机构地区:[1]温州医科大学附属衢州医院(衢州市人民医院)血液科,浙江衢州324000
出 处:《中国妇幼保健》2023年第21期4073-4076,共4页Maternal and Child Health Care of China
基 金:浙江省医学会临床科研基金项目(2021ZYC-A214)。
摘 要:目的 探究妊娠期血小板减少患者平均血小板体积(MPV)、血小板压积(PCT)、血小板体积分布宽度(PDW)特征及对不良妊娠结局的影响。方法 回顾性分析2015年5月—2023年5月就诊于温州医科大学附属衢州医院妇产科的妊娠期血小板减少患者98例,根据患者妊娠结局划分为不良妊娠结局组(18例)和正常妊娠结局组(80例)。比较两组患者一般临床资料(包括年龄、孕周、胎次、孕前体质量指数、高血压病史、糖尿病病史及流产史)、血小板相关参数[包括血小板计数(PLT)、MPV、PCT、PDW]及凝血功能相关指标[凝血酶原时间(PT)、部分活化凝血活酶时间(APTT)、FⅧ活性及纤维蛋白原(FIB)]。通过Spearman相关性分析及多因素logistic回归分析筛选妊娠期血小板减少患者不良妊娠结局的危险因素。结果 不良妊娠结局组患者平均PLT、PCT水平均显著低于正常妊娠结局组,平均MPV、PDW及FⅧ活性均显著高于正常妊娠结局组,差异均有统计学意义(均P<0.05)。Spearman相关性分析表明,妊娠期血小板减少患者MPV(r=0.219,P=0.030)、PDW(r=0.273,P=0.007)及FⅧ活性(r=0.276,P=0.006)水平与不良妊娠结局呈正相关性,PLT(r=-0.189,P=0.047)及PCT(r=-0.333,P=0.001)水平与不良妊娠结局呈负相关性。多因素logistic回归分析发现,妊娠期血小板减少患者MPV(OR=1.415,P=0.006)、PDW(OR=1.245,P=1.079)及FⅧ活性(OR=1.068,P=0.002)水平增高是患者不良妊娠结局的危险因素,PLT(OR=0.914,P=0.012)、PCT(OR=0.564,P=0.005)水平升高是患者不良妊娠结局的保护因素。结论 妊娠期血小板减少患者MPV、PDW、PCT及FⅧ活性水平变化与不良妊娠结局发生具有紧密相关性,严密监测患者血小板相关参数及凝血功能变化对于辅助判断妊娠结局、及早对症干预具有一定临床意义。Objective To explore the characteristics of mean platelet volume(MPV),platelet hematocrit(PCT) and platelet volume distribution width(PDW) in patients with thrombocytopenia during pregnancy and their effects on adverse pregnancy outcomes.Methods From May 2015 to May 2023,a total of 98 patients with thrombocytopenia during pregnancy were retrospectively analyzed.According to the pregnancy outcome,they were divided into two groups:adverse pregnancy outcome group(18 cases) and normal pregnancy outcome group(80 cases).The general clinical data(including age,gestational age,parity,pre-pregnancy body mass index,history of hypertension,diabetes and abortion),platelet-related parameters [including platelet count(PLT),MPV,PCT and PDW] and coagulation function-related indicators [prothrombin time(PT),partially activated thromboplastin time(APTT),FⅧ activity and FIB] were compared between the two groups.Spearman correlation analysis and multivariate logistic regression analysis were used to screen the risk factors of adverse pregnancy outcome in patients with thrombocytopenia during pregnancy.Results The average levels of PLT and PCT in patients with adverse pregnancy outcome group were significantly lower than those in patients with normal pregnancy outcome group,and the average activities of MPV,PDW and FⅧ were significantly higher than those in patients with normal pregnancy outcome group,with statistical significance(all P<0.05).Spearman correlation analysis showed that the levels of MPV(r=0.219,P=0.030),PDW(r=0.273,P=0.007) and FⅧ activity(r=0.276,P=0.006) were positively correlated with the adverse pregnancy outcome,and the levels of PLT(r=-0.189,P=0.047) and PCT(r=-0.333,P=0.001) were negatively correlated with the adverse pregnancy outcome.Multivariate logistic regression analysis showed that the increased levels of MPV(OR=1.415,P=0.006),PDW(OR=1.245,P=1.079) and FⅧ activity(OR=1.068,P=0.002) were the risk factors for the adverse pregnancy outcome,and the increased levels of PLT(OR=0.914,P=0.012) and PCT(OR=
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