高危孕妇孕早期D-二聚体/纤维蛋白原比值与子痫前期及围产期结局的关系  

Relationship Between D-Dimer/Fibrinogen Ratio in Early Pregnancy and Preeclampsia and Perinatal Outcomes in High-Risk Pregnant Women

作　　者：刘丽萍 付东宏[2] LIU Liping;FU Donghong(Department of Obstetrics and Gynecology,Anyang Maternal and Child Health Hospital,Anyang 455001,China;Department of Surgery,Anyang Cancer Hospital,Anyang 455000,China)

机构地区：[1]安阳市妇幼保健院妇产科,河南安阳455001 [2]安阳市肿瘤医院外科,河南安阳455000

出　　处：《河南医学研究》2025年第6期1044-1047,共4页Henan Medical Research

摘　　要：目的探讨高危孕妇孕早期D-二聚体(D-D)/纤维蛋白原(FIB)比值(D/F)与子痫前期发生及围产期结局的关系。方法选择2020年1月至2023年1月安阳市妇幼保健院收治的103例高危孕妇作为研究组,另外将同期于安阳市妇幼保健院健康体检的112例正常孕妇作为对照组。所有纳入对象入院后均检测血清D-D、FIB水平,并计算D/F比值。随访高危孕妇并根据是否发生子痫前期分为子痫前期组(44例)和非子痫前期组(59例),根据病情程度将观察组分为轻度子痫前期25例和重度子痫前期19例。比较各组D/F水平差异,采用受试者工作特征(ROC)曲线评估D/F对高危孕妇子痫前期的预测价值。同时分析高危孕妇孕早期D/F与围产期结局的关系。结果研究组孕妇孕早期外周血D-D、FIB及D/F均高于对照组(P<0.05);重度子痫前期孕妇孕早期外周血D-D、FIB及D/F均高于轻度子痫前期(P<0.05)。子痫前期组高危孕妇孕早期外周血D-D、FIB及D/F均高于非子痫前期组(P<0.05)。ROC曲线分析显示,外周血D/F预测高危孕妇子痫前期发生的曲线下面积为0.842,截断值为1.18,灵敏度及特异度为90.46%、65.58%。妊娠结局不良组高危孕妇孕早期外周血D-D、FIB及D/F均高于妊娠结局正常组(P<0.05)。ROC曲线分析显示,外周血D/F预测高危孕妇不良围产期结局的曲线下面积为0.907,截断值为1.06,灵敏度及特异度为85.71%、85.33%。结论高危孕妇孕早期外周血D/F比值升高,且与子痫前期及不良围产期结局的发生密切相关,有望作为预测高危孕妇子痫前期发生的有效生物标志物。Objective To explore the relationship between D-dimer(D-D)to fibrinogen(Fib)ratio(D/F)in early pregnancy and preeclampsia occurrence and perinatal outcome in high-risk pregnant women.Methods A total of 103 high-risk pregnant women admitted to Anyang Maternal and Child Health Hospital from January 2020 to January 2023 were selected as study group,and 112 normal pregnant women who came for physical examination during the same period were selected as control group.The levels of serum D-D and Fib were detected in all subjects after admission,and the D/F ratio was calculated.High-risk pregnant women were followed up and divided into preeclampsia group(44 cases)and non-preeclampsia group(59 cases)according to the presence or absence of preeclampsia.According to the severity of the disease,the observation group was divided into 25 cases of mild preeclampsia and 19 cases of severe preeclampsia.The difference of D/F level in each group was compared,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive value of D/F for preeclampsia in high-risk pregnant women.The relationship between D/F in the first trimester and perinatal outcomes was analyzed.Results The D-D,Fib and D/F in peripheral blood of pregnant women in study group were higher than those in control group(P<0.05).The D-D,Fib and D/F of peripheral blood of women with severe preeclampsia in early pregnancy were significantly higher than those of women with mild preeclampsia in early pregnancy(P<0.05).The levels of D-D,Fib and D/F in early pregnancy of high-risk pregnant women in the preeclampsia group were higher than those in non-preeclampsia group(P<0.05).ROC curve analysis showed that the area under the curve of peripheral blood D/F for predicting preeclampsia in high-risk pregnant women was 0.842,the cut-off value was 1.18,and the sensitivity and specificity were 90.46% and 65.58%,respectively.The levels of D-D,Fib and D/F in early pregnancy of high-risk pregnant women in the poor pregnancy outcome group were higher than those i

关 键 词：高危孕妇 D-二聚体/纤维蛋白原比值 子痫前期 围产期结局 

分 类 号：R714.24[医药卫生—妇产科学]