本文選題：子癇前期　切入點：血小板參數　出處：《新疆醫(yī)科大學》2014年碩士論文

【摘要】：目的：比較正常妊娠、輕度子癇前期、重度子癇前期分娩前血小板參數、凝血相關指標的變化情況,為確立治療方案或及時終止妊娠提供決策依據。方法：采用回顧性分析、分層抽樣的方法,將晚期妊娠分為正常妊娠組、輕度子癇前期組、重度子癇前期組。根據NCSS-PASS2011軟件算出每組需要樣本量最低30例,再隨機選取我院2012年12月到2013年11月期間每組各40名患者,進行的血小板及凝血功能分析。結果：1.輕度子癇前期的血小板計數與正常妊娠組之間無統(tǒng)計學差異(P0.05),重度子癇前期血小板計數下降明顯。2.子癇前期的血小板平均體積、血小板平均分布寬度高于正常妊娠,重度子癇前期的血小板平均體積、血小板平均分布寬度也高于輕度子癇前期,差異均有統(tǒng)計學意義(P0.05)。3.血小板平均分布壓積在三組之間的差異無統(tǒng)計學意義(P0.05)。4.重度子癇前期的凝血酶原時間低于輕度子癇前期和正常妊娠組,并且輕度子癇前期的凝血酶原時間低于正常妊娠組,差異均有統(tǒng)計學意義(P0.05)。5.纖維蛋白原、凝血酶時間、D-二聚體在三組間的結果均是重度子癇前期與輕度子癇前期的差異無統(tǒng)計學意義(P0.05),但子癇前期的測量值高于正常妊娠。6.活化部分凝血酶原時間在三組之間的差異無統(tǒng)計學意義(P0.05)。結論：1.輕度子癇前期血小板數量變化不明顯,幼稚血小板代償性增生。2.根據血小板平均體積、血小板壓積可以判斷外周血小板破壞情況。3.子癇前期處于高凝狀態(tài)、纖溶亢進。4.子癇前期主要是以外源性凝血途徑為主。5.血小板壓積和活化部分凝血酶時間在子癇前期的病情變化中無明顯變化,有待進步研究。6.臨床上可以通過檢測血小板參數和凝血功能,了解子癇前期病情轉歸,為子癇前期的個性化抗凝治療提供幫助。
[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.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R714.246

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