不同年龄和孕期的健康孕妇血浆D-二聚体的临界值差异性比较  

Comparison of Differences in Plasma D-dimer Levels among Healthy Pregnant Women of Different Ages and Gestational Periods

作　　者：罗璇 王海霞[1] 赵蓉 李荣[2] LUO Xuan;WANG Haixia;ZHAO Rong(Department of Laboratory Medicine,The First Affliated Hospital of Chongqing Medical University,Chongqing 400016,China;Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院检验科,重庆400016 [2]重庆医科大学附属第一医院产科,重庆400016 [3]重庆医科大学检验医学院,重庆400016

出　　处：《实用妇产科杂志》2023年第5期366-369,共4页Journal of Practical Obstetrics and Gynecology

基　　金：重庆市科卫联合医学科研项目(编号:2022MSXM120)。

摘　　要：目的:比较不同年龄和孕期的健康孕妇血浆D-二聚体的差异。方法:选择2020年5月至2021年1月在重庆医科大学附属第一医院进行产前检查的健康孕妇1846例,按孕期分为3组:早孕组(孕周≤13^(+6)周)481例;中孕组(孕14^(+0)~27^(+6)周)591例;晚孕组(孕28^(+0)~40^(+6)周)774例。采用乳胶免疫比浊法对其血浆D-二聚体进行定量检测,统计学分析不同年龄和孕周的健康孕妇血浆D-二聚体的差异。结果:孕早期、孕中期和孕晚期的D-二聚体值分别是正常人群D-二聚体参考值上限的3.26倍、6.16倍和10.06倍,与孕早期的P_(95)值比较,孕中期和孕晚期D-二聚体的P_(95)值逐渐增高,差异有统计学意义(P<0.05)。孕妇血浆D-二聚体水平与孕妇年龄无差异性。不同孕期的D-二聚体的临界值为孕早期≤1.63 mg/L,孕中期≤3.08 mg/L,孕晚期≤5.03 mg/L。结论:目前推荐用于正常人群血浆D-二聚体水平参考范围(≤0.5 mg/L)并不适用于健康孕期妇女,应当独立分析健康孕妇的D-二聚体水平,有助于评估孕妇的血液状态,尽早识别妊娠血栓相关性疾病。Objective:To comparethe differences in plasma D-dimer levels among healthy pregnant women of different ages and gestational periods.Methods:From May 2020 to January 2021,1846 healthy pregnant women who underwent prenatal examinations in the First Affiliated Hospital of Chongqing Medical University were select-ed and divided into three groups based on their gestational age:the first trimester group(≤13^(+6) gestational weeks,481 cases),the second trimester group(14^(+0)-27^(+6)gestational weeks 591 cases),the third trimester group(28^(+0)-40^(+6)gestational weeks,774 cases).The level of plasma D-dimer was quantitatively detected by la-tex immunoturbidimetry,and statistical analysis was conducted on the diferences in plasma D-dimer among healthy pregnant women of different ages and gestational weeks.Results:The D-dimer values in first trimester,second trimester,and third trimester were 3.26,6.16,and 10.06 times the upper limit of the reference value for D-dimer in the normal population,respectively.Compared with the P gs values in first trimester,the P_(95) values of D-dimer in second and third trimester gradually increased,with a statistically significant difference(P<0.05).There was no difference in plasma D-dimer levels among pregnant women of different ages.The plasma D-dimer cut-off value was≤1.63 mg/L in the first trimester,≤3.08 mg/L in the second trimester and≤5.03 mg/L in the third trimester.Conclusions:The current recommended reference range for plasma D-dimer level in normal popu lation(≤0.5 mgl/L)is not applicable to healthy pregnant women.The D-dimer level in healthy pregnant women should be independently analyzed to help assess the blood status of pregnant women and identify pregnancy re-lated thrombosis diseases as soon as possible.

关 键 词：健康孕妇 D-二聚体参考区间 孕妇年龄 孕期 

分 类 号：R714.1[医药卫生—妇产科学]