先兆子痫孕妇血栓弹力图相关参数及D-D、FIB的检测价值  

Thromboelastography-related parameters and D-dimer and fibrinogen levels in pregnant women with preeclampsia

作　　者：韩俊锋 杨瑞利 董玲 屈蕾 米哲 郭晓波[3] 张养民[3] Han Junfeng;Yang Ruili;Dong Ling;Qu Lei;Mi Zhe;Guo Xiaobo;Zhang Yangmin(Clinical Laboratory Center,Northwest Women's and Children's Hospital,Xi'an 710061,Shaanxi Province,China;Department of Laboratory Medicine,Genertec Universal CREC Xi'an Hospital,Xi'an 710016,Shaanxi Province,China;Department of Blood Transfusion,Xi'an Central Hospital,Xi'an 710003,Shaanxi Province,China)

机构地区：[1]西北妇女儿童医院医学检验中心,西安710061 [2]通用环球中铁西安医院检验科,西安710016 [3]西安市中心医院输血科,西安710003

出　　处：《中国基层医药》2024年第11期1704-1709,共6页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的分析血栓弹力图(TEG)相关参数及D-二聚体(D-D)、纤维蛋白原(FIB)与先兆子痫患者病情严重程度、妊娠结局的关系。方法采用病例对照研究,收集2022年3月至2023年9月于西北妇女儿童医院就诊的先兆子痫患者92例(患者组),另取同时间段于院内体检的健康孕妇92例(对照组),进行TEG检查及D-D、FIB水平检测,完成组间比较,患者组根据不同病情严重程度分组,对比不同病情严重程度患者间各项TEG参数及D-D、FIB水平的差异,进行TEG相关参数与D-D、FIB的相关性分析,统计患者组不良妊娠结局,完成先兆子痫孕妇不良妊娠结局的危险因素分析。结果患者组R值、K值分别为(3.06±0.36)min、(1.21±0.14)min,均显著低于对照组的(5.44±0.61)min、(1.79±0.21)min,α角、CI值、MA值及D-D、FIB水平分别为(71.31±7.63)°、(3.89±0.41)、(65.71±7.01)mm、(2.22±0.24)mg/L、(4.51±0.49)g/L,均显著高于对照组的(64.85±6.79)°、(2.19±0.23)、(58.96±6.09)mm、(1.92±0.21)mg/L、(3.75±0.40)g/L,差异均有统计学意义(t=32.22、22.04、-6.06、-34.68、-6.97、-9.02、-11.52,均P<0.001);患者组中重度患者R值、K值均显著低于轻度患者,α角、CI值、MA值及D-D、FIB水平显著高于轻度患者,差异均有统计学意义(t=11.06、7.16、-8.01、-12.05、-3.91、-13.74、-8.269,均P<0.001)。先兆子痫患者R值、K值与D-D及R值与FIB均呈负相关(r=-0.504、-0.612、-0.493,均P<0.05),MA值、CI值与D-D及α角与FIB呈正相关(r=0.436、0.534、0.492,均P<0.05)。该研究中41例孕妇发生不良妊娠结局。发生不良妊娠结局的患者R值、K值分别为(2.48±0.25)min、(1.12±0.14)min,显著低于未发生患者的(2.75±0.29)min、(1.28±0.13)min,α角、CI值、MA值及D-D、FIB水平为(76.62±8.01)°、(4.42±0.46)、(69.77±7.06)mm、(2.57±0.27)mg/L、(4.97±0.51)g/L,均显著高于未发生患者的(67.04±7.01)°、(3.46±0.37)、(62.45±6.82)mm、(1.94±0.21)mg/L、(4.14±0.43)g/L,差异均有统计学意Objective To corelate thromboelastography(TEG)-related parameters and D-dimer and fibrinogen levels with the severity of preeclampsia and pregnancy outcomes in patients with preeclampsia.Methods A case-control study was conducted involving 92 patients with preeclampsia who received treatment at Northwest Women's and Children's Hospital between March 2022 and September 2023(patient group)and 92 healthy pregnant women who underwent routine check-ups during the same period(control group).All participants underwent TEG tests,and D-dimer and fibrinogen levels were measured.Intergroup comparisons were performed,and patients were categorized based on the severity of their condition.TEG parameters and D-dimer and fibrinogen levels were compared among patients with varying severities of preeclampsia.TEG-related parameters were correlated with D-dimer and fibrinogen levels.Adverse pregnancy outcomes in the patient group were statistically analyzed,and risk factors for these adverse outcomes in women with preeclampsia were identified.Results In the patient group,the R and K values were(3.06±0.36)minutes and(1.21±0.14)minutes,respectively,both of which were significantly lower than those in the control group[(5.44±0.61)minutes,(1.79±0.21)minutes,t=32.22,22.04,both P<0.001].Theαangle,CI value,MA value,and D-dimer and fibrinogen levels in the patient group were(71.31±7.63)°,(3.89±0.41),(65.71±7.01)mm,(2.22±0.24)mg/L,and(4.51±0.49)g/L,respectively,all of which were significantly higher than those in the control group[(64.85±6.79)°,(2.19±0.23),(58.96±6.09)mm,(1.92±0.21)mg/L,(3.75±0.40)g/L,t=-6.06,-34.68,-6.97,-9.02,-11.52,all P<0.001].In the patient group,severe cases had significantly lower R and K values compared with mild cases,while theαangle,CI value,MA value,and D-dimer and fibrinogen levels were significantly higher in severe cases than in mild cases(t=11.06,7.16,-8.01,-12.05,-3.91,-13.74,-8.269,all P<0.001).In patients with preeclampsia,the R and K values were negatively correlated with D-dimer levels,a

关 键 词：血栓弹力描记术 先兆子痫 纤维蛋白原 妊娠结局 危险因素 病例对照研究 

分 类 号：R714.244[医药卫生—妇产科学]