孕产妇血浆D-二聚体水平及其对静脉血栓栓塞性疾病的临床意义  

Analysis on levels of plasma D-dimer in maternal patients and its clinical significance in venous thromboembolism

作　　者：包晓晖 

机构地区：[1]河南省禹州市妇幼保健院,464670

出　　处：《中国实用医刊》2017年第23期71-72,共2页Chinese Journal of Practical Medicine

摘　　要：目的探讨孕产妇血浆D-二聚体水平及其对静脉血栓栓塞性疾病（VTE）的临床意义。方法选择孕期及产褥期妇女520例，其中妊娠12周～分娩前的300例作为孕期组，分娩至产后96h的220例作为产褥期组。另选取同期体检正常妇女60例作为非孕组。比较三组妇女血浆D-二聚体水平；分析产褥期组不同分娩方式产妇在产后48h、48～96h血浆D-二聚体水平的变化。结果孕期组和产褥期组D-二聚体水平高于非孕组，差异有统计学意义（P〈0．05）。220例产褥期组妇女中，阴道分娩者产后48h、48～96h血浆D-二聚体水平均低于剖宫产者。两组孕产妇中发生VTE1例，发生率为0．19％（1／520），为下肢静脉血栓，分娩方式为剖宫产，经B超、静脉血管造影确诊，其孕期血浆D-二聚体水平为162．12mg／L，呈阳性。结论孕期妇女血浆D-二聚体的水平高于非孕妇女，血浆D-二聚体结合B超可用于筛查VTE，以便于做到早诊断、早治疗。Objective To analyze the plasma D-dimer level in maternal patients and its clinical significance in venous thromboembolism （VTE）. Methods A total of 520 maternal patients were select- ed, while 300 cases of pregnant women in 12 weeks to before delivery were divided into gestation group, and 220 cases of parturients from delivery to postpartum 96 h were divided into puerperium group. Sixty cases of normal women were selected at the same time as non-pregnancy group. Plasma D-dimer level was compared among the three groups; plasma D-dimer levels within 48 h, in 48 -96 h after delivery of women with different modes of delivery were analyzed. Results The levels of plasma D-dimer in gesta- tion group and puerperium group were higher than that in non-pregnancy group, the differences were sig- nificant （P 〈 0. 05 ）. In peurperium group, plasma D-dimer level within 48 h, in 48 - 96 h after delivery in women with vaginal delivery was lower than that in women with cesarean delivery. There was 1 case of VTE, with incidence of 0. 19% （1/520） , in the pregnant and puerperal women. The delivery way were cesarean in the VTE woman diagnosed by type B ultrasound and venous angiography, and serum D-dimer level during pregnancy was 162. 12 mg/L and positive. Conclusions The level of plasma D-dimer in pregnant and peurperal woman was higher than that of the non-pregnant woman; plasma D-dimer com- bined with type B ultrasound can be used to screen VTE which benefits to early diagnosis and treatment.

关 键 词：妊娠 产褥期 D-二聚体 

分 类 号：R714[医药卫生—妇产科学]