血浆PDW、D-二聚体、纤维蛋白原在妊娠期高血压患者产后出血中的预测价值  

Predictive value of plasma PDW,D-dimer and fibrinogen in postpartum hemorrhage of patients with gestational hypertension

作　　者：王爱华[1] 杨奕梅 孙宇[1] 包蕾[1] WANG Aihua;YANG Yimei;SUN Yu;BAO Lei(Department of Obstetrics,Kunming Maternal and Child Health Hospital,Kunming,Yunnan 650031,China)

机构地区：[1]云南省昆明市妇幼保健院产科,云南昆明650031

出　　处：《国际检验医学杂志》2021年第20期2531-2535,共5页International Journal of Laboratory Medicine

摘　　要：目的研究血小板分布宽度(PDW)、D-二聚体(D-D)及纤维蛋白原(FBG)在预测妊娠期高血压患者产后出血中的价值。方法将该院2017年1月至2020年1月收治的150例妊娠期高血压患者及60例健康孕妇纳为研究对象,分为高血压组和健康组,随访至其分娩,统计其产后出血病例,并分析血浆PDW、D-D及FBG在预测妊娠期高血压患者产后出血中的价值。结果研究发现,150例妊娠期高血压患者产后出血发生率为18.67%,显著高于健康组的1.67%,差异有统计学意义(P<0.05);两组血浆PDW水平差异无统计学意义(P>0.05),高血压组血浆D-D水平显著高于健康组,FBG水平显著低于健康组,差异有统计学意义(P<0.05);妊娠期高血压患者产后出血者与未出血者胎盘早剥、胎盘前置、瘢痕子宫、软产道损伤、宫缩无力及血浆D-D、FBG水平差异有统计学意义(P<0.05),年龄、分娩方式、产次、妊娠周期等其他状况差异无统计学意义(P>0.05);多因素Logistic回归分析提示,胎盘早剥、胎盘前置、软产道损伤、宫缩无力、血浆D-D及FBG均是影响妊娠期高血压患者产后出血的独立危险因素。绘制受试者工作特征(ROC)曲线发现,血浆D-D及FBG在预测妊娠期高血压产妇产后出血中均具有良好效能,但血浆PDW在预测产后出血中的价值不高。结论妊娠期高血压患者产后出血发生率高,而产后1 h血浆D-D水平较健康产妇明显升高,FBG水平较健康产妇明显降低,在预测患者产后出血中具有较好的临床价值,可作为指导临床治疗的有效指标。Objective To investigate the predictive value of plasma platelet distribution width(PDW),D-dimer(D-D)and fibrinogen(FBG)in postpartum hemorrhage of patients with gestational hypertension.Methods A total of 150 women with gestational hypertension and 60 healthy pregnant women in the hospital from January 2017 to January 2020 were enrolled and divided into hypertension group and healthy group,and all women were followed up till childbirth.The postpartum hemorrhage cases were recorded,then the predictive value of plasma PDW,D-dimer and FBG in postpartum hemorrhage of patients with gestational hypertension was analyzed.Results The incidence rate of postpartum hemorrhage was 18.67%in hypertension group,which was higher than 1.67%in healthy group,and the difference was statistically significant(P<0.05).Plasma PDW showed no significant difference between two groups(P>0.05).Hypertension group had higher D-D level and lower FBG level than those in healthy group,and the differences were statistically significant(P<0.05).In patients with gestational hypertension,the placental abruption,placental previa,scarred uterus,soft birth canal injury,uterine weakness,and plasma D-D and FBG levels showed significant difference between hemorrhage patients and patients without hemorrhage(P<0.05),while no significant difference was found in patients with different age,delivery methods,parity and gestational weeks and other conditions(P>0.05).Multivariate Logistic regression analysis indicated that placental abruption,placental previa,scarred uterus,soft birth canal injury,uterine weakness,and plasma D-D and FBG levels were all independent risk factors affecting postpartum hemorrhage in patients with hypertension during pregnancy.Receiver operating characteristic(ROC)curve indicated that both D-D and FBG had high clinical value in the prediction of postpartum hemorrhage of patients with gestational hypertension,while plasma PDW had relatively low value in the clinical prediction.Conclusion The incidence of postpartum hemorrhage in patient

关 键 词：血小板分布宽度 D-二聚体 纤维蛋白原 妊娠期高血压 产后出血 预测价值研究 

分 类 号：R714.246[医药卫生—妇产科学]