监测九项止凝血参数预警孕早期稽留流产的研究  

Study on monitoring nine anticoagulation parameters to predict missed abortion in early pregnancy

作　　者：王国增[1] 刘志强 胡际东[3] 焦满静[1] 景宝建 刘素欣 席艺华 郜宇 WANG Guozeng;LIU Zhiqiang;HU Jidong;JIAO Manjing;JING Baojian;LIU Suxin;XI Yihua;GAO Yu(Department of Laboratory Medicine,Zhuozhou Hospital,Zhuozhou Hebei 072750,China;Department of reproductiom,Zhuozhou Hospital,Zhuozhou Hebei 072750,China;Department of Obstetrics,Zhuozhou Hospital,Zhuozhou Hebei 072750,China)

机构地区：[1]河北省涿州市医院检验科,河北涿州072750 [2]河北省涿州市医院生殖科,河北涿州072750 [3]河北省涿州市医院产科,河北涿州072750

出　　处：《中国妇产科临床杂志》2023年第3期267-269,共3页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：河北省保定市科技局科研课题项目(2141ZF174)。

摘　　要：目的研究孕早期止凝血等参数变化,探讨稽留流产的预警效能。方法选取2019年6月至2021年6月在河北省涿州市医院产科收治的孕早期(5~12周)产妇273例为研究对象,71例健康未孕女性为对照组,比较不同妊娠结局孕早期(5~12周)产妇的止凝血等参数变化,分析各参数对稽留流产的预警效能。结果与同期正常孕妇相比,稽留流产组FIB显著降低(P<0.01),TT显著升高(P<0.01);(9周前)稽留流产组和正常妊娠(9周前)组的APTT与正常未孕相比显著降低(P<0.01)。ROC分析显示FIB判断稽留流产发生的AUC和临界值为:(9周前)稽留流产组患者0.724(95%Cl:0.648~0.800),2.57 g/L,敏感性,特异性分别为89.3%,55.8%;(孕9~12周)稽留流产组患者0.945(95%Cl:0.912~0.979),2.145 g/L,敏感性,特异性分别为100%,91.4%。结论FIB对于孕早期稽留流产有较好的预警价值,可辅助提高该病的早期诊断率。Objective To study the changes of nine anticoagulation parameters such as anticoagulation in early pregnancy,and explore the early warning efficacy of missed abortion.Methods 273 parturients in the first trimester(5-12 weeks)were selected as the study object,and 71 healthy non pregnant women were selected as the control group.The changes of coagulation and other parameters of parturients in the first trimester(5th-12 gestational weeks)with different pregnancy outcomes were compared,and the early warning effect of each parameter on missed abortion was analyzed.Results FIB was significantly lower(P<0.01)and TT was significantly higher(P<0.01)in the recurrent miscarriage group compared with normal pregnant women in the same period;APTT was significantly lower(P<0.01)in the recurrent miscarriage group and normal pregnancy group(before 9 gestational weeks)compared with normal unpregnant.ROC analysis showed that the AUC and critical values for FIB to determine the occurrence of recurrent miscarriage were:(before 9 gestational weeks)recurrent miscarriage group patients 0.724(95%CI:0.648-0.800),2.57 g/L,sensitivity,specificity 89.3%,55.8%,respectively;(9-12 gestational week)patients in the recurrent miscarriage group 0.945(95%CI:0.912-0.979),2.145 g/L,sensitivity,specificity 100%,91.4%,respectively.Conclusion FIB has a good early warning value for missed abortion in early pregnancy,and helps to improve the early diagnosis rate of the disease.

关 键 词：稽留流产 止凝血参数 妊娠早期 预警价值 

分 类 号：R714.21[医药卫生—妇产科学]