晚孕期母血浆D-二聚体对妊娠期高血压疾病的诊断价值  

Diagnostic value of maternal plasma D-dimer and hypertensive disorders of pregnancy in late pregnancy

作　　者：陈益明 黄建霞 施晓春 何佩 沈涌海 CHEN Yiming;HUANG Jianxia;SHI Xiaochun;HE Pei;SHEN Yonghai(Department of Prenatal Screening Laboratory,Hangzhou Women's Hospital,Hangzhou Maternity and Child Health Care Hospital,Hangzhou 310008,Zhejiang,China;Department of Obstetrics,Hangzhou Women's Hospital,Hangzhou Maternity and Child Health Care Hospital,Hangzhou 310008,Zhejiang,China;Department of Clinical Laboratory,Hangzhou Women's Hospital,Hangzhou Maternity and Child Health Care Hospital,Hangzhou 310008,Zhejiang,China)

机构地区：[1]杭州市妇产科医院(杭州市妇幼保健院)产前筛查实验室,浙江杭州310008 [2]杭州市妇产科医院(杭州市妇幼保健院)产科,浙江杭州310008 [3]杭州市妇产科医院(杭州市妇幼保健院)检验科,浙江杭州310008

出　　处：《检验医学》2020年第8期753-756,共4页Laboratory Medicine

基　　金：浙江省医药卫生科技计划项目(2018ZD036);杭州市余杭区科技局科研项目(医疗卫生-2018008)。

摘　　要：目的评价妊娠第28~32周孕妇血浆D-二聚体(DD)水平对妊娠期高血压疾病(HDP)的诊断价值。方法收集2014年11月—2019年4月杭州市妇产科医院(杭州市妇幼保健院)产科住院分娩的2299例孕妇资料,其中1705例为正常孕妇(对照组),299例孕妇患有妊娠高血压(GH)(GH组),158例孕妇患有子痫前期(PE)(PE组),137例孕妇患有重度子痫前期(SPE)(SPE组)。采用受试者工作特征(ROC)曲线来评价晚孕期母血浆DD水平对HDP的诊断价值。结果GH组、PE组和SPE组的DD水平分别为1730μg/L、1950μg/L和2030μg/L,均高于对照组的1520μg/L,差异有统计学意义(P<0.001),且有随病情进展逐渐升高的趋势。在对GH、PE、SPE的诊断价值方面,晚孕期母血浆DD的曲线下面积(AUC)分别为0.560(0.525~0.595,P=0.001)、0.614(0.567~0.660,P<0.001)、0.640(0.589~0.692,P<0.001),当晚孕期母血浆DD的最佳临界值分别为1325μg/L、1875μg/L、1795μg/L时,对应的敏感性、特异性分别为0.746、0.389,0.544、0.652,0.635、0.624。结论晚孕期母血浆DD水平对HDP具有诊断价值。Objective To investigate the diagnostic value of maternal plasma D-dimer(DD)and hypertensive disorders of pregnancy(HDP)in the 28-32 gestational weeks.Methods The data of 2299 pregnant women who delivered in Hangzhou Women's Hospital(Hangzhou Maternity and Child Health Care Hospital)from November 2014 to April 2019 were collected.There were 299 gestational hypertension(GH)patients,158 preeclampsia(PE)patients and 137 severe preeclampsia(SPE)patients.A total of 1705 healthy pregnant women were enrolled as control group.The performance of DD for HDP was evaluated by receiver operating characteristic(ROC)curve.Results In GH,PE and SPE groups,the levels of DD were 1730,1950 and 2030μg/L,respectively,which were higher than that in control group(1520μg/L,P<0.001).With progress,the DD levels increased gradually.For the diagnosis of GH,PE and SPE,the areas under curves(AUC)of DD were 0.560(0.525-0.595,P=0.001),0.614(0.567-0.660,P<0.001)and 0.640(0.589-0.692,P<0.001),respectively.When the cut-off values of DD were 1325,1875 and 1795μg/L,the sensitivities were 0.746,0.544 and 0.635,and the specificities were 0.389,0.652 and 0.624,respectively.Conclusions The levels of DD in the late trimester of pregnancy play a predictive role to HDP.

关 键 词：晚孕期 D-二聚体 妊娠期高血压疾病 诊断价值 

分 类 号：R446.1[医药卫生—诊断学]