1、生殖健康004临床常用血生化指标变化在高龄孕产妇 围生期的应用价值探讨何 云 李娅慧 徐 敏成都市妇女儿童中心医院，四川 成都 610073【摘要】目的：研究血生化指标变化在高龄孕产妇围生期的应用价值。方法：选择 2021 年 12 月2022 年 7 月本院收治的高龄孕产妇 50 例纳入实验组，同期收治的适龄孕产妇 50 例作为观察对象纳入对照组。对两组孕产妇实施血生化指标检查，分析指标变化，探析诊断价值。结果：实验组孕产妇妊娠早期 TBA 指标显著低于对照组，妊娠早、中、晚期 HDL-C 指标与FBG 指标显著高于对照组（P0.05）；处于产后 3d 内，实验组孕产妇 TC 指标、HDL-
2、C 指标、TG 指标均显著高于对照组，FBG 指标低于对照组（P0.05）。实验组孕产妇妊娠早期 PT 指标显著高于对照组（P0.05）；处于妊娠中、晚期，实验组孕产妇 APTT 指标明显低于对照组，PT 指标显著高于对照组（P0.05）；处于产后 3d 内，实验组孕产妇 FDP 指标低于对照组（P0.05）。实验组孕产妇出现妊娠不良事件概率为 6.00%（3/50）显著低于对照组的 24.00%（12/50）（P0.05）。结论：运用血生化指标变化检测运用在对高龄孕产妇围生期状态评估中，价值较高，值得运用。【关键词】血生化指标；变化；高龄；孕产妇；围生期；糖脂代谢指标；凝血功能指标Study
3、 on the application value of the changes of clinical common blood biochemical indexes in the perinatal period of the elderly pregnant and parturient womenHE Yun,LI Yahui,XU MinChengdu Women and Childrens Central Hospital,Chengdu,Sichuan 610073,China【Abstract】Objective:To study the application value
4、of the changes of blood biochemical indexes in the perinatal period of elderly pregnant and parturient women.Methods:50 elderly pregnant and parturient women admitted to our hospital from December 2021 to July 2022were selected to be included in the experimental group,and 50 cases of right age pregn
5、ant and parturient women admitted in the same period were included in the control group.The blood biochemical indicators of the two groups of pregnantand parturient women were examined,the changes of indicators were analyzed,and the diagnostic value was analyzed.Results:The TBA index in the early pr
6、egnancy of the experimental group was significantly lower than that of the control group,the HDL-C indicators and FBG indicators in the early,middle and late pregnancy stages were significantly higher than those of the control group(P0.05);Within 3 days after delivery,the TC index,HDL-C index and TG
7、 index of pregnant and lying in women in the experimental group were significantly higher than those in the control group,and the FBG index was lower than that in the control group(P0.05).The PT index of early pregnancy in the experimental group was significantly higher than that in the control grou
8、p(P0.05);In the middle and late pregnancy,the APTT index of pregnant and lying in womenin the experimental groupwas significantly lower than that in the control group,and the PT index was significantly higher than that in the control group(P0.05);The FDP index of the experimental group within 3days
9、after delivery was lower than that of the control group(P0.05);There was no significant difference in D-D index and FIB index between the two groups in different pregnancy periods(P0.05).The probability of pregnancy adverse events in the experimental group was 6.00%(3/50),which was significantly low
10、er than 24.00%in the control group(12/50)(P0.05).Conclusion:The use of blood biochemical index changes in the evaluation of perinatal status of elderly pregnant and parturient women is of high value and worth using.【Key Words】Blood biochemical indicators;Change;Advanced age;Maternal;Perinatal period
11、;Glucose and lipid metabolism indicators;Coagulation function indicators临床中，将年龄 35 岁的首次妊娠孕产妇称作为高龄产妇。有研究证实，对高龄产妇来讲，出现早产、流产、妊高症、妊娠糖尿病、胎儿窘迫以及胎儿宫内迟缓发育等等不良事件的概率比适龄期孕产妇要高，会引起孕产妇血液学检验水平和妊娠结局等相关指标出现明显的变化。所以，需强化对高龄孕产妇健康状况的研究。有诸多的学者证实，大部分的高龄孕产妇出现精神障碍、心理障碍的风险和概率高于适龄孕产妇，而其中高龄的孕产妇如果为经济条件比较差，工作职业不稳定，工作压力大以及身体素质比较
12、差等，会使得孕产妇出现不良妊娠事件。所以，需给予其血生化检验，依照检验的指标对其身体状况进行评估，确保母婴安全1-3。1 资料与方法1.1 一般资料生 殖健康005Fertility&Health选择 2021 年 12 月2022 年 7 月本院收治的高龄孕产妇 50 例纳入实验组，年龄 35 43 岁，平均年龄（38.162.28）岁；同期收治的适龄孕产妇50例作为观察对象纳入对照组，年龄2233岁，平均年龄（26.143.24）岁。两组体重指数等一般资料比较差异不大（P 0.05）。1.2 方法两组孕产妇都在妊娠的早期（孕龄 12 周）、妊娠中期（孕龄在 2025 周）、妊娠晚期（孕龄在
13、3842 周）以及产后 3d 之内对其肘正中静脉采集，测量其糖脂代谢指标以及凝血功能指标。1.3 观察指标及评价标准在妊娠早期、妊娠中期、妊娠晚期与产后3d内，两组糖脂代谢指标，包含：TC 指标、TBA 指标、HDL-C 指标、FBG 指标与 TG 指标；分析两组凝血功能指标，包含：APTT 指标、D-D 指标、PT 指标、FIB 指标与 FDP 指标。其中，血清总胆固醇（英文全称：total cholesterol，英文简称：TC）、总胆汁酸（英文全称：total bile acid，英文简称：TBA）、高密度脂蛋白胆固醇（英文全称：high density lipoprotein chol
14、esterol，英文简称：HDL-C）、空腹血糖（英文全称：fasting blood glucose，英文简称：FBG）与三酰甘油（triglyceride，英文简称：TG）。凝血功能指标：活化部分凝血活酶时间（英文全称：activated partial thromboplas tintime，英文简称：APTT）、D-二聚体（英文全称：D-dimer，英文简称：D-D）、凝血酶原时间（英文全称：prothrombin time，英文简称：PT）、纤维蛋白原（英文全称：fibrinogen，英文简称：FIB）与纤维蛋白原降解产物（英文全称：fibrinogen degradation pr
15、oducts，英文简称：FDP）。1.4 数据处理采用 SPSS 21.0 统计学软件进行数据分析。计数资料采用（%）表示，进行 x2检验，计量资料采用（xs）表示，进行t检验，P0.05 为差异具有统计学意义。2 结果2.1 分析两组孕产妇糖脂代谢指标，详见表1。2.2 分析两组孕产妇凝血功能指标，详见表2。2.3 分析两组妊娠不良事件出现概率实验组孕产妇出现妊娠不良事件概率为 6.00%表 1 两组各期糖脂代谢指标对比（xs，mmol/L）妊娠时期实验组（n=50）对照组（n=50）TCTBAHDL-CFBGTGTCTBAHDL-CFBGTG妊娠早期6.301.122.610.24*3.4
16、60.41*5.520.74*2.640.536.390.73 2.850.52 2.360.62 4.640.622.570.45妊娠中期6.720.723.430.123.450.34*5.780.81*2.910.626.320.74 3.400.52 2.570.39 5.120.572.870.57妊娠晚期6.860.783.280.533.560.33*5.730.87*3.830.826.490.68 3.250.27 2.370.82 5.010.603.780.51产后 3d 内6.650.57*3.420.612.530.61*3.310.61*5.870.83*6.370.54 3.500.50 2.390.65 5.110.662.980.42注：*表示与对照组相比，P0.05。表 2 两组凝血功能指标对比（xs）妊娠时期实验组（n=50）对照组（n=50）APTT（s）D-D（mg/L）PT（s）FIB（g/L）FDP（mg/L）APTT（s）D-D（mg/L）PT（s）FIB（g/L）FDP（mg/L）妊娠早期33.633.350.140.01#12.591
