妊娠期D-二聚体水平变化及意义.doc

妊娠期D-二聚体水平变化及意义[摘要]目的 观察妊娠期D-二聚体水平的变化及其意义。方法 232例来我院妇产科就诊的女性分为妊娠期组128例和非妊娠期组104例。妊娠组按妊娠年龄分为＜30岁组、≥30岁组，按孕期分类标准分为早期、中期、晚期妊娠组。比较其D-二聚体水平的差别。结果 妊娠组D-二聚体水平高于非妊娠组（P＜0.05）；中期妊娠组和晚期妊娠组D-二聚体水平高于早期妊娠组（P＜0.05），晚期妊娠组D-二聚体水平高于中期妊娠组（P＜0.05）。结论 妊娠期的D-二聚体水平升高明显，随着孕周增加，D-二聚体水平逐渐升高，孕妇年龄对其无明显影响。 [关键词] D-二聚体；妊娠 [中图分类号] R446.6 [文献标识码] B[文章编号] 1673-9701（2011）27-20-02 Changes and Its Clinical Significance of Plasma Level of D-Dimer in Pregnant Women YONG Ancui Department of Obstetrics and Gynecology，Ningbo City Zhenhai District People’s Hospital, Ningbo 315202, China [Abstract] Objective To observe and compare changes and its clinical significance of plasma level of D-Dimer in pregnant women. Methods All 232 cases selected from our hospital were divided into pregnancy group with 128 casas and inpregnancy group with 104 casas, Pregnancy group were divided according to age with 85 casas （age＜30）and with 43 cases（age≥30）, and divided into early pregnancy with 46 casas，middle pregnancy with 42 casas and late pregnancy with 40 casas according to pregnancy period. The differences of D-Dimer level were compared in groups. Results D-Dimer level in pregnancy group was higher than that in inpregnancy group （P＜0.05)； D-Dimer levels in middle pregnancy and late pregnancy were much higher than that in early pregnancy（P＜0.05），D-Dimer level in late pregnancy was higher than that in middle pregnancy（P＜0.05). Conclusion Plasma levels of D-dimer obviously increased in pregnant women with the increase of pregnancy period. The pregnant woman age has no significant effect on D-dimer level. [Key words] D-Dimer；Pregnancy D-二聚体是交联的纤维蛋白单体经纤溶酶裂解出的D碎片二聚体，伴有微血栓形成的许多疾病可能导致D-二聚体的增高[1，2]。所以临床上常用检测患血浆D-二聚体含量方法判断患者是否处于深静脉血栓、肺栓塞及弥漫性血管内凝血前状态。由于正常孕妇在妊娠及分娩期体内凝血、抗凝和纤溶功能均发生明显改变，凝血酶、凝血因子及纤维蛋白原含量增加，抗凝剂纤溶功能减弱。据研究，妊娠期妇女D-二聚体水平可能会随着妊娠时间的延长而发生生理性的变化，呈现高凝状态[3]。因此本研究检测比较女性妊娠期及非妊娠期的D-二聚体含量，探讨不同孕周、不同年龄孕妇的血浆D-二聚体含量的变化及意义，现报道如下。 1资料与方法 1.1 临床资料 选取我院2010年2月～2011年2月妇产科就诊患者232例，年龄19～58岁，平均年龄(32±9.6)岁。妊娠期128例