血栓弹力图对早期复发性流产患者妊娠率的预测价值  

Predictive Value of Thrombelastography on Pregnancy Rate of Patients with Early Recurrent Spontaneous Abortion

作　　者：李慧梁 唐新桥 蔡丹 LI Hui-liang;TANG Xin-qiao;CAI Dan(Xiangtan City Central Hospital,Xiangtan Hunan 411100 China)

机构地区：[1]湖南省湘潭市中心医院,湖南湘潭411100

出　　处：《医学临床研究》2020年第7期995-997,1001,共4页Journal of Clinical Research

基　　金：湘潭市科技计划项目(SF-YB20171004)。

摘　　要：【目的】探讨血栓弹力图血栓弹力图对早期复发性流产(RSA)患者妊娠率的预测价值。【方法】选取2016年1月至2017年12月在本院诊治的RSA患者72例,按照随机数表法分为A组(采用阿司匹林+低分子肝素钙治疗)和B组(采用阿司匹林治疗),每组36例。另外选取同期在本院产检的40例正常孕妇作为对照组(C组)。A组和B组RSA患者在计划妊娠前2个月开始用药,并持续用药至孕后1个月。A组和B组治疗前和停药后进行血栓弹力图检测,C组则在孕前和孕后1个月时的血栓弹力图检测,比较各组孕前、孕后的血栓弹力图指标及妊娠丢失率,并分析血栓弹力图参数与妊娠丢失率相关性。【结果】孕前,A组和B组的R值、α角显著低于C组,MA值、K值显著高于C组,其差异均具有统计学意义(P<0.05);A组R值、α角显著低于B组,K值显著高于B组,其差异均具有统计学意义(P<0.05),但A组和B组的MA值比较差异无统计学意义(P>0.05)。孕后,A组、C组R值、α角显著高于B组,K值、MA值显著低于B组,其差异均具有统计学意义(P<0.05);A组、C组R值、K值、α角、MA值比较差异均无统计学意义(P>0.05)。A组、B组、C组的妊娠丢失率分别为16.7%(6/36)、38.9%(14/36)、2.5%(1/40),妊娠丢失率C组<A组<B组,组间比较差异有统计学意义(P<0.05)。二元Logistic回归模型分析显示:妊娠丢失率与MA值呈显著相关(r=0.614,P<0.05),而与R值、K值、α角无相关性(P>0.05)。【结论】血栓弹力图能够对早期复发性流产患者的血栓前状态进行检测,能够一定程度上对患者的妊娠丢失率进行预测,值得临床推广应用。【Objective】To explore the application of thromboelastography to predict the pregnancy rate of patients with early recurrent spontaneous abortion(RSA).【Methods】A total of 72 RSA patients from January 2016 to December 2017 in our hospital were selected and randomly divided into group A and group B with 36 cases in each group.In addition,40 normal pregnant women in the same period were selected as group C(the control group).Patients in the group A received both aspirin and low molecular weight heparin calcium,while patients in the group B only received aspirin treatment.RSA patients of both groups started taking the medication two months before the planned pregnancy and continued the medication until 1 month after pregnancy.Thromboelastogram in both group A and B was detected before therapy and after drug withdrawal,while in control group thromboelastogram was detected before pregnancy and 1 month after pregnancy.Thromboelastogram was followed up for 12 months.Thromboelastogram index and pregnancy loss rate were compared among groups before and after pregnancy.The correlation between thromboelastogram parameters and pregnancy loss rate were analyzed.【Results】Before pregnancy,the R value and alpha(α)angle of group A and B were significantly lower than those of Group C,while the MA value and K value of group A and B were significantly higher than Group C.The differences were statistically significant(P<0.05).The R value andαangle in group A were lower than those in group B,while K value in group A was higher than in group B.The differences were statistically significant(P<0.05),however,the MA value in group A and group B dii not show significant difference(P>0.05).After pregnancy,the R value andαangle of group A and group C were significantly higher than that of group B,and the K value and MA value were significantly lower than group B.The differences were statistically significant(P<0.05).The K value,alpha angle and MA value in group A and C had no significant difference(P>0.05).The pregnancy loss rate

关 键 词：流产 习惯性 血栓弹力描记术 妊娠率 

分 类 号：R714.21[医药卫生—妇产科学]