血浆FDP、D-D及血清NO、NOS与产后出血的关系研究  

Study on the relationship between plasma FDP,D-D,serum NO,NOS and postpartum hemorrhage

作　　者：王留香 王川红[1] WANG Liuxiang;WANG Chuanhong(Maternal and Child Health Hospital,Zhengzhou,Henan,450000)

机构地区：[1]郑州市妇幼保健院妇产科,河南郑州450000

出　　处：《实验与检验医学》2020年第3期462-465,共4页Experimental and Laboratory Medicine

基　　金：国家中医临床研究基地业务建设第二批科研专项(No.JDZX2018327836)。

摘　　要：目的探讨产前血浆纤维蛋白(原)降解产物(FDP)、D-二聚体(D-D)、一氧化氮(NO)及一氧化氮合酶(NOS)对于预测产后出血的临床价值。方法选取我院产科分娩产妇1426例,产前18h均行血浆FDP、D-D及血清NO、NOS水平检测,按是否发生产后出血分为病例组(n=53)及对照组(n=1373),比较两组患者FDP、D-D、NO及NOS表达水平差异,绘制ROC曲线,分析FDP、D-D、NO及NOS检测对产后出血的预测价值。结果病例组产妇产前48h的血浆FDP、D-D及血清NO、NOS水平均显著的高于对照组,差异均具有统计学意义(P<0.05);产前48h的血浆FDP预测产后出血的灵敏度为88.20%、特异度为71.47%、AUC值为0.831;产前48h的血浆D-D预测产后出血的灵敏度为91.59%、特异度为83.28%、AUC值为0.887;产前48h的血浆NO预测产后出血的灵敏度为75.53%、特异度为62.06%、AUC值为0.709;产前48h的血浆NOS预测产后出血的灵敏度为77.01%、特异度为64.88%、AUC值为0.716。结论监测产妇产前48h的血浆FDP、D-D及血清NO、NOS水平对于预测产后出血、指导分娩治疗具有一定的价值。Objective To explore the clinical value of detecting fibrinogen degradation products(FDP),D-dimer(D-D),nitric oxide(NO)and nitric oxide synthase(NOS)in prenatal plasma for predicting postpartum hemorrhage.Methods A total of 1426 parturients in obstetrics department of our hospital were selected.The levels of plasma FDP,D-D and serum NO and NOS were measured 18 hours before delivery.According to whether postpartum hemorrhage occurred,they were divided into case group(n=53)and control group(n=1373).The differences of expression levels of FDP,D-D,NO and NOS between the two groups were compared,and ROC curves were drawn.FDP,D-D,NO and NOS were analyzed separately.And the predictive value of combined detection for postpartum hemorrhage.Results The plasma FDP,D-D,NO and NOS levels at 48 hours before delivery in the case group were significantly higher than those in the control group(P<0.05).The sensitivity,specificity and AUC value of plasma FDP at 48 hours before delivery were 88.20%,71.47%and 0.831 respectively,and the sensitivity,specificity and AUC value of plasma D-D at 48 hours before delivery were 91.59%,83.28%and 0.887 respectively.The sensitivity,specificity and AUC value for predicting postpartum hemorrhage were 75.53%,62.06%and 0.709 for plasma NO at 8 hours,77.01%,64.88%and 0.716 for plasma NOS at 48 hours before delivery.Conclusion Monitoring the levels of plasma FDP,D-D,NO and NOS 48 hours before delivery has certain value in predicting postpartum hemorrhage and guiding delivery treatment.

关 键 词：纤维蛋白(原)降解产物 D-二聚体 一氧化氮 一氧化氮合酶 产后出血 

分 类 号：R446.1[医药卫生—诊断学] R714.461[医药卫生—临床医学]