BNP、Hb及FIB联合检测对孕晚期产妇产后出血的预测价值  

Predictive value of the combined detection of BNP,Hb and FIB for postpartum hemor⁃rhage of women in their third trimester

作　　者：李小芝 唐连敏 付翠芳 薛云 姚莉芸 LI Xiaozhi;TANG lianmin;FU Cuifang;XUE Yun;YAO Liyun(Department of Obstetrics,the Third Hospital of Xingtai,Xingtai,Hebei,China,054000;Department of Laboratory Medicine,the Third Hospital of Xingtai,Xingtai,Hebei,China,054000)

机构地区：[1]邢台市第三医院产科,河北邢台054000 [2]邢台市第三医院检验科,河北邢台054000

出　　处：《分子诊断与治疗杂志》2021年第2期203-206,共4页Journal of Molecular Diagnostics and Therapy

基　　金：邢台市科技支撑计划项目(2018ZC115)。

摘　　要：目的探讨外周血脑钠肽(BNP)、血红蛋白(Hb)及纤维蛋白原(FIB)联合检测对孕晚期产妇产后出血的预测价值研究。方法收集2017年3月至2019年3月本院收治的65例产后出血产妇的临床资料(观察组),选取同期自然分娩未发生产后出血的70例产妇设为对照组。对比两组产妇孕晚期BNP、Hb、FIB水平,分析产后严重出血及产后一般出血的产妇的BNP、Hb、FIB水平;以Logistic回归模型分析影响孕晚期产妇产后出血的危险因素,绘制ROC曲线分析BNP、Hb、FIB检测及三者联合检测对孕晚期产妇产后出血的预测价值。结果观察组产妇BNP水平高于对照组,Hb、FIB水平低于对照组,差异均有统计学意义(P<0.05)。产后普通出血产妇BNP水平低于产后严重出血产妇,Hb、FIB水平低于对高于产后严重出血产妇,差异均统计学意义(P<0.05)。前置胎盘、宫缩乏力、胎儿体质量、BNP、Hb、FIB为影响产妇产后出血的单因素(P<0.05);进一步分析得出:前置胎盘、宫缩乏力、BNP、Hb、FIB为影响产妇产后出血的独立危险因素(P<0.05)。采用ROC曲线分析BNP、Hb、FIB及三者联合检测孕晚期产妇产后出血的诊断价值,BNP、Hb、FIB及三者联合曲线下面积分别为0.879、0.902、0.831、0.988,联合下面积曲线检测最大。结论孕晚期测定产妇外周血BNP、Hb、FIB水平对其产后出血的发生有较大预测价值,联合检测上述指标对保障产妇生命安全有重要意义。Objective To explore the predictive value of the combined detection of peripheral blood brain natriuretic peptide(BNP),hemoglobin(Hb)and fibrinogen(FIB)for postpartum hemorrhage of women in their third trimester.Methods The clinical data of 65 women with postpartum hemorrhage admit⁃ted to this hospital from March 2017 to March 2019 were selected,and 70 women who had no postpartum hemorrhage during natural delivery were selected as the controls group.The levels of BNP,Hb,and FIB of women in their third trimester between the two groups were measured and compared.Logistic regression model was used to analyze the risk factors of postpartum hemorrhage of the women in the third trimester,and the ROC curve was drawn to analyze the predictive value of BNP,Hb,FIB and the combined detection of the three for postpartum hemorrhage of the women in their third trimester.Results Maternal BNP levels in the observation group were higher than those in the control group,and Hb and FIB levels were lower than those in the control group and the differences were statistically significant(P<0.05).The level of BNP in women with ordinary hemorrhage after delivery was lower than that in women with severe postpartum hemorrhage and the levels of Hb and FIB were lower than those in women with severe hemorrhage after delivery,the differences were statistically significant(P<0.05).Placenta previa,uterine inertia,fetal body weight,BNP,Hb,FIB were the single factors that affected postpartum hemorrhage(P<0.05).The conditional single factors were se⁃lected,and further analysis shows that placenta previa,uterine inertia,BNP,Hb,and FIB are independent risk factors affecting postpartum hemorrhage(P<0.05).The ROC curve was used to analyze the diagnostic val⁃ue of BNP,Hb,FIB and the three combined detection for postpartum hemorrhage of women in their third tri⁃mester.The area under the curve of BNP,Hb,FIB and the three combined curves were 0.879,0.902,0.831,0.988,respectively,and the area under the combined curve was the largest.Conclusion The d

关 键 词：BNP HB FIB 孕晚期产妇 产后出血 

分 类 号：R714.461[医药卫生—妇产科学]