CAJ | 학술논문

目的：探讨32周前、后发病的重度子痫前期（S-PE）血常规、凝血及部分生化参数的不同。方法回顾性分析63例20～31+6周发病（早发组）和44例32～36周（晚发组）发病S-PE患者外周血常规、血浆白蛋白（ALB）、血浆总蛋白（TB）、尿蛋白（Upro）、血清钙（Ca）、凝血酶时间（TT）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（Fib）、D二聚体、抗凝血酶Ⅲ活性(AT-Ⅲ)参数。结果早发组PLT为（192.53±70.53）×109/L，晚发组为（169.70±48.28）×109/L，两组比较差异有统计学意义（P<0.05）；早发组D二聚体为（580.61±1303.22）μg/L，晚发组为（299.63±1276.21）μg/L，两组比较差异有统计学意义（P<0.05）；早发组ATⅢ活性为（84.04±17.00）%，晚发组为（73.25±17.95）%，两组比较差异有统计学意义（P<0.05）。而在凝血功能指标APTT、TT、Fib、生化指标ALB、TB、Upro及其他血常规指标WBC、MPV差异均无统计学意义。结论32周前发病的重度子痫前期比32周后发病的子痫前期高凝状态更明显，发病越早的重度子痫前期更需要抗凝治疗。
목적：탐토32주전、후발병적중도자간전기（S-PE）혈상규、응혈급부분생화삼수적불동。방법회고성분석63례20～31+6주발병（조발조）화44례32～36주（만발조）발병S-PE환자외주혈상규、혈장백단백（ALB）、혈장총단백（TB）、뇨단백（Upro）、혈청개（Ca）、응혈매시간（TT）、응혈매원시간（PT）、활화부분응혈활매시간（APTT）、섬유단백원（Fib）、D이취체、항응혈매Ⅲ활성(AT-Ⅲ)삼수。결과조발조PLT위（192.53±70.53）×109/L，만발조위（169.70±48.28）×109/L，량조비교차이유통계학의의（P<0.05）；조발조D이취체위（580.61±1303.22）μg/L，만발조위（299.63±1276.21）μg/L，량조비교차이유통계학의의（P<0.05）；조발조ATⅢ활성위（84.04±17.00）%，만발조위（73.25±17.95）%，량조비교차이유통계학의의（P<0.05）。이재응혈공능지표APTT、TT、Fib、생화지표ALB、TB、Upro급기타혈상규지표WBC、MPV차이균무통계학의의。결론32주전발병적중도자간전기비32주후발병적자간전기고응상태경명현，발병월조적중도자간전기경수요항응치료。
Objective To compare the hematological, biochemical and coagulation parameters before and after 32 weeks' gestation with severe preeclampsia (S-PE).Methods A retrospective study was performed in 63 S-PE patients 20-31+6 weeks' gestation(early onset group)and 44 S-PE patients between 32-36 weeks' gestation(late onset gruop). The following parameters were compared between the two groups: white blood cells (WBC), platelet (PLT), mean platelet volume (MPV), Hemoglobin (HGB), hematocrit (HCT), albumin (ALB), total plasma protein, urine protein (Upro), serum calcium (Ca), thrombin time (TT), prothrombin time (PT), Activated partial thromboplastin time (APTT), Fibrinogen (Fib), D-Dimer, AntithrombinⅢ(ATⅢ). Results The values of PLT, D-Dimer and ATⅢwere (192.53±70.53)×109/L,(580.61±1303.22)μg/L and(84.04±17.00)%, respectively in early onset group. The corresponding values of PLT, D-Dimer and ATⅢwere(169.70±48.28)×109/L,(299.63±1276.21)μg/L and (73.25±17.95)%respectively in late onset group. There were significant different for these three parameters between the two groups. The were no significant difference between the two groups for the following parameters:APTT,TT,Fib, ALB,TB,Upro, WBC and MPV.Conclusion S-PE before 32 weeks' gestation is more likely to present thrombphilin state, which may suggest the necessity of anti-coagulation therapy in early-onset S-PE.