狼疮样抗凝物质联合凝血指标对复发性流产妊娠结局的价值  

The Value of Lupus Anticoagulant Combined with Coagulation Indices in Predicting Pregnancy Outcomes in Recurrent Miscarriage

作　　者：时梦 周保成[1] 魏肖 葛江兰 SHI Meng;ZHOU Baocheng;WEI Xiao;GE Jianglan(Department of Laboratory,Lianyungang Maternal and Child Health Hospital,Lianyungang,Jiangsu 222000,China)

机构地区：[1]连云港市妇幼保健院检验科,江苏连云港222000

出　　处：《中国医药指南》2025年第2期32-35,共4页Guide of China Medicine

摘　　要：目的探究狼疮样抗凝物质(LA)联合凝血指标对复发性流产妊娠结局的价值。方法选取2022年7月至2023年6月连云港市妇幼保健院收治的259例复发性流产再次妊娠患者作为对象,以妊娠结局为随访终点,根据不同妊娠结局对患者进行分组,复发性流产再次流产为观察组(162例),复发性流产成功分娩为对照组(97例)。所有患者接受LA、凝血指标检测,对比两组患者的LA阳性率、凝血指标[(凝血酶原时间(PT)、纤维蛋白原(FIB)、D-二聚体(D-D)、凝血酶时间(TT)和活化部分凝血活酶时间(APTT)],Pearson相关性分析LA与凝血指标的相关性,结合ROC曲线分析LA单独及联合凝血指标检测对复发性流产妊娠结局的预测价值。结果观察组LA阳性患者25例,阳性率为15.41%(25/162),对照组LA阳性患者1例,阳性率为1.03%(1/97),观察组LA阳性率高于对照组(P<0.05)。观察组PT、Fib、D-D水平均高于对照组(P<0.05)。两组TT和APTT水平比较无差异(P>0.05)。Pearson相关性分析结果显示,LA与TT和APTT无相关性(r=0.053、0.092,P=0.320、0.557),与PT呈负相关(r=-0.365,P=0.001),与Fib和D-D呈正相关(r=0.372、0.359,均P=0.001)。结论凝血指标联合检测对复发性流产妊娠结局的预测价值较高,可作为评估复发性流产患者妊娠结局的重要参考指标。Objective To investigate the value of lupus anticoagulant(LA)combined with coagulation indices in the outcome of pregnancies complicated by recurrent miscarriages.Methods A total of 259 patients with recurrent miscarriages who were pregnant again and admitted to Lianyungang Maternal and Child Health Hospital from July 2022 to June 2023 were selected as the study subjects.The pregnancy outcome was used as the follow-up endpoint,and patients were grouped based on different pregnancy outcomes:the observation group consisted of patients with recurrent miscarriages who experienced another miscarriage(162 cases),and the control group consisted of patients with recurrent miscarriages who successfully delivered(97 cases).All patients underwent testing for LA and coagulation indices,and the LA positivity rate and coagulation indices[(prothrombin time(PT),fibrinogen(FIB),D-dimer(D-D),thrombin time(TT),and activated partial thromboplastin time(APTT)]were compared between the two groups.The correlation between LA and coagulation indices was analyzed using Pearson’s correlation analysis,and the predictive value of LA alone and in combination with coagulation index testing for the pregnancy outcome of recurrent miscarriages was analyzed using the ROC curve.Results There were 25 LA-positive patients in the observation group,with a positivity rate of 15.41%(25/162),and 1 LA-positive patient in the control group,with a positivity rate of 1.03%(1/97).The LA positivity rate in the observation group was higher than that in the control group(P<0.05).The levels of PT,Fib,and D-D in the observation group were all higher than those in the control group(P<0.05).There was no significant difference in TT and APTT levels between the two groups(P>0.05).The results of Pearson’s correlation analysis showed that LA had no correlation with TT and APTT(r=0.053,0.092,P=0.320,0.557),a negative correlation with PT(r=-0.365,P=0.001),and a positive correlation with Fib and D-D(r=0.372,0.359,both P=0.001).Conclusions The combined detection of coagu

关 键 词：复发性流产 狼疮样抗凝物质 凝血指标 妊娠结局 预测价值 

分 类 号：R714.21[医药卫生—妇产科学]