目的: 研究不同孕期阶段(早、中、晚)孕妇凝血四项、血浆纤维蛋白(原)降解产物[plasma fibrin/ fibrinogen degradation products,FDP]、D-二聚体的变化及临床意义,为临床诊疗提供理论支持。方法: 回顾性分析2021年1月至2021年12月200例孕妇就诊资料中的凝血四项,纤维蛋白原(fibrinogen,FIB)、凝血酶原时间(prothrombin time,PT)、凝血酶时间(thrombin time,TT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)。并对FDP与D-二聚体的检测结果进行统计分析,比较孕早期、中期、晚期三个阶段凝血四项、FDP和D-二聚体水平的变化。结果: 孕早期、孕中期与孕晚期PT水平比较,差异有统计学意义(P＜0.05);孕早期、孕中期与孕晚期三个阶段的TT相比,差异无统计学意义(P＞0.05);孕早期的APTT明显长于中期、晚期孕妇,差异有统计学意义(P＜0.05);孕早期、中期、晚期孕妇,随着孕周的增加,FIB水平逐渐升高,差异有统计学意义(P＜0.05)。孕早期、孕中期与孕晚期三个时期的FDP和D-二聚体水平,随着孕周的增加而升高,差异具有统计学意义(P＜0.05)。结论: 对产妇分娩前进行凝血四项、FDP、D-二聚体水平的检测,可以掌握患者的凝血功能,对异常情况进行及时预防治疗,对产后患者出血与血栓的预防治疗有重要意义。

Objective: To study the changes and clinical significance of four coagulation items, plasma fibrin (ogen) degradation products(FDP) and D-dimer in different pregnancy stages (early, middle and late), and to provide theoretical support for clinical diagnosis and treatment. Methods: The data of 200 pregnant patients in our hospital from January 2021 to December 2021 were fibrinogen, fibrinogen(FIB), prothrombin time (PT), thrombin time (TT), and activated partial thromboplastin time(APTT).The detection results of plasma fibrin (original) degradation product (fibrinogendegradationproducts, FDP) and D-dimer were also statisanalyzed. Comparative analysis of the changes of blood coagulation, FDP and D-dimer levels in the first, middle and late pregnancy stages. Results: There were significant differences in PT levels between the first, second and third trimesters (P＜0.05); there was no significant difference in TT between the first, second and third trimesters (P＞0.05); the APTT in the first trimester was significantly longer than that in the second trimester and third trimester, and the difference was statistically significant (P＜0.05); in the first trimester, the second trimester, and the third trimester, the FIB level gradually increased with the increase of gestational weeks, and the difference was statistically significant (P＜0.05). The levels of FDP and D-dimer in the first trimester, second trimester and third trimester increased with the increase of gestational age, and the difference was statistically significant (P＜0.05). Conclusion: The detection of four coagulation levels, FDP and D-dimer levels before childbirth can master the coagulation function of patients and conduct timely preventive treatment of abnormal conditions, which is of great significance to the preventive treatment of bleeding and thrombosis in postpartum patients.