重庆市璧山区健康孕晚期女性血浆D-二聚体参考区间的建立及验证  

Establishment and validation of reference intervals for plasma D-dimer in healthy pregnant women in the third trimester in Bishan District,Chongqing

作　　者：黄立媛 刘亚莉 朱黎黎 汪志学[1] 游航 季飞虎 HUANG Liyuan;LIU Yali;ZHU Lili;WANG Zhixue;YOU Hang;JI Feihu(Department of Clinical Laboratory,Bishan Hospital of Chongqing Medical University/Bishan Hospital of Chongqing,Chongqing 402760,China;Department of Clinical Laboratory,the People's Hospital of Yubei District of Chongqing City,Chongqing 401120,China)

机构地区：[1]重庆医科大学附属璧山医院/重庆市璧山区人民医院检验科,重庆402760 [2]重庆市渝北区人民医院检验科,重庆401120

出　　处：《检验医学与临床》2025年第3期356-360,共5页Laboratory Medicine and Clinic

基　　金：重庆市自然科学基金面上项目(CSTB2022NSCQ-MSX0143);重庆市渝北区科技计划项目[2023(农社)04]。

摘　　要：目的建立重庆市璧山区健康孕晚期女性不同孕周血浆D-二聚体(D-D)参考区间,为临床防治妊娠期并发血栓性疾病提供正常参考区间。方法回顾性选取2023年1-12月在重庆医科大学附属璧山医院做产前检查的724例健康单胎孕晚期女性作为试验组。按孕周将试验组分为健康未足月组(28~36周,293例)与健康足月组(37~42周,431例)。按育龄将健康未足月组、健康足月组分为<30岁(健康未足月组122例,健康足月组279例)和≥30岁(健康未足月组171例,健康足月组152例)。另选取254例同期在重庆医科大学附属璧山医院体检的健康育龄非孕女性作为对照组,根据年龄将其分为<30岁(124例)与≥30岁(130例)。检测各组血浆D-D水平,建立血浆D-D的单侧参考区间。绘制受试者工作特征(ROC)曲线分析D-D对妊娠期合并症的诊断效能。采用Pearson相关分析D-D水平与孕周、年龄的相关性。结果试验组正态性检验结果显示总体D-D水平为[1.93(1.35,2.73)]mg/L。对照组正态性检验结果显示总体D-D水平为[0.22(0.14,0.33)]mg/L。试验组D-D水平高于对照组,差异有统计学意义(U=64.5,P<0.01)。健康未足月组、健康足月组、对照组相同年龄段D-D水平比较,差异有统计学意义(P<0.05)。Pearson相关分析结果显示,D-D水平与孕周呈正相关(r=0.175,P<0.05),与年龄无相关性。璧山区正常孕晚期女性的D-D的单侧95%CI为:健康未足月组≤4.18 mg/L,健康足月组≤4.63 mg/L,健康未足月组D-D水平为[1.81(1.21,2.49)]mg/L,健康足月组D-D水平为[2.00(1.42,2.90)]mg/L。妊娠期合并症未足月组D-D水平为[4.52(3.61,6.19)]mg/L,妊娠期合并症足月组D-D水平为[5.16(4.51,7.39)]mg/L,与健康未足月组、健康足月组D-D水平比较,妊娠期合并症未足月组D-D水平高于健康未足月组,妊娠期合并症足月组D-D水平均高于健康足月组,差异均有统计学意义(U=106.0、162.0,P<0.05)。ROC曲线分析结果显示,D-D水平预测妊Objective To establish the reference intervals of plasma D-dimer(D-D)in healthy pregnant women at different gestational weeks in Bishan district of Chongqing,and to provide normal reference intervals for clinical prevention and treatment of pregnancy complicated with thrombotic diseases.Methods A total of 724 healthy singleton pregnant women in the third trimester who underwent prenatal examination in Bishan Hospital Affiliated to Chongqing Medical University from January to December 2023 were retrospectively selected as the experimental group.According to the gestational age,the experimental group was divided into healthy pre-term group(28-36 weeks,293 cases)and healthy full-group(37-42 weeks,431 cases).The healthy pre-term group and healthy term group were divided into<30 years old(healthy pre-term group 122 cases,healthy full-term group 279 cases)and≥30 years old(healthy pre-term group 171 cases,healthy full-term group 152 cases)according to their reproductive age.Another 254 healthy non-pregnant women of childbearing age who underwent physical examination in Bishan Hospital Affiliated to Chongqing Medical University during the same period were selected as the control group.According to age,they were divided into<30 years old group(124 cases)and≥30 years old group(130 cases).Twenty healthy women in the third trimester of pregnancy in 2024 were randomly selected to verify the reference interval of D-D level.Sixty women(30 cases in pre-term pregnancy complication group,30 cases in full-term pregnancy complication group)in the third trimester of pregnancy with pregnancy complications in 2024 were retrospectively selected to verify the reference interval of D-D level in women in the third trimester of pregnancy with pregnancy complications.The levels of plasma D-D in each group were measured,and the percentile(P95)was calculated to establish the unilateral reference interval of plasma D-D.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of D-D for complications durin

关 键 词：孕晚期 D-二聚体 参考区间 血栓性疾病 静脉血栓栓塞症 

分 类 号：R714.1[医药卫生—妇产科学]