凝血-纤溶失衡与子痫前期的关系及对产后大出血的预测价值研究  

The Relationship between Coagulation-fibrinolytic Imbalance and Preeclampsia and The Predictive Value of Postpartum Hemorrhage

作　　者：郑艳丽 王静[1] 胡海燕[1] 李芬霞[1] 贺云云 ZHENG Yan-li;WANG Jing;HU Hai-yan;LI Fen-xia;HE Yun-yun(Obstetrics department 1,The Second Affiliated Hospital of Xi'an Medical university,Xi'an,Shaanxi,710038,China)

机构地区：[1]西安医学院第二附属医院产一科,陕西西安710038

出　　处：《现代生物医学进展》2023年第12期2301-2304,2342,共5页Progress in Modern Biomedicine

基　　金：陕西省重点研发计划项目(2019SF-051)。

摘　　要：目的:分析凝血-纤溶失衡与子痫前期的关系及对产后大出血的预测价值。方法:选择我院自2018年1月至2021年12月接诊的160例子痫前期孕妇作为观察组,另选同期的160例健康妊娠孕妇作为对照组;以凝血酶-抗凝血酶复合物(TAT)/纤溶酶-α2纤溶酶抑制物复合物(PIC)比值评价凝血-纤溶失衡程度,使用Pearson相关性分析TAT/PIC比值与分娩孕周、分娩出血量的关系,通过AUC评价TAT/PIC比值对产后大出血的预测效能。结果:观察组血浆TAT水平高于对照组,PIC水平低于对照组,TAT/PIC比值大于对照组(P<0.05);经Pearson相关性分析,子痫前期孕妇TAT/PIC比值与分娩出血量呈正相关,与出生体重呈负相关(P<0.05);产后大出血组血浆TAT水平高于非产后大出血组,PIC水平低于非产后大出血组,TAT/PIC比值大于非产后大出血组(P<0.05);经ROC曲线分析,TAT/PIC比值预测子痫前期孕妇产后大出血的AUC为0.910,大于TAT的0.665和PIC的0.650(P<0.05)。结论:子痫前期的发生可能与凝血-纤溶失衡有关,而TAT/PIC比值与分娩出血量及出生体重的关系密切,预测产后大出血的效能较好,值得临床予以重视应用。Objective:To analyze the relationship between coagulation-fibrinolysis imbalance and preeclampsia and its predictive value for postpartum hemorrhage.Methods:From January 2018 to December 2021,160 cases of preeclampsia pregnant women in our hospital were selected as the observation group,and 160 healthy pregnant women during the same period were selected as the control group.The ratio of thrombin-antithrombin complex(TAT)/fibrinolytic-α2 fibrinolytic inhibitor complex(PIC)was used to evaluate the degree of clotting-fibrinolytic imbalance.Pearson correlation analysis was used to analyze the relationship between TAT/PIC ratio and gestational age and delivery blood loss.The predictive efficacy of TAT/PIC ratio for postpartum hemorrhage was evaluated by receiver operating characteristic(ROC)area under curve(AUC).Results:Plasma TAT level in observation group was higher than control group,PIC level was lower than control group,TAT/PIC ratio was higher than control group(P<0.05).According to Pearson correlation analysis,TAT/PIC ratio was positively correlated with delivery blood loss(P<0.05),but negatively correlated with birth weight(P<0.05).The plasma TAT level in postpartum hemorrhage group was higher than that in non-postpartum hemorrhage group,the PIC level was lower than that in non-postpartum hemorrhage group,and the TAT/PIC ratio was higher than that in non-postpartum hemorrhage group(P<0.05).According to ROC curve analysis,the AUC of TAT/PIC in predicting postpartum hemorrhage of preeclampsia was 0.910,which was higher than 0.665 of TAT and 0.650 of PIC(P<0.05).Conclusion:The occurrence of preeclampsia may be related to coagulation-fibrinolysis imbalance,and TAT/PIC ratio is closely related to delivery blood loss and birth weight,so it has good efficacy in predicting postpartum hemorrhage and deserves clinical.

关 键 词：子痫前期 凝血-纤溶失衡 分娩孕周 分娩出血量 产后大出血 

分 类 号：R714.244[医药卫生—妇产科学]