D-D、PS、FⅤ、t-PAI-C预测产妇分娩后血栓前状态及血栓发生的价值  

Predictive value of D-D,PS,FⅤand t-PAI-C for pre-thrombotic state and thrombus in puerpera after delivery

作　　者：董玲 段美婷 王亚峰 韩俊锋 DONG Ling;DUAN Meiting;WANG Yafeng;HAN Junfeng(Medical Laboratory Center,Northwest Women and Children Hospital,Xi'an,710061,China)

机构地区：[1]西北妇女儿童医院医学检验中心,西安710061

出　　处：《临床血液学杂志》2023年第8期537-540,544,共5页Journal of Clinical Hematology

摘　　要：目的探究D-二聚体(D-D)、蛋白S(PS)、凝血因子(F)Ⅴ、组织纤溶酶原激活物-纤溶酶原激活物抑制剂-1复合物(t-PAI-C)预测产妇分娩后血栓前状态(PTS)及血栓发生的价值。方法选择2021年9月—2022年8月分娩产妇122例,术后均进行超声检查,根据是否发生PTS,分为阳性组(n=53)及阴性组(n=69),比较2组的D-D、PS、FⅤ、t-PAI-C水平,分析4项指标对PTS的预测价值。根据术后是否发生静脉血栓栓塞(VTE)分为VTE组(n=21)及未发生组(n=101),比较2组D-D、PS、FⅤ、t-PAI-C水平,分析4项指标对VTE诊断价值。结果阳性组的D-D、FⅤ、t-PAI-C水平均高于阴性组,PS水平低于阴性组,差异有统计学意义(P<0.05);采用ROC曲线分析,4项指标联合预测产后PTS的AUC为0.985,均高于单一的D-D、PS、FⅤ及t-PAI-C的0.795、0.837、0.815、0.824(P<0.05);VTE组D-D、FⅤ、t-PAI-C水平均高于非VTE组,PS水平低于非VTE组,差异有统计学意义(P<0.05);D-D、PS、FⅤ、t-PAI-C联合对VTE诊断的灵敏度、特异度、准确率分别为85.71%、92.08%、90.98%,Kappa值为0.711。结论D-D、PS、FⅤ、t-PAI-C联合检测有助于预测产后PTS发生,并为VTE诊断提供参考,有助于临床防治PTS及VTE的发生。Objective To explore the predictive value of D-dimer(D-D),protein S(PS),coagulation factor(F)V and tissue plasminogen activator plasminogen activator inhibitor-1 complex(t-PAI-C)for pre-thrombotic state(PTS)and thrombus in puerpera after delivery.Methods A total of 122 puerpera undergoing delivery in the hospital were enrolled between September 2021 and August 2022.All underwent ultrasound examination after surgery.According to presence or absence of PTS,they were divided into positive(n=53)and negative group(n=69).The levels of D-D,PS,FⅤand t-PAI-C were compared between the two groups,and their predictive value for PTS was analyzed.According to presence or absence of postoperative venous thromboembolism(VTE),they were divided into VTE group(n=21)and non-VTE group(n=101),levels of D-D,PS,FⅤand t-PAI-C were compared between the two groups,and their diagnostic value for VTE was analyzed.Results The levels of D-D,FⅤand t-PAI-C in positive group were higher than those in negative group,while PS was lower than that in negative group(P<0.05).ROC curves analysis showed that AUC of D-D combined with PS,FⅤand t-PAI-C for predicting postpartum PTS was 0.985,greater than that of single index(0.795,0.837,0.815,0.824,P<0.05).The levels of D-D,FⅤand t-PAI-C in VTE group were higher than those in non-VTE group,while PS was lower than that in non-VTE group(P<0.05).The sensitivity,specificity,accuracy and Kappa value of D-D combined with PS,FⅤand t-PAI-C in the diagnosis of VTE were 85.71%,92.08%,90.98%and 0.711,respectively.Conclusion The combined detection of D-D,PS,FⅤand t-PAI-C may be beneficial to predict postpartum PTS,which can provide reference for VTE diagnosis and be conducive to clinical prevention and treatment of PTS and VTE.

关 键 词：D-二聚体 蛋白S 凝血因子Ⅴ 组织纤溶酶原激活物-纤溶酶原激活物抑制剂-1复合物 血栓前状态 血栓 

分 类 号：R446.11[医药卫生—诊断学]