凝血指标与子宫内膜异位症盆腔粘连相关性研究  

Relation between coagulation parameters and pelvic adhesions in endometriosis

作　　者：林巧 丁少杰[1] 车璇[1] 李田田 张信美[1] LIN Qiao;DING Shao-jie;CHE Xuan;LI Tian-tian;ZHANG Xin-mei(Department of Gynecology,Women’s Hospital,Zhejiang University School of Medicine,Hangzhou 310006,China(The first author is currently working in department of obstetrics and gynecology, Taizhou Cancer Hospital,Zhejiang Province)

机构地区：[1]浙江大学医学院附属妇产科医院妇科,浙江杭州310006 [2]浙江省台州市肿瘤医院妇产科

出　　处：《中国实用妇科与产科杂志》2019年第6期677-680,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家重点研发计划(2017YFC1001202)

摘　　要：目的探讨凝血指标与子宫内膜异位症(内异症)盆腔粘连的相关性。方法回顾性分析2016年6月至2018年2月于浙江大学医学院附属妇产科医院经手术治疗的内异症患者408例的临床资料,评价凝血指标的变化与盆腔粘连严重程度的相关性。结果有盆腔粘连的内异症患者血浆纤维蛋白原(FIB)高于无粘连者[3.1(2.7～4.5)g/L vs. 2.8(2.6～3.2)g/L,P<0.01],血浆凝血酶原时间(PT)短于无粘连者[12.9(12.5～13.3)s vs. 13.1(12.7～13.5)s,P<0.01],血小板计数(PLT)和活化部分凝血酶原时间(APTT)差异无统计学意义(P>0.05)。FIB与盆腔粘连评分呈正相关(r=0.248,P<0.01)。在盆腔粘连的判断中,FIB的曲线下面积(AUC)为0.630,诊断界值为2.87g/L,FIB≥2.87g/L的内异症患者盆腔粘连的发生率增加(χ2=15.4,P<0.01)。结论凝血指标与内异症的盆腔粘连存在相关性,尤其FIB与盆腔粘连的发生发展相关,可协助判断内异症所致的盆腔粘连的严重程度。Objective To investigate the correlation between coagulation parameters and pelvic adhesions in endometriosis.Methods The clinical data of 408 patients with endometriosis who underwent surgery in Women’s Hospital School of Medicine Zhejiang University from June 2016 to February 2018 were retrospectively analyzed to evaluate the correlation between coagulation parameters and the severity of pelvic adhesions.Results In endometriosis cases,the levels of plasma fibrinogen(FIB)in patients with pelvic adhesions were significantly shorter than those without pelvic adhesions[median:3.1 g/L(range:2.7-4.5 g/L)vs. 2.8 g/L(range:2.6-3.2 g/L),respectively;P<0.01],the plasma prothrombin time(PT)in patients with pelvic adhesions were significantly shorter than those without pelvic adhesions[median:12.9 s(range:12.5-13.3 s)and 13.1 s(range:12.7-13.5 s),respectively;P<0.01],while there was no difference in the levels of platelet count(PLT)or activated partial prothrombin time(APTT)(P>0.05). FIB was positively correlated with pelvic adhesion scores(r=0.248,P<0.01).In the judgment of pelvic adhesion,the area under the curve(AUC)of FIB was 0.630,and the cut-off value was 2.87 g/L.The incidence of adhesions in patients with FIB greater than 2.87 g/L increased(χ^2=15.4,P<0.01).Conclusion Coagulation parameters was correlated with the pelvic adhesions in endometriosis,especially fibrinogen,which may help to judge the severity of pelvic adhesions caused by endometriosis.

关 键 词：子宫内膜异位症 凝血 纤维蛋白原 粘连 

分 类 号：R711.71[医药卫生—妇产科学]