血栓弹力图与传统凝血指标对妊娠期孕妇高凝状态的诊断价值  

The value of thromboelastogram and traditional clotting index in the diagnosis of hypercoagulability in pregnant women

作　　者：叶萍[1] 董雪梅[1] 张翀[1] YE Ping;DONG Xue-mei;ZHANG Chong(Department of Clinical Laboratory Center,Gansu Maternal and Childcare Hospital,Lanzhou730050,China)

机构地区：[1]甘肃省妇幼保健院临床检验中心,甘肃兰州730050

出　　处：《中国实验诊断学》2022年第11期1623-1627,共5页Chinese Journal of Laboratory Diagnosis

基　　金：甘肃省自然科学基金(项目编号18JR3RA037)。

摘　　要：目的分析妊娠期正常孕妇血栓弹力图及传统凝血实验各参数,比较两者的相关性及其在评价孕妇高凝血状态的早期诊断价值。方法回顾性分析2018年1月至2019年12月就诊于甘肃省妇幼保健院建档立卡的健康妊娠期妇女300例以及68名健康非孕妇女。按孕周的不同将300名孕妇分为早孕组、中孕组、晚孕组。收集常规凝血指标以及血栓弹力图(thrombelastography,TEG)相关参数结果,并对各指标进行相关性分析,同时应用受试者工作曲线评价TEG与常规凝血功能指标对孕妇高凝状态的诊断价值。结果随着妊娠的进展,孕妇传统凝血指标PT、APTT、TT逐渐缩短,而FIB逐渐升高;TEG参数R、K值降低,α角及MA值升高。将非孕对照组与妊娠期各组及妊娠期各组之间进行比较,中孕组与对照组和早孕组比较,晚孕组与对照组和早孕组比较传统凝血各检测项目差异均具有统计学意义(P<0.05);中孕组及晚孕组较未孕对照组R、K值降低,α角升高,差异均具有统计学意义(P<0.05);晚孕组较对照组MA值显著升高(P<0.05)。采用spearman检验分析TEG与传统凝血项目的相关关系,发现R值与PT、α角与FIB、MA值与FIB均呈正相关(P<0.05)。用ROC曲线分析TEG与传统凝血指标在评估孕妇血液高凝状态的诊断价值,与PT比较,R值的AUC更高为0.8004,与MA值、α角比较FIB的AUC值为0.819。结论TEG参数与常规凝血功能指标在评价正常孕妇高凝状态显著相关且各有优势,二者不可相互替代。Objective To analyze the parameters of thromboelastography and traditional coagulation test in normal pregnant women during pregnancy,to compare the correlation between the two,and their early diagnostic value in evaluating the hypercoagulable state of pregnant women.Methods A retrospective analysis was made of 300healthy pregnant women and 68healthy non-pregnant women who visited Gansu Maternal and Child Health Hospital from January2018to December 2019.According to the different gestational weeks,300pregnant women were divided into early pregnancy group,middle pregnancy group and late pregnancy group.The results of conventional coagulation indexes and related parameters of thromboelastography(TEG)were collected,and the correlation of each index was analyzed.At the same time,the receiver operating curve was used to evaluate the diagnostic value of TEG and conventional coagulation function indexes in pregnant women with hypercoagulability.Results With the progress of pregnancy,the traditional coagulation indexes PT,APTT and TT of pregnant women gradually shortened,while FIB gradually increased;TEG parameters R and K values decreased,andαangle and MA values increased.The non-pregnant control group was compared with each pregnancy group and between each pregnancy group,the middle pregnancy group was compared with the control group and the early pregnancy group,and the late pregnancy group was compared with the control group and the early pregnancy group.Compared with the non-pregnant control group,the R and K values of the middle pregnancy group and the late pregnancy group were decreased,and theαangle was increased,and the differences were statistically significant(P<0.05).The value was significantly increased(P<0.05).Spearman test was used to analyze the correlation between TEG and traditional coagulation items,and it was found that R value and PT,αangle and FIB,and MA value and FIB were all positively correlated(P<0.05).The ROC curve was used to analyze the diagnostic value of TEG and traditional coagulation i

关 键 词：妊娠 血栓弹力图 传统凝血指标 受试者工作曲线 

分 类 号：R714.1[医药卫生—妇产科学]