D-D、FDP和TM在产科DIC早期诊断中的临床意义  

The clinical significance of D-dimer,fibrinogen degradation products and thrombomodulin in early diagnosis of obstetrics DIC

作　　者：田文芳 李东晖 王德文 TIAN Wenfang;LI Donghui;WANG Dewen(The Second People's Hospital of Zhuhai,Zhuhai,Guangdong 519020,China)

机构地区：[1]珠海市中西医结合医院

出　　处：《实验与检验医学》2019年第3期392-394,共3页Experimental and Laboratory Medicine

基　　金：珠海市科技计划项目,编号20161027E030023

摘　　要：目的研究D-二聚体(D-D)、血栓调节蛋白(TM)和纤维蛋白(原)降解产物(FDP)在产科弥漫性血管内凝血(DIC)早期诊断中的临床意义。方法对30例正常早孕妇女,30例中孕妇女,30例晚孕妇女和30例正常对照妇女和16例产科早期DIC患者检测D-D、FDP、TM水平。结果正常妊娠的各时期孕妇的D-D、FDP、TM值与正常对照组比较,差异均有统计学意义(P<0.05);产科早期DIC组与正常妊娠各时期及正常对照组比较,有显著性差异(P<0.05)。TM水平在不同妊娠时期差异无统计学意义(P>0.05),D-D、FDP随着孕期的延长呈上升趋势,但这两项指标的早孕组和中孕组对比差异没有统计学意义(P>0.05),晚孕组的D-D和FDP与早孕组和中孕组相比差异有统计学意义(P<0.05)。结论正常孕妇凝血机制会发生改变,处于高凝状态。一旦有早期DIC发生,D-D、FDP、TM水平会有较明显的升高,因此,D-D、FDP、TM可作为产科DIC早期诊断的敏感指标。Objective To investigate the clinical significance of D dimer(D-D),fibrinogen degradation products(FDP)and thrombomodulin(TM)in the early diagnosis of obstetrics disseminated intravascular coagulation(DIC)and the changes in different period of healthy pregnant women.Methods Thirty healthy early pregnant women,30 medium pregnant women and 30 late pregnant women,30 healthy women and 16 early DIC of obstetrics were enrolled in the study.The levels of D-D,FDP,TM were detected.Results Compared with the healthy women,the levels of D D,FDP,TM in the early,medium and late pregnancy were significant different(P<0.05);There were significant differences between the early DIC of obstetrics group and the normal pregnancy stages and the normal control group(P<0.05).There was no statistically significant difference in TM level between different pregnancy stages(P>0.05).D-D and FDP showed an upward trend with the extension of pregnancy.However,there was no significant difference in the early pregnancy group and the middle pregnancy group(P>0.05),and there was statistically significant difference between the d-d and FDP in the late pregnancy group and the early pregnancy group and the middle pregnancy group(P<0.05).Conclusions In different healthy gestation,the blood coagulation mechanism will change.Once the early DIC has occurs,the levels of D-D,FDP,TM will increase significantly.Therefore,D-D,FDP,TM can be used as a sensitive indicator in early diagnosis of obstetrics DIC.

关 键 词：纤维蛋白降解产物 D-二聚体 血栓调节蛋白 妊娠 早期弥漫性血管内凝血 

分 类 号：R446.61[医药卫生—诊断学] R714.1[医药卫生—临床医学]