D-二聚体、纤维蛋白原、心肌酶谱在妊娠期糖尿病中的临床意义  

Clinical significance of D-dimer, fibrinogen and myocardial zymogram in gestational diabetes mellitus

作　　者：吴兆晴 徐金霞[1] Zhao-qing Wu;Jin-xia Xu(Department of Obstetrics,The Women and Children's Health Hospital of Jiangsu,Huai'an,Jiangsu 223002,China)

机构地区：[1]淮安市妇幼保健院产科

出　　处：《中国现代医学杂志》2020年第3期97-101,共5页China Journal of Modern Medicine

摘　　要：目的研究D-二聚体、纤维蛋白原、心肌酶谱在妊娠期糖尿病中的临床意义。方法选取2017年2月-2018年2月淮安市妇幼保健院产检、分娩的75例妊娠期糖尿病(GDM)患者为研究对象(研究组),另选取该院正常孕妇75例(对照组),比较两组孕中期和产前血清D-二聚体、纤维蛋白原、心肌酶谱、孕妇妊娠结局及新生儿情况的差异。同时对研究组患者的新生儿血清D-二聚体、纤维蛋白原、心肌酶谱及不良新生儿结局,以及不良孕妇结局进行多因素分析。结果研究组患者的孕中期和产前血清D-二聚体、纤维蛋白原、心肌酶谱水平与对照组比较,差异有统计学意义(P<0.05),研究组高于对照组;研究组患者的顺产率和新生儿Apgar评分低于对照组,先兆流产、妊娠高血压、产后出血、产期感染情况高于对照组,新生儿早产、死亡及胎儿宫内窘迫综合征高于对照组(P<0.05);研究组患者产前血清D-二聚体、纤维蛋白原、心肌酶谱分别与不良妊娠结局、不良新生儿结局及新生儿Apgar评分呈正相关(P<0.05);D-二聚体、纤维蛋白原、心肌酶谱可作为不良孕妇结局和新生儿结局的独立危险因素。结论妊娠糖期尿病患者血清D-二聚体、纤维蛋白原及心肌酶谱与不良孕妇结局及不良新生儿结局呈正相关,及时对患者的血清纤溶系统和凝血功能进行预测并及早干预,对于患者的预后具有积极意义。Objective To study the significance of D-dimer,fibrinogen and myocardial zymogram in gestational diabetes mellitus.Methods Seventy-five patients with GDM prenatal examination and treated in Huai'an women and children's hospital from February 2017 to February 2018 were selected as the study subjects.Another 75 normal pregnant women in our hospital were selected.The differences of serum D-dimer,fibrinogen,myocardial zymogram,pregnancy outcome and fetal status between the two groups were compared.At the same time,the serum D-dimer,fibrinogen,myocardial zymogram,adverse neonatal outcomes and adverse pregnant outcomes were analyzed.Results Serum D-dimer,fibrinogen and myocardial zymogram levels of patients with disease were significantly higher than those of healthy group on pregnancy outcome and fetal status after delivery(P<0.05).The Apgar score of infants was significantly lower than that of healthy group(P<0.05).The incidence of threatened abortion,pregnancy hypertension,postpartum hemorrhage and puerperal infection was significantly higher than that of healthy group(P<0.05),and the incidence of premature birth,death and intrauterine distress syndrome was significantly higher than that of healthy group(P<0.05).The prenatal serum D-dimer,fibrinogen,myocardial zymogram,adverse pregnancy outcomes and adverse neonatal outcomes were positive correlated with neonatal Apgar evaluation.D-dimer,fibrinogen and myocardial enzymes were independent risk factors for adverse pregnant outcomes and neonatal outcomes.Conclusion The adverse pregnancy outcomes of diabetes mellitus patients are positively correlated with serum D-dimer,fibrin and myocardial enzymes.Timely prediction of serum fibrinolytic system and coagulation function and early intervention are of positive significance for the prognosis of patients.

关 键 词：妊娠期糖尿病/糖尿病 不良妊娠结局 D-二聚体 纤维蛋白原 心肌酶 

分 类 号：R587.1[医药卫生—内分泌]