期血小板数量变化不明显,幼稚血小板代偿性增生。2.根据血小板平均体积、血小板压积可以判断外周血小板破坏情况。3.子痫前期处于高凝状态、纤溶亢进。4.子痫前期主要是以外源性凝血途径为主。5.血小板压积和活化部分凝血酶时间在子痫前期的病情变化中无明显变化,有待进步研究。6.临床上可以通过检测血小板参数和凝血功能,了解子痫前期病情转归,为子痫前期的个性化抗凝治疗提供帮助。
[Abstract]:Objective: to compare the changes of platelet parameters and coagulation parameters before delivery in normal pregnancy, mild preeclampsia and severe preeclampsia. The third trimester pregnancy was divided into normal pregnancy group, mild preeclampsia group and severe preeclampsia group. According to NCSS-PASS2011 software, the minimum sample size of each group was 30 cases. From December 2012 to November 2013, 40 patients in each group were randomly selected. Results: 1. There was no significant difference in platelet count between mild preeclampsia group and normal pregnancy group (P 0.05). The platelet count of severe preeclampsia decreased significantly. The mean distribution width of platelet in severe preeclampsia was higher than that in mild preeclampsia. There was no significant difference in platelet mean distribution between the three groups. The prothrombin time of severe preeclampsia was lower than that of mild preeclampsia and normal pregnancy. The prothrombin time of mild preeclampsia group was lower than that of normal pregnancy group. The results of the three groups showed that there was no significant difference between severe preeclampsia and mild preeclampsia, but the measured value of pre-eclampsia was higher than that of normal pregnancy .6.Activating partial prothrombin time was found in the three groups. There was no significant difference between the two groups (P 0.05). Conclusion 1. There was no significant change in platelet count in mild preeclampsia. Puerperal platelet compensatory hyperplasia .2.According to the average volume of platelets, platelet pressure can be used to judge the destruction of peripheral platelets .3.The preeclampsia is in a state of hypercoagulability. Fibrinolytic hyperactivity .4.The main preeclampsia is exogenous coagulation pathway .5.Platelet compaction and activated partial thrombin time have no significant changes in the state of preeclampsia. In order to provide help for individualized anticoagulant therapy of pre-eclampsia, the clinical parameters of platelet and coagulation function can be detected to understand the outcome of pre-eclampsia.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.246

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