血栓弹力图与平均血小板体积对胎儿生长受限的诊断价值  

Diagnostic Value of Thromboelastography and Mean Platelet Volume in Fetal Growth Restriction

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作  者:陈艳梅 王慧玲[1] 杨宝艳 郭彩萍[1] CHEN Yanmei;WANG Huiling;YANG Baoyan(Department of Obstetrics and Gynecology Yan'an People's Hospital,Shaanxi Yan'an 716000)

机构地区:[1]延安市人民医院妇产科,陕西延安716000

出  处:《医学临床研究》2023年第11期1635-1637,1641,共4页Journal of Clinical Research

摘  要:【目的】探讨血栓弹力图(TEG)与平均血小板体积(MPV)对胎儿生长受限(FGR)的诊断价值。【方法】选取2019年1月至2022年1月本院收治的81例FGR孕妇(观察组),并选取同期同孕周的80例正常孕妇作为对照组,两组均进行TEG检查,记录凝固时间(K值)、凝血反应时间(R值)、血栓最大振幅(MA值)及凝固角(Angle角),并检测MPV水平。分析FGR发生的影响因素及TEG指标、MPV水平对FGR的诊断价值。【结果】两组年龄、孕周、体重指数(BMI)、分娩次数(经产妇、初产妇)、妊娠期糖尿病、瘢痕子宫、胎膜早破比较,差异无统计学意义(P>0.05);观察组妊娠期高血压、自然流产≥2次、羊水过少占比高于对照组(P<0.05)。两组K值、Angle角比较,差异无统计学意义(P>0.05);观察组MA值、MPV水平高于对照组,R值低于对照组(P<0.05)。Logistic回归分析显示:妊娠期高血压、自然流产≥2次、羊水过少、R值、MA值、MPV水平为FGR发生的危险因素(P<0.05);受试者工作特征(ROC)曲线分析显示:R值、MA值及MPV水平诊断FGR的截断值分别为6.88 min、67.27 mm、11.32 fL,曲线下面积(AUC)值分别为0.687、0.758、0.794。【结论】FGR孕妇TEG指标R值、MA值与MPV水平均异常变化,对FGR的发生具有一定诊断价值。【Objective】To investigate the clinical significance and diagnostic value of thromboelastography(TEG)and mean platelet volume(MPV)in fetal growth restriction(FGR).【Methods】Eighty-one pregnant women with FGR in our hospital from January 2019 to January 2022 were selected as the observation group,and eighty normal pregnant women of the same gestational weeks in the same period were selected as the control group.All of them underwent TEG,recorded coagulation time(K value),coagulation reaction time(R value),maximum thrombus amplitude(MA value)and coagulation angle(Angle value),and MPV level.The influencing factors of FGR and the diagnostic value of TEG index and MPV level were analyzed.【Results】There were no significant differences in women's pregnant age gestational age,body mass index(BMI),production experience,gestational diabetes mellitus,scar uterus and premature rupture of membranes between the two groups(P>0.05).The proportion of gestational hypertension,spontaneous abortion≥2 times and oligohydramnios in FGR pregnant women was higher than that in normal pregnant women(P<0.05).There were no significant differences in both K value and Angle value between the FGR pregnant women and normal pregnant women(P>0.05).The MA value and MPV level of the FGR pregnant women were higher than those of normal pregnant women,while the R value of the observation group was lower than that of normal pregnant women(P<0.05).Logistic regression analysis showed that gestational hypertension,spontaneous abortion≥2 times,oligohydramnios,R value,MA value and MPV level were the risk factors of FGR(P<0.05).ROC analysis showed that the cut off values of R value,MA value and MPV level of TEG index were 6.88 min,67.27 mm and 11.32 fL,respectively,and their AUC values were 0.687,0.758 and 0.794,respectively.【Conclusion】There are abnormal changes in TEG index R value,MA value and MPV level in the pregnant women with FGR,which has a certain diagnostic value for the occurrence of FGR.

关 键 词:胎儿发育 胎儿疾病/诊断 血栓弹力描记术 平均血小板体积 

分 类 号:R714.43[医药卫生—妇产科学]

 

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