前置胎盘剖宫产产妇产后出血量与胎盘附着部位及前列腺素E1、谷胱甘肽过氧化酶1水平的相关性  

Association between the postpartum hemorrhage after cesarean delivery of women with placenta previa and their placental attachment site and the levels of prostaglandin E1 and glutathione peroxidase 1

作　　者：游璐 张英 卢珍[2] YOU Lu;ZHANG Ying;LU Zhen(High Tech Branch,The First Affiliated Hospital of Anhui Medical University,Fuyang City,Anhui Province,236000;Taihe County People's Hospital of Fuyang City)

机构地区：[1]安徽医科大学第一附属医院高新院区,阜阳236000 [2]安徽省太和县人民医院

出　　处：《中国计划生育学杂志》2022年第6期1416-1419,1424,共5页Chinese Journal of Family Planning

摘　　要：目的:探究血清前列腺素E1(PGE1)及谷胱甘肽过氧化酶1(GPX1)与前置胎盘患者剖宫产后产后出血量及胎盘附着位置关系及诊断价值。方法:将本院2019年6月—2021年6月收治的52例行剖宫产终止妊娠的前置胎盘患者纳为观察组,50例因骨盆、胎儿偏大、臀围等因素行剖宫产的无妊娠合并症产妇作为对照组,剖宫产术后即刻采集外周静脉血,检测血清PGE1、GPX1水平,容积法联合称重法计算产后出血量,比较两组及观察组不同临床特征产妇产后出血量、血清PGE1及GPX1水平,分析PGE1、GPX1在预测产后出血价值。结果:观察组术后血清PGE1(41.15±10.17 pg/ml)、GPX1(34.15±3.36 U/L)水平均低于对照组(53.64±12.16 pg/ml、47.45±5.56 U/L),产后大出血发生率(50.0%)高于对照组(4.0%)(P<0.05),平均出血量(1164.59±179.58 ml)高于对照组(619.69±56.69 ml),且观察组产后大出血者血清PGE1、GPX1水平均低于非大出血者,胎盘附着位置为前壁者、合并胎盘植入者以及中央型前置胎盘患者水平均低于对应的阴性患者,产后平均出血量高于对应的阴性患者(均P<0.05)。Pearson线性相关性分析提示,前置胎盘患者剖宫产术后血清PGE1、GPX1水平与产后出血量均呈负相关(P<0.05)。绘制受试者工作特征曲线,术后血清PGE1(AUC=0.759)、GPX1(AUC=0.749)预测胎盘前置剖宫产患者产后大出血均有一定效能,而两者联合应用(AUC=0.826)预测效能最佳。结论:检测血清PGE1及GPX1水平对评估前置胎盘患者剖宫产术后产后出血有一定临床指导意义。Objective:To investigate the association between the postpartum hemorrhage after cesarean delivery of women with placenta previa and their placental attachment site and the levels of prostaglandin E1(PGE1)and glutathione peroxidase 1(GPX1),and to study the diagnostic values of the levels of (PGE1)and GPX1 for placenta previa.Methods:From June 2019 to June 2021,52 women with placenta previa who underwent cesarean section for pregnancy termination were included in observation group,and another 50 women without pregnancy comorbidities who also underwent cesarean section due to maternal pelvis size,fetal size,or maternal hip girth were included in control group.The peripheral venous blood of the women in the two groups was collected immediately after cesarean section,and the serum PGE1 and GPX1 levels of the women were detected.The postpartum hemorrhage of the women were calculated by volumetric method combined with weighing method.The postpartum hemorrhage and the serum PGE1 and GPX1 levels of the women were compared between the two groups,and which of the women with different clinical characteristics in the observation group were also observed and compared.The value of the serum PGE1 and GPX1 levels of the women for predicting their postpartum hemorrhage was analyzed.Results:The levels of serum PGE1(41.15±10.17 pg/ml)and GPX1(34.15±3.36 U/L)of the women in the observation group were significantly lower than those(53.64±12.16 pg/ml and 47.45±5.56 U/L)of the women in the control group.The incidence of postpartum hemorrhage(50.0%)of the women in the observation group was significantly higher than that(4.0%)of the women in the control group(P<0.05),the average blood loss(1164.59±179.58 ml)of the women in the observation group was significantly higher than that(619.69±56.69 ml)of the women in the control group.In the observation group,the serum levels of PGE1 and GPX1 of the women with postpartum massive hemorrhage were significantly lower than those of the women without postpartum massive hemorrhage,which of the

关 键 词：前置胎盘 剖宫产术 产后出血 胎盘附着部位 前列腺素-1 谷胱甘肽过氧化酶-1 相关性 预测 

分 类 号：R714.461[医药卫生—妇产科学]