在正常妊娠和产褥期止血。

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在正常妊娠和产褥期止血。

Semin Thromb Hemost。2003年4月29日(2):125 - 30。

PubMed ID

12709915 (在PubMed

]

文摘

在正常怀孕止血平衡凝固性过高的方向变化,从而减少出血并发症与交付。最重要的初始因素对急性止血在交付是,然而,子宫肌肉收缩,血流中断。Thromboelastogram Sonoclot等全球测试签名,和一种新的方法分析整体等离子止血,所有显示变化的代表怀孕期间血凝过快。内源性凝血酶生成,增加了活化蛋白C抵抗,稍微减少局部血栓形成质激活时间(aPTT)、凝血酶原增加复杂程度(PT)测量国际标准化比率(INR)小于0.9已报告。在正常怀孕,血小板计数正常范围内除了在怀孕后期良性的妊娠期血小板减少时,80 - 150 x 10 9 / L,可以观察到。血小板营业额通常是正常的。血小板激活和释放beta-thromboglobulin和血小板因子4报告。正常怀孕期间出血时间不变。大多数凝血因子和纤维蛋白原增加怀孕期间。因子(F)习近平是唯一的凝血因子,减少。 Blood coagulation inhibitors are mainly unchanged but the level of free protein S decreases markedly and the level of tissue factor pathway inhibitor increases. Thrombomodulin levels increase during pregnancy. Fibrinolytic capacity is diminished during pregnancy, mainly because of markedly increased levels of plasminogen activator inhibitor-1 (PAI-1) from endothelial cells and plasminogen activator inhibitor-2 (PAI-2) from the placenta. Thrombin-activated fibrinolysis inhibitor is reported to be unaffected. The total hemostatic balance has been studied by analyses of prothrombin fragment 1+2, thrombin-antithrombin complex, fibrinopeptide A, soluble fibrin, D-dimer, and plasmin-antiplasmin complex. There is activation of blood coagulation and a simultaneous increase in fibrinolysis without signs of organ dysfunction during normal pregnancy. These changes increase as pregnancy progresses. During delivery, there is consumption of platelets and blood coagulation factors, including fibrinogen. Fibrinolysis improves and increases fast following childbirth and expulsion of the placenta, resulting in increased D-dimer levels. These changes are self-limiting at normal delivery. The hemostatic changes, noted during pregnancy, normalize after delivery within 4 to 6 weeks. Platelet count and free protein S, however, can be abnormal longer. Hemostasis should not be tested earlier than 3 months following delivery and after terminating lactation to rule out influences of pregnancy. PAI-1 and PAI-2 levels decrease fast postpartum, but PAI 2 has been detected up to 8 weeks postpartum. alpha 2 -antiplasmin, urokinase, and kallikrein inhibitor levels have been reported to be increased 6 weeks postpartum.

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药物靶点

药物	目标	类	生物	药理作用	行动
尿激酶	纤溶酶原激活物抑制剂1	蛋白质	人类	是的	底物 诱导物	细节