Hcy联合凝血功能检测在早孕先兆流产中的应用  

Application of combined detection of homocysteine and coagulation in threatened abortion at early pregnancy

作　　者：郭跃丽[1] 万菁[1] 孔万仲[1] 李淼[1] 孙云[1] 

机构地区：[1]温州市中医院,浙江温州325000

出　　处：《中国妇幼健康研究》2015年第2期289-291,共3页Chinese Journal of Woman and Child Health Research

基　　金：浙江省温州市科技局资助项目(2013S0051)

摘　　要：目的探讨同型半胱氨酸(Hcy)联合凝血功能相关指标的检测在早孕先兆流产患者中的应用价值。方法选取59例先兆流产患者为研究组,另选取81例正常妊娠妇女为对照组。测定Hcy、纤维蛋白原(Fg)、D-二聚体(D-D)、血小板(PLT),并对结果进行分析。结果研究组的Hcy(5.53±1.13μmol/L)、Fg(4.00±0.89 g/L)较对照组的Hcy(4.63±1.26μmol/L)、Fg(3.45±0.73g/L)明显升高,差异均有统计学意义(t值分别为3.82、4.64,均P<0.05);同样,在研究组中D-D和PLT水平也高于对照组,差异均有统计学意义(t值分别为1.75、6.96,均P<0.05)。经Spearman相关性分析得出,Hcy分别与Fg、D-D及PLT呈正相关关系(r值分别为0.721、0.447、0.368,均P<0.05)。对59例先兆流产患者进行随访,按妊娠结局分为顺利分娩、难免流产、过期流产3组,单因素方差分析显示3组Hcy、D-D水平比较差异均有统计学意义(F值分别为59.348、15.916,均P<0.05),Fg和PLT水平比较差异均无统计学意义(均P>0.05)。结论联合检测血Hcy、Fg、D-D、PLT水平可以判断早期妊娠妇女体内的高凝状态,从而为分析早期先兆流产病因提供依据,更加合理地指导临床治疗,以阻止不良妊娠结局的发生。Objective To investigate the value of combined detection of homocysteine （ Hcy） and coagulation indexes in threatened abortion patients at early pregnancy.Methods The serum levels of Hcy, fibrinogen （ Fg） , D-dimer （ D-D） and platelet （ PLT） were detected for 59 cases of threatened abortion patients in study group and 81 cases of normal pregnant women in control group.Results The levels of Hcy and Fg in the study group （5.53 ±1.13μmol/L, 4.00 ±0.89g/L） were significantly increased compared with the control group （4.63 ±1.26μmol/L, 3.45 ±0.73g/L）, and the differences were significant （t value was 3.82 and 4.64, respectively, both P〈0.05）.D-D and PLT levels in the study group were also higher than the control group,and the differences were significant （ t value was 1.75 and 6.96, respectively, both P〈0.05）.Spearman correlation analysis showed that Hcy presented positive correlation with Fg, D-D and PLT （r value was 0.721, 0.447 and 0.368, respectively, all P〈0.05）.The study group was followed up and they were divided into smooth delivery group, inevitable abortion group and missed abortion group according to pregnancy outcomes.Univariate analysis of three groups showed statistical differences in Hcy and D-D levels （ F value was 59.348 and 15.916, respectively, both P〈0.05） but no significant differences in Fg and PLT among three groups （both P〉0.05）.Conclusion Combined detection of plasma levels of Hcy, Fg, D-D and PLT can evaluate the hypercoagulable degree of early pregnancy and provide evidence for analyzing the causes of threatened abortion, so that clinical treatment can be reasonably guided to terminate adverse pregnant outcomes.

关 键 词：先兆流产 同型半胱氨酸 纤维蛋白原 D-二聚体 血小板 

分 类 号：R714.21[医药卫生—妇产科学]