晚孕期母血浆凝血酶、纤维蛋白原、D二聚体与妊娠期高血压疾病的相关性及诊断价值  

Correlation and diagnostic value of maternal plasma thrombin,fibrinogen and D-dimer in last trimester with gestational hypertension

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 Maternity and Child Health Care Hospital,Hangzhou 310008,China;Department of Obstetrics,Hangzhou Maternity and Child Health Care Hospital,Hangzhou 310008,China;Department of Laboratory,Hangzhou Maternity and Child Health Care Hospital,Hangzhou 310008,China)

机构地区：[1]杭州市妇产科医院产前筛查实验室,浙江杭州310008 [2]杭州市妇产科医院产科,浙江杭州310008 [3]杭州市妇产科医院检验科,浙江杭州310008

出　　处：《健康研究》2021年第1期56-60,共5页Health Research

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周孕妇血浆凝血酶原时间(prothrombin time,PT)、凝血酶时间(thrombin time,TT)、活化部分凝血酶原时间(activated partial prothrombin time,APTT)、纤维蛋白原(fibrinogen,FIB)和D-二聚体(D-dimer,D-D)水平与妊娠期高血压疾病的相关性及诊断价值。方法回顾性分析医院产科住院分娩的2355例孕妇资料,其中,1814例正常孕妇、286例妊娠高血压(gestational hypertension,GH)、143例子痫前期(preeclampsia,PE)和112例重度子痫前期(severe preeclampsia,SPE),采用受试者工作特征曲线(receiver operating characteristic curve,ROC)评价血浆凝血酶功能、FIB、D-D水平对妊娠期高血压疾病的相关性及诊断价值。结果GH组、PE组、SPE组的PT、FIB、D-D水平与正常组比较,各组间TT和APTT水平比较,差异均有统计学意义(均P<0.01)。PT、FIB和D-D对GH有诊断价值,D-D对PE有诊断价值,TT和D-D对SPE有诊断价值,PT(AUC=0.565)和D-D(AUC=0.575)对妊娠期高血压疾病有一定的诊断价值(P<0.001)。结论晚孕期孕妇凝血系统各指标与GH、PE有一定的相关性,PT和D-D水平对妊娠期高血压疾病具有一定诊断价值。Objective To evaluate the correlation and diagnostic value of plasma prothrombin time(PT),thrombin time(TT),activated partial prothrombin time(APTT),fibrinogen(FIB)and D-dimer(D-D)levels with hypertensive disorders in pregnancy between the 28th and 32nd weeks of gestation.Methods This study retrospectively analyzed 2355 pregnant women who delivered in the obstetrics department,of which 1,814 were healthy pregnant women,286 had gestational hypertension(GH),143 had preeclampsia(PE),and 112 had severe preeclampsia(SPE).The relevance and diagnostic value of plasma thrombin function,FIB and D-D levels on gestational hypertension were analyzed using the receiver operating characteristic curve(ROC).Results The levels of PT,FIB and D-D in the GH,PE and SPE groups were statistically significantly different from the normal group.There were differences in TT and APTT levels between each group.(all P<0.01).PT,FIB,and D-D had diagnostic values for GH and D-D for PE.TT and D-D for SPE.PT(AUC=0.565)and D-D(AUC=0.575)had diagnostic values for gestational hypertension disorders(P<0.001).Conclusions There was a correlation between the indexes of coagulation and GH and PE during pregnancy.PT and D-D levels had definitive diagnostic values for hypertensive disorder in pregnancy.PT and D-D levels were of diagnostic value for gestational hypertension.

关 键 词：凝血酶 妊娠高血压 子痫前期 重度子痫前期 

分 类 号：R714.7[医药卫生—妇产科学]