血清D-二聚体、FDP水平在中期妊娠引产后并发DIC患者诊断中的意义  

Serum D-Dimer and fibrinogen degradation products levels in patients with DIC complicating mid-term pregnancy termination and their diagnostic significance

作　　者：王曼 陈岚 Wang Man;Chen Lan(Gynecology of Yangtze River Hospital of Yangtze River Water Resources Commission(Stosomiasis Prevention and Monitoring Center)Wuhan,China)

机构地区：[1]长江水利委员会长江医院(血吸虫病防治监测中心)妇科

出　　处：《实用休克杂志(中英文)》2024年第4期227-230,共4页Journal of Practical Shock

摘　　要：目的探讨分析中期妊娠引产后并发弥散性血管内凝血患者的血清D-二聚体、纤维蛋白原降解产物水平及诊断意义。方法将本院在2020年6月至2023年6月期间收治80例中期妊娠引产后并发弥散性血管内凝血患者设为观察组,同期选取80例中期妊娠引产未合并弥散性血管内凝血的患者作为对照组。检测血清中的D-二聚体和纤维蛋白原降解产物水平,Spearman法分析中期妊娠引产后中国弥散性血管内凝血诊断积分系统评分与血清D-二聚体、纤维蛋白原降解产物的相关性。ROC曲线预测D-二聚体、纤维蛋白原降解产物诊断中期妊娠引产后并发弥散性血管内凝血的价值。结果两组年龄、孕周、孕前体质指数、孕次、引产次数等基础资料比较,均无明显统计学意义(P>0.05)。与对照组相比,观察组D-二聚体、纤维蛋白原降解产物水平均更高(P<0.05)。Spearman相关分析显示,血清D-二聚体、纤维蛋白原降解产物水平与中期妊娠引产后并发弥散性血管内凝血严重程度呈正相关(r=0.576,0.745,P<0.001)。血清D-二聚体、纤维蛋白原降解产物及两项联合诊断中期妊娠引产后并发弥散性血管内凝血患者的AUC及95%CI分别是0.632(0.588~0.776)、0.790(0.740~0.841)、0.831(0.751~0.916),诊断的约登指数值分别是0.495、0.586、0.774,它们的灵敏度和特异度分为46.23%和73.46%、70.05%和80.63%、70.14%和92.58%。结论中期妊娠引产后并发弥散性血管内凝血患者的血清D-二聚体和纤维蛋白原降解产物水平显著升高,并与弥散性血管内凝血严重程度呈正相关,可以作为早期弥散性血管内凝血诊断和干预的重要检测指标。联合检测这两个指标对DIC的早期干预具有重要临床意义。Objective To investigate and analyze the serum d-dimer(D-D)and fibrinogen degradation products(FDP)levels in patients with disseminated intravascular coagulation(DIC)complicating mid-term pregnancy termination and their diagnostic significance.Methods A total of 80 patients with DIC complicating mid-term pregnancy termination treated at our hospital from June 2020 to June 2023 were enrolled as the observation group,and 80 patients with mid-term pregnancy termination without DIC during the same period were selected as the control group.The levels of serum D-D and FDP were measured,and Spearman's method was used to analyze the correlation between the chinese disseminated intravascular coagulation scoring system(CDSS)scores and serum D-D and FDP.The ROC curve was used to predict the value of D-D and FDP in diagnosing DIC complicating mid-term pregnancy termination.Results There were no significant differences in baseline data such as age,gestational weeks,pre-pregnancy body mass index,parity,and number of terminations between the two groups(P>0.05).Compared with the control group,the levels of D-D and FDP in the observation group were significantly higher(P<0.05).Spearman correlation analysis showed that the levels of serum D-D and FDP were positively correlated with the severity of DIC complicating mid-term pregnancy termination(r=0.576,0.745,P<0.001).The AUC and 95%CI of D-D,FDP,and their combined diagnosis for DIC complicating mid-term pregnancy termination were 0.632(0.588~0.776),0.790(0.740~0.841),and 0.831(0.751~0.916),respectively.The Youden index values for diagnosis were 0.495,0.586,and 0.774,with sensitivities and specificities of 46.23%and 73.46%,70.05%and 80.63%,and 70.14%and 92.58%,respectively.Conclusions Serum D-D and FDP levels are significantly elevated in patients with DIC complicating mid-term pregnancy termination and are positively correlated with the severity of DIC.They can serve as important detection indicators for the early diagnosis and intervention of DIC.The combined measurement of these

关 键 词：中期妊娠 弥散性血管内凝血 D-二聚体 纤维蛋白原降解产物 

分 类 号：R71[医药卫生—妇产科学]