Objective To investigate the change of coagulation function in patients with pregnancy induced hypertension (PIH) in different stages, and to provide reference for clinical effective prevention and treatment of PIH. Methods A total of 21 patients with mild PIH, 15 patients with moderate PIH, 10 patients with severe PIH were selected and the blood samples were collected from January 2015 to June 2017. 30 cases of normal pregnant women during the same pregnant period and 30 cases of healthy women (normal physical examination) were selected as the control group 1 and control group 2, respectively. The coagulation function was measured by ACL-TOP700 automatic hemagglutination analyzer, and then compared the results of prothrombin (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB), D-dimer (DD), fibrin degradation products (FDP), and antithrombin Ⅲ (AT Ⅲ ) of each group. Results The results of PT, APTT, TT, FIB, DD, FDP, and AT Ⅲ of mild PIH group were (11.28±0.83)s, (31.12±2.05)s, (14.25±0.81)s, (4.29±0.51)g/L, (1.41±0.48)mg/L, (6.04±1.71)mg/L, (82.31±6.21)％, respectively; those of moderate PIH group were (11.19±0.91) s, (30.92±2.13)s, (13.94±0.79)s, (5.27±0.61)g/L, (1.62±0.52)mg/L, (7.26±1.93)mg/L, (79.25±5.85)％, respectively;those of severe PIH group were (10.12±0.85)s, (26.33±1.98)s, (11.35±0.84)s, (6.45±0.55)g/L, (2.21±0.55) mg/L, (12.40±2.54)mg/L, (63.47±6.42)％, respectively; those of normal pregnancy group were (11.42±0.89)s, (32.24±1.93)s, (14.91±0.70)s, (4.22±0.57)g/L, (1.45±0.61)mg/L, (5.26±1.63)mg/L, (83.25±6.47)％, respectively;those of non-pregnant healthy control group were (13.51±1.42)s, (37.43±2.81)s, (16.52±1.34)s, (3.35±0.62)g/L, (0.46±0.52)mg/L, (2.54±1.31)mg/L, (98.41±7.35)％, respectively. Compared with non-pregnant healthy control group, the levels of PT, APTT, TT, and AT Ⅲ decreased in normal pregnancy group, mild PIH group, moderate PIH group, and severe PIH group, and the levels of FIB, DD, and FDP increased, with statistically significant differences (P<0.05). There were no statistically significant differences in the levels of PT, APTT, TT, FIB, DD, FDP, and AT Ⅲ among normal pregnancy group, mild PIH group, and moderate PIH group (P>0.05). Compared with normal pregnancy group, the levels of PT, APTT, TT, and AT Ⅲ of severe PIH group decreased, and the levels of FIB, DD, FDP increased, with statistically significant differences (P<0.05). Conclusion The blood of the pregnant women in late pregnancy was in the hypercoagulable state, and the hypercoagulable state of pregnant women with severe PIH was more obvious than that of normal pregnant women. With the increase in the severity of PIH, the hypercoagulable state of blood had an increasing trend. Prenatal monitoring of maternal coagulation function, is of great guiding significance to the prevention and treatment of severe PIH in late pregnancy.%目的 探讨不同程度妊娠高血压综合征(简称妊高征)患者妊娠晚期凝血功能状况的变化,为临床有效防治妊高征提供参考.方法 采集2015年1月至2017年6月间妊娠晚期妊高征患者血液样本,其中轻度妊高征组21例,中度妊高征组15例,重度妊高征组10例,选取同孕期正常妊娠女性30例作为正常妊娠组,选取同时期正常体检健康女性30例作为非孕健康对照组,采用ACL-TOP700全自动血凝分析仪对患者凝血功能进行测定,对比分析各组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、D-二聚体(DD)、纤维蛋白降解产物(FDP)及抗凝血酶Ⅲ(ATⅢ).结果 轻度妊高征组PT、APTT、TT、FIB、DD、FDP和ATⅢ检测结果分别(11.28±0.83)s、(31.12±2.05)s、(14.25±0.81)s、(4.29±0.51)g/L、(1.41±0.48)mg/L、(6.04±1.71)mg/L和(82.31±6.21)％;中度妊高征组PT、APTT、TT、FIB、DD、FDP和ATⅢ检测结果分别(11.19±0.91)s、(30.92±2.13)s、(13.94±0.79)s、(5.27±0.61)g/L、(1.62±0.52)mg/L、(7.26±1.93)mg/L和(79.25±5.85)％;重度妊高征组PT、APTT、TT、FIB、DD、FDP和ATⅢ检测结果分别(10.12±0.85)s、(26.33±1.98)s、(11.35±0.84)s、(6.45±0.55)g/L、(2.21±0.55)mg/L、(12.40±2.54)mg/L和(63.47±6.42)％;正常妊娠组PT、APTT、TT、FIB、DD、FDP和ATⅢ检测结果分别(11.42±0.89)s、(32.24±1.93)s、(14.91±0.70)s、(4.22±0.57)g/L、(1.45±0.61)mg/L、(5.26±1.63)mg/L和(83.25±6.47)％;非孕健康对照组PT、APTT、TT、FIB、DD、FDP和ATⅢ检测结果分别(13.51±1.42)s、(37.43±2.81)s、(16.52±1.34)s、(3.35±0.62)g/L、(0.46±0.52)mg/L、(2.54±1.31)mg/L和(98.41±7.35)％;正常妊娠组、轻度妊高征组、中度妊高征组和重度妊高征组与非孕健康对照组相比,PT、APTT、TT和ATⅢ降低,FIB、DD、FDP升高,差异均有统计学意义(均P<0.05);轻度妊高征组和中度妊高征组与正常妊娠组相比,PT、APTT、TT、FIB、DD、FDP及ATⅢ差异均无统计学意义(均P>0.05);重度任高征组与正常妊娠组相比,PT、APTT、TT和ATⅢ降低,FIB、DD、FDP升高,差异均有统计学意义(均P<0.05).结论 妊娠晚期女性血液处于高凝状态,妊娠晚期重度妊高征患者较正常妊娠女性血液高凝状态现象更为明显,随着妊高征程度的增加,血液高凝状态具有增强趋势,产前监测产妇的凝血功能,对妊娠晚期重度妊高征患者的预防及治疗具有重要指导意义.
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