上海交通大学学报（医学版）

上海交通大学学报(医学版) ›› 2020, Vol. 40 ›› Issue (12): 1614-1617.doi: 10.3969/j.issn.1674-8115.2020.12.007

• 论著·临床研究 • 上一篇    下一篇

妊娠期糖尿病孕妇分娩前凝血指标的改变及其临床意义

郭彦彦，郭 飞，李 彤，李雨晨，黄荷凤，刘欣梅   

  1. 上海交通大学医学院附属国际和平妇幼保健院胚胎源性疾病研究所，上海市胚胎源性疾病重点实验室，上海 200030
  • 出版日期:2020-12-28 发布日期:2021-02-02
  • 通讯作者: 刘欣梅，电子信箱：nanlilac@hotmail.com。
  • 作者简介:郭彦彦（1993—），女，硕士生；电子信箱：gyy3690@163.com。
  • 基金资助:
    国家自然科学基金（81671456）；上海市青年科技英才扬帆计划（18YF1424700）。

Changes and significance of coagulation indexes in pregnant women with gestational diabetes mellitus

GUO Yan-yan, GUO Fei, LI Tong, LI Yu-chen, HUANG He-feng, LIU Xin-mei   

  1. Institute of Embryonic Diseases, International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Embryo-Derived Diseases, Shanghai 200030, China
  • Online:2020-12-28 Published:2021-02-02
  • Supported by:
    National Natural Science Foundation of China (81671456); Shanghai Youth Science and Technology Talent to Sail Plan (18YF1424700).

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摘要： 目的·探究妊娠期糖尿病（gestational diabetes mellitus, GDM）孕妇分娩前凝血指标的改变及其与血糖值之间的相关性。方法·收集孕晚期临近分娩的132例GDM孕妇（GDM组）和160名健康孕妇（对照组）的临床基本资料并采集血样，检测血糖和凝血相关指标的水平，包括口服糖耐量试验（oral glucose tolerance test，OGTT）0、1、2 h血糖，部分凝血活酶时间（activated partial thromboplastin time，APTT） ，凝血酶时间（thrombin time，TT），血浆凝血酶原时间（pro-thrombin time，PT），D-二聚体（D-dimer），纤维蛋白原（fibrinogen，FIB）和国际标准化比值（international normalized ratio，INR），并进行相关性分析。结果·GDM组孕妇的纤维蛋白原FIB和INR的水平均显著高于对照组（P=0.003，P=0.005）。2组APTT、TT、PT 及D-dimer水平比较，差异均无统计学意义（均P>0.05）。FIB分别与OGTT 1 h血糖和OGTT 2 h血糖呈正相关（均P=0.000），与OGTT 0 h血糖无相关性（P=0.505）。INR与各时点OGTT 血糖均无相关性（均P>0.05）。结论·GDM孕妇分娩前血浆中FIB的水平显著升高，且与OGTT 1 h和OGTT 2 h血糖水平呈正相关。

关键词: 妊娠期糖尿病, 纤维蛋白原, 口服糖耐量试验

Abstract:

Objective · To explore the changes of blood coagulation parameters before delivery and their correlation with blood glucose. Methods · The basic clinical data and blood samples were collected from 132 pregnant women with GDM and 160 healthy pregnant women who were near labor in the third trimester. The levels of blood glucose and coagulation-related indicators, including the values of oral glucose tolerance test (OGTT) at 0, 1 and 2 h, activated partial thromboplastin time (APTT), thrombin time (TT), pro-thrombin time (PT), D-dimer, fibrinogen (FIB) and international normalized ratio (INR), were detected, and the statistical analysis was carried out. Results · The levels of FIB and INR in the GDM group were significantly higher than those in the control group (P=0.003, P=0.005). There were no significant differences between the two groups on the levels of APTT, TT, PT, and D-dimer (all P>0.05). The level of FIB was significantly positively correlated with the values of OGTT at 1 h (P=0.000) and 2 h (P=0.000), and the level of FIB had no correlation with the value of OGTT at 0 h (P=0.505). There was no correlation between the level of INR and all the OGTT values (all P>0.05). Conclusion · Plasma FIB levels of GDM women were significantly increased before delivery, and FIB was significantly positively correlated with the values of OGTT at 1 h and 2 h.

Key words: gestational diabetes mellitus, fibrinogen, oral glucose tolerance test

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