产前FIB及血栓弹力图相关参数对产后出血的预测价值分析  

Analysis of the predictive value of prenatal FIB and thromboelastography-related parameters for postpartum hemorrhage

作　　者：高梅 GAO Mei(Laboratory Department,Dalian Women’s and Children’s Medical Center,Dalian 116000,China)

机构地区：[1]大连市妇女儿童医疗中心检验科,116000

出　　处：《中国实用医药》2022年第6期5-8,共4页China Practical Medicine

摘　　要：目的分析产前检测纤维蛋白原(FIB)及血栓弹力图(TEG)的相关参数对于产后出血的预测价值。方法选取在本院进行分娩并出现产后出血的40例产妇作为观察组,另选取同期在本院分娩但未出现产后出血的40例产妇为对照组。两组产妇均进行产前凝血四项和TEG相关参数检测。分析FIB及TEG相关参数对产后出血的预测价值。结果两组产妇产前凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)水平比较,差异无统计学意义(P>0.05);观察组产妇产前FIB水平(2.42±0.46)g/L低于对照组的(4.12±0.85)g/L,差异具有统计学意义(P<0.05)。观察组产妇产前血液凝固时间(K)长于对照组,最大振幅(MA)小于对照组,综合溶血指数(CI)低于对照组,差异具有统计学意义(P<0.05);两组产妇产前凝血反应时间(R)和凝固角(α)比较,差异无统计学意义(P>0.05)。Logistic回归分析显示,FIB、K值、MA值及CI值均为产后出血的影响因素(P<0.05)。以FIB、K值、MA值及CI值对预测产后出血构建受试者工作曲线(ROC),结果显示,FIB界值取3.14时,其曲线下面积、敏感性、特异性分别为0.787、80.95%、78.95%;K值界值取2.32时,其曲线下面积、敏感性、特异性分别为0.739、66.67%、84.21%;MA值界值取61.8时,其曲线下面积、敏感性、特异性分别为0.737、76.19%、78.95%;当CI值界值取1.46时,其曲线下面积、敏感性、特异性分别为0.729、73.68%、76.19%,其中FIB预测产后出血价值最高,其次为K值。结论产前FIB及TEG相关参数(K值、MA值、CI值)对预测产后出血具有一定的价值,可为临床防范和治疗产后出血提供依据。Objective To analyze the predictive value of prenatal fibrinogen(FIB)and thromboelastography(TEG)-related parameters for postpartum hemorrhage.Methods 40 women who delivered in our hospital and had postpartum hemorrhage were selected as the observation group,and 40 women who delivered in our hospital at the same time but did not have postpartum hemorrhage were selected as the control group.In both groups,prenatal coagulation tests and TEG-related parameters were performed.The predictive value of FIB and TEG-related parameters for postpartum hemorrhage was analyzed.Results The differences in the levels of prenatal prothrombin time(PT),activated partial thromboplastin time(APTT)and thrombin time(TT)between the two groups were not statistically significant(P>0.05).The prenatal FIB level of the observation group was(2.42±0.46)g/L,which was lower than(4.12±0.85)g/L of the control group,and the difference was statistically significant(P<0.05).The prenatal blood coagulation time(K)of the observation group was longer than that of the control group,the maximum amplitude(MA)was smaller than that of the control group,and the coagulation index(CI)was lower than that of the control group.All the differences were statistically significant(P<0.05).There was no statistically significant difference in prenatal coagulation reaction time(R)and coagulation angle(α)between the two groups(P>0.05).Logistic regression analysis showed that FIB,K value,MA value and CI value were all influential factors for postpartum hemorrhage(P<0.05).The receiver operating curve(ROC)was constructed by predicting postpartum hemorrhage with FIB,K value,MA value and CI value.The results showed that the area under the curve,sensitivity and specificity were 0.787,80.95%and 78.95%,respectively,for a FIB cut-off value of 3.14;the area under the curve,sensitivity,and specificity were 0.739,66.67%,and 84.21%,respectively,for the K cut-off value of 2.32;the area under the curve,sensitivity,and specificity were 0.737,76.19%,and 78.95%,respectively,for a MA cut-

关 键 词：纤维蛋白原 血栓弹力图 产后出血 预测价值 

分 类 号：R714.461[医药卫生—妇产科学]