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中华产科急救电子杂志 ›› 2023, Vol. 12 ›› Issue (01) : 1 -5. doi: 10.3877/cma.j.issn.2095-3259.2023.01.001

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妊娠期易栓症的临床诊断进展
王迪, 王谢桐()   
  1. 山东第一医科大学附属省立医院产科,济南 250021
    山东第一医科大学附属省立医院产科,济南 250021;山东省妇幼保健院产科,济南 250014
  • 收稿日期:2022-11-11 出版日期:2023-02-18
  • 通信作者: 王谢桐

Progress in clinical diagnosis of thrombophilia during pregnancy

Di Wang, Xietong Wang()   

  • Received:2022-11-11 Published:2023-02-18
  • Corresponding author: Xietong Wang
引用本文:

王迪, 王谢桐. 妊娠期易栓症的临床诊断进展[J]. 中华产科急救电子杂志, 2023, 12(01): 1-5.

Di Wang, Xietong Wang. Progress in clinical diagnosis of thrombophilia during pregnancy[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2023, 12(01): 1-5.

易栓症是各种遗传性或获得性因素导致血栓形成和血栓栓塞倾向的病理状态,其主要临床表现是静脉血栓栓塞症(venous thromboembolism,VTE)[1]。易栓症不一定发生血栓性疾病,但可能影响子宫-胎盘循环,导致胎盘微血栓形成,从而造成不良妊娠结局。易栓症根据病因分为遗传性易栓症和获得性易栓症。遗传性易栓症的病因有明显的种族差异,在汉族人群中,遗传性易栓症的常见病因是蛋白C、蛋白S和抗凝血酶缺乏;遗传性易栓症是血栓栓塞性疾病比较明确的高危因素,与不良妊娠结局的关系一直存在争议,对胎盘源性疾病的发生可能有协同促成作用。获得性易栓症主要是抗磷脂综合征(antiphospholipid syndrome,APS),可导致复发性流产、不明原因死胎、早发子痫前期和胎盘功能不良,增加围产期血栓栓塞风险。无论是遗传性还是获得性易栓症,对于有血栓形成或血栓病史孕产妇的抗凝治疗没有争议。目前APS的治疗主要使用低分子肝素和阿司匹林,治疗失败者称为难治性APS,其治疗仍在不断探索中;遗传性易栓症指标异常且有不能用其他原因解释的胎盘源性疾病的抗凝预防或治疗决策还存在争议。

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