摘要
随着孕周的增加,妊娠女性的高凝状况逐渐递增,其血液中的抗凝因子、凝血因子和纤溶系统三者共同协调维持体内血液循环动态平衡。若动态平衡被打破,血栓前状态(PTS)形成,将引起妊娠期肝内胆汁淤积症(ICP)等病理性妊娠,严重影响妊娠结局。低分子肝素(LMWH)不但可改善ICP患者的PTS,还可通过多种机制改善肝脏微循环,降低胆汁酸水平,阻止ICP的发生。目前LMWH在ICP中的应用报道较少,其对妊娠结局的影响在学术上也颇有争议,还需后续大量随机对照试验以获取高级别的循证医学证据。
With the increase of gestational weeks,the hypercoagulability of pregnant women increases gradually,and the blood anticoagulant factors,coagulation factors and fibrinolytic system coordinate to maintain the dynamic balance of blood circulation in the body.If the dynamic balance is broken,the pretrombotic state(PTS)will form,which will cause intrahepatic cholestasis during pregnancy(ICP)and other pathological pregnancy,and seriously affect the pregnancy outcome.Low molecular weight heparin(LMWH)can not only improve PTS of ICP patients,but also improve liver microcirculation,through various mechanisms to reduce bile acid and prevent the occurrence of ICP.At present,there are few reports on the application of LMWH in ICP,and its effect on pregnancy outcome is quite controversial academically.A large number of randomized controlled trials are needed to obtain high-level evidence-based medicine evidence.
作者
黄丹
余蕾
曾晓玲
HUANG Dan;YU Lei;ZENG Xiaoling(Department of Obstetrics,Affiliated Hospital of Guizhou Medical University,Guiyang 550000,China)
出处
《医学综述》
2020年第18期3589-3593,3600,共6页
Medical Recapitulate
关键词
妊娠期肝内胆汁淤积
低分子肝素
血栓前状态
妊娠结局
Intrahepatic cholestasis during pregnancy
Low molecular weight heparin
Prethrombotic state
Pregnancy outcome
