D-二聚体/血小板、血管生成抑制蛋白1预测药物流产后异常子宫出血价值  

Value of the D-dimer/platelet value and the inhibitor of angiogenesis protein 1 level of women for predicting their abnormal uterine bleeding after medical abortion

作　　者：王丽雅 张晓蕾 郑金普 邓茂兰 WANG Liya;ZHANG Xiaolei;ZHENG Jinpu;DENG Maolan(Danzhou People's Hospital,Danzhou,Hainan Province,571700)

机构地区：[1]海南省儋州市人民医院,571700

出　　处：《中国计划生育学杂志》2023年第2期272-275,共4页Chinese Journal of Family Planning

基　　金：海南省医药卫生科研项目(21A200007)。

摘　　要：目的:探讨药物流产后异常子宫出血者D-二聚体/血小板(DPR)、血管生成抑制蛋白1(VASH-1)表达水平及预测价值。方法:选取2019年3月-2022年3月本院自愿要求行药物流产者123例,根据终止妊娠后异常子宫出血发生情况分为异常组(21例)和正常组(102例),流产术前分别检测血浆D-二聚体(D-D)水平、血小板并计算DPR,血清VASH-1水平;采用受术者工作特征曲线(ROC)评价DPR、VASH-1对流产后发生异常子宫出血的预测价值,多因素logistic回归分析异常子宫出血相关因素。结果:异常组DPR[(0.85±0.31)×10^(-11)mg]、VASH-1[(567.32±84.15)ng/L]水平高于正常组[(0.57±0.24)×10^(-11)mg、(319.64±68.53)ng/L](P<0.05)。两组流产史、纤维蛋白原、D-二聚体、血小板比较存在差异(P<0.05)。ROC曲线分析显示,DPR、VASH-1诊断药物流产后发生异常子宫出血的曲线下面积(AUC)分别为0.852、0.809,截点值分别为0.71×10^(-11)mg、323.48ng/L,特异度分别为62.2%、53.6%,敏感度分别为93.5%、93.5%;二者联合诊断的AUC为0.904,特异度为85.3%,敏感度87.1%。多因素分析显示,有流产史,纤维蛋白原>4g/L、DPR及VASH-1高水平是药物流产后发生异常子宫出血的危险因素(P<0.05)。结论:DPR、VASH-1在药物流产后异常子宫出血者中呈高表达,可作为预测异常子宫出血的参考指标。Objective: To explore the D-dimer/platelet(DPR) value and the angiogenesis inhibitory protein 1(VASH-1) level of women after medical abortion, and its predictive value for the abnormal uterine bleeding of the women. Methods: A total of 123 pregnant women who wanted medical abortion were selected and were divided into group A(21 cases with abnormal uterine bleeding) and group B(102 cases without abnormal uterine bleeding) according to the situation of uterine bleeding from March 2019 to March 2022. The levels of the plasma D-dimer and platelets, and the serum VASH-1 of the women before abortion in the two groups were detected, and their DPR was calculated. The predictive value of the DPR and the VASH-1 level of the women after abortion for their abnormal uterine bleeding were evaluated by receiver operating characteristic curve(ROC). The related factors of the abnormal uterine bleeding of the women were analyzed by multivariate logistic regression. Results: The DPR(0.85±0.31×10^(-11)mg) and the VASH-1 level(567.32±84.15 ng/L) of the women in group A were significantly higher than those(0.57±0.24×10^(-11)mg and 319.64±68.53ng/L) of the women in group B(P<0.05). There were significant differences in the abortion history, and the fibrinogen, D-dimer, and platelet levels of the women between the two groups(P<0.05). ROC curve analysis showed that the area under the curve(AUC) of the DPR and the VASH-1 level for diagnosing abnormal uterine bleeding of the women after medical abortion were 0.852 and 0.809, the cut-off values of which were 0.71×10^(-11)mg and 323.48ng/L, the specificity of which were 62.2% and 53.6%, and the sensitivity of which was 93.5% and 93.5%. The AUC, the specificity, and the sensitivity of the combined of the DPR and the VASH-1 level for diagnosing abnormal uterine bleeding of the women after medical abortion were 0.904,85.3%,and 87.1%,respectively.Multivariate analysis showed that the history of abortion,the fibrinogen level>4g/L,the high DPR value and the VASH-1level of the women were the

关 键 词：药物流产 D-二聚体/血小板 血管生成抑制蛋白1 异常子宫出血 预测 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]