血栓弹力图及血栓前状态预测高龄孕妇流产的研究  

Study of Thromboela-stogram and Pre-thrombotic Status for Prediction of Miscarriage in Elderly Pregnant Women

作　　者：周凯娜 江玉华[1] 蒋小萃 ZHOU Kaina;JIANG Yuhua;JIANG Xiaocui(Department of Obstetrics,Guangzhou Huadu District Maternal and Child Health Hospital(Huzhong Hospital),Guang-zhou,Guangdong Province,510800 China)

机构地区：[1]广州市花都区妇幼保健院(胡忠医院)产科,广东广州510800

出　　处：《系统医学》2023年第19期172-174,178,共4页Systems Medicine

摘　　要：目的探究血栓弹力图(thromboela-stogram,TEG)及血栓前状态(pre-thrombotic status,PTS)预测高龄孕妇流产的价值。方法选取2020年8月—2022年6月广州市花都区妇幼保健院(胡忠医院)收治的50例高龄流产孕妇纳入流产组,另选取同期在本院体检的42例健康高龄孕妇作为对照组。比较两组TEG、PTS参数水平,分别绘制ROC曲线分析TEG、PTS参数指标水平对高龄孕妇流产的预测价值。结果流产组反应时间、凝血时间均短于对照组,凝固角、最大振幅均大于对照组,综合凝血指数高于对照组,差异有统计学意义(P<0.05);受试者工作特征曲线显示,反应时间、凝血时间、凝固角、最大振幅、综合凝血指数对高龄孕妇流产预测的AUC分别为0.866、0.851、0.865、0.772、0.894,且五者联合预测的AUC为0.982,明显高于单个参数,差异有统计学意义(P<0.05)。流产组抗凝血酶Ⅲ、蛋白S水平均低于对照组,D-二聚体水平高于对照组,差异有统计学意义(P<0.05);受试者工作特征曲线显示,抗凝血酶Ⅲ、蛋白S、D-二聚体对高龄孕妇流产预测的AUC分别为0.771、0.812、0.773,且三者联合预测的AUC为0.944,明显高于单个参数,差异有统计学意义(P<0.05)。结论相较于健康高龄孕妇,高龄流产孕妇的TEG和PTS处于异常状态,机体存在高凝倾向,TEG各项参数及其联合与PTS各项参数及其联合对高龄孕妇流产均有预测价值,且相比于单项参数,联合预测价值更高。Objective To explore the value of thromboela-stogram(TEG)and pre-thrombotic status(PTS)in predicting abortion in older pregnant women.Methods 50 elderly pregnant women with abortion admitted to Huadu District Maternal and Child Health Hospital(Huzhong Hospital)in Guangzhou from August 2020 to June 2022 were included in the abortion group,and 42 healthy elderly pregnant women who underwent physical examination in the hospital during the same period were selected as the control group.The levels of TEG and PTS parameters were compared between the two groups,and ROC curves were drawn respectively to analyze the predictive value of TEG and PTS parameters on abortion in elderly pregnant women.Results The reaction time and coagulation time of the abortion group were shorter than those of the control group,the coagulation Angle and maximum amplitude were greater than that of the control group,and the comprehensive coagulation index was higher than that of the control group,the difference was statistically significant(P<0.05);the working characteristic curves of subjects showed that the AUC of reaction time,coagulation time,coagulation Angle,maximum amplitude and comprehensive coagulation index for predicting abortion of elderly pregnant women were 0.866,0.851,0.865,0.772 and 0.894,respectively,and the AUC predicted by the five combined parameters was 0.982,which was significantly higher than that of a single parameter,the difference was statistically significant(P<0.05).The levels of antithrombinⅢand protein S in abortion group were lower than those in control group,and the D-dimer level was higher than that in control group,the difference was statistically significant(P<0.05);the subject working characteristic curve showed that the AUC predicted by antithrombinⅢ,protein S and D-dimer for abortion in elderly pregnant women was 0.771,0.812 and 0.773,respectively,and the AUC predicted by the three combined parameters was 0.944,which was significantly higher than that of a single parameter,and the difference was statist

关 键 词：高龄孕妇 流产 血栓弹力图 血栓前状态 预测价值 

分 类 号：R714[医药卫生—妇产科学]