血栓前状态与不良妊娠的相关性研究  

Study on relationship between prethrombotic state and adverse pregnancy

作　　者：安宏亮[1] 江海燕 张劲丰[1] 苏荣[1] 邬素珍[3] 邓卫红[3] 庞俏茹[3] 黄星华[1] 

机构地区：[1]佛山市中医院检验科,广东佛山528000 [2]佛山市皮肤病防治所 [3]佛山市中医院妇科

出　　处：《现代预防医学》2013年第19期3585-3588,3596,共5页Modern Preventive Medicine

基　　金：广东省佛山市卫生局医学科研基金项目(2012145)

摘　　要：目的 研究血栓前状态（PTS）与发生不良妊娠特别是不明原因复发性自然流产（URSA）的相关性。方法 收集2011年7月～2012年6月就诊于佛山市中医院妇科的460例病例，分为正常生育组212例，不良妊娠248例（其中URSA组82例、继发性不孕组112例、偶发自然流产组54例）。检测PT、APTT、TT、Fbg、FDP、D-Dimer、HCY 7个与PTS相关的项目，分析各组间结果的差异。结果 PT、APTT、Fbg、TT结果为正态分布，HCY、D-Dimer、FDP结果为偏态分布。4组间PT（F = 2.795，P = 0.060）、APTT（F = 1.926，P = 0.107）、HCY（χ2 = 5.883，P = 0.450）结果的总体差异无统计学意义（P﹥0.05）；4组间TT（F = 13.875，P = 0.000）、Fbg（F = 11.930，P = 0.000）、FDP（χ2 = 24.854，P = 0.000）、D-Dimer（χ2 = 8.702，P = 0.034）结果的总体差异有统计学意义（P﹤0.05）。正常生育组与3个不良妊娠组分别进行TT、Fbg、FDP、D-Dimer结果的比较：与继发不孕组、偶发性自然流产组间的差异均无统计学意义（P﹥0.05）；与URSA组间Fbg、TT、FDP结果的差异有统计学意义（P﹤0.008），D-Dimer结果的差异无统计学意义（χ2 = 3.692，P = 0.055，P﹥0.05）。偶发性自然流产组与URSA组间Fbg、TT、FDP结果的差异有统计学意义（P﹤0.008），D-Dimer结果的差异无统计学意义（χ2 = 3.150，P = 0.076，P﹥0.05）。经二元Logistic回归分析Fbg、TT、FDP与URSA的发生相关（χ2 = 51.723，P﹤0.01），回归方程对URSA患者的预测准确性为53.7%，正常者的预测准确性为89.6%，总体准确性为79.6%。结论 PTS与继发性不孕、偶发性自然流产的发生无关，与URSA的发生相关；通过检测FDP、Fbg、TT凝血项目可进行URSA患者的血栓前状态的筛查。OBJECTIVE To study the correlation of prethrombotic state （IriS） and the occurrence of adverse pregnancy es- pecially in unexplained recurrent spontaneous abortion （URSA）. METHODS Collected 460 women who were in Department of Gynecology of Foshan Hospital of Traditional Chinese Medicine from July 2011 to June 2012, divided them into normal fer- tility group 212 cases, adverse pregnancy 248 cases （among them, 82 cases in group URSA, secondary infertility group 112 cases, episodic spontaneous abortion group 54 cases）. Detected PT, AP＇Iq＇, TY, Fbg, FDP, D-Dimer, HCY 7 and PTS related projects, analyzed differences in results in groups. RESULTS PT, APTY, Fbg, 13＂ results were normal distribution, HCY, D-Dimer, FDP results were partial distribution. In the 4 groups, PT （F = 2.795, P = 0.060）, APTI＂ （F = 1.926, P = 0.107）, HCY （~2 = 5.883, P = 0.450） results in the overall differences were not statistically significant （P 〉 0.05） ; In the 4 groups TY （F = 13.875, P = 0.000）, Fbg （F = 11.930, P = 0.000）, FDP （~ = 24.854, P = 0.000）, D-Dimer （X2 = 8.702, P = 0.034） results in the overall differences were statistically significant （P 〈 0.05）. TF, Fbg, FDP, D-Dimer results were analyzed in normal fertile group and 3 adverse pregnancy groups, compared with secondary infertility group and episodic spontaneous abortion, the differences were not statistically significant （P 〉 0.05） ; compared with URSA group, the differences in Fbg, TI＇, FDP results were statistically significant （P 〈 0.008）, the difference in D-Dimer was not statistically significant （~ = 3.692, P = 0.055, P 〉 0.05）. Fbg, TF, FDP results in episodic spontaneous abortion group and URSA group were significantly different （P 〈 0.008）, the difference of D-Dimer was not statistically significant （~ = 3.150, P = 0.076, P 〉 0.05）. By dual Logistic regression analysis, TI＇, FDP and Fbg involved in the pathogenesis of URSA （~ = 51.723, P 〈 0.01 ）, the regression equatio

关 键 词：血栓前状态 不良妊娠 不明原因复发性自然流产 

分 类 号：R714.2[医药卫生—妇产科学]