临产期孕妇纤维蛋白单体含量预测产后出血量及其临床意义  

Predictive value of fibrin monomer concentration detection for amount of postpartum hemorrhage and the clinical significance in parturient women

作　　者：何宗忠[1] 宋梅[2] 王晓东[1] 林林东[1] 沈雪曼[1] 段德令 史秋霞[1] 欧炜华[1] 周红云[1] 龚娅[1] 

机构地区：[1]广州军区广州总医院附属157医院检验科,广东广州510510 [2]广州军区广州总医院附属157医院妇产科

出　　处：《中国妇幼保健》2015年第28期4799-4801,共3页Maternal and Child Health Care of China

摘　　要：目的探讨纤维蛋白单体(FM)、凝血酶原时间(PT)、国际化比值(INR)、部分凝血酶活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白(FIB)及血小板计数(PLT)在临产期孕妇产后出血量预测中的临床应用价值。方法检测159例临产期孕妇的PT、APTT、TT、FIB、FM及PLT,并分为出血组(24 h产后出血量>500 ml,19例)和无出血组(24 h产后出血量≤500 ml,140例),另选取24例正常非孕妇女作为对照组,比较各组妇女各指标变化。结果 TT及PLT各组间比较,差异无统计学意义(P>0.05);FM、PT、INR、APTT及FIB各组间比较,差异均有统计学意义(P<0.05)。159例临产期孕妇中FM水平≤50μg/ml者146例,仅13例发生产后大出血,占8.90%;而>50μg/ml者13例,其中6例发生产后大出血,占46.15%;发生产后出血比例比较差异有统计学意义(χ2=12.401,P<0.001)。产后大出血并发症的发生与年龄、PT、INR、APTT、FIB、TT及PLT无关,与FM呈正相关,与FIB呈负相关。结论 FM及其他凝血纤溶指标对临产期孕妇产后出血量的预测有重要的临床意义。Objective： To explore the clinical application value of fibrin monomer （FM）, prothrombin time （PT）, international ratio （INR）, activated partial thromboplastin time （APTF）, thrombin time （TT）, fibrin （FIB）, and platelet （PLT） in predicting the amount of postpartum hemorrhage in parturient women. Methods： PT, APTT, TT, FIB, FM, and PLT of 159 parturient women were detected, then the women were divided into bleeding group （ 19 parturient women, the amount of postpartum hemorrhage within 24 hours〉500 ml） and non-bleeding group （140 parturient women, the amount of postpartum hemorrhage within 24 hours≤500 ml） ; 24 normal non-pregnant women were selected as control group ; the changes of different indexes in the three groups were compared. Results： There was no statistically significant difference in TT and PLT among the three groups （P〉0. 05 ） ; there were statistically significant differences in FM, PT, INR, APTT, and FIB among the three groups （P〈0. 05 ） . Among 159 parturient women, FM levels in 146 parturient women were less than 50 μg/ml, postpartum hemorrhage only occurred in 13 parturient women, accounting for 8. 90% ; FM levels in 13 parturient women were more than 50 μg/ml, postpartum hemorrhage occurred in 6 parturient women, accounting for 46. 15% ; there was statistically significant difference in the proportion of postpartum hemorrhage （χ^2 = 12. 401, P〈0. 001 ） . The occurrence of complications of postpartum hemorrhage was not correlated with age, PT, INR, APTt, FIB, TT, and PLT, which was positively correlated with FM and negatively correlated with FIB. Conclusion： FM and other indicators of coagulation and fibrinolysis have important clinical significance in predicting the amount of postpartum hemorrhage in parturient women.

关 键 词：纤维蛋白单体 产后出血量 临产期孕产妇 凝血纤溶指标 

分 类 号：R446.11[医药卫生—诊断学]