Wang Tongfei, Kang Xiaomin, He Liying, Liu Zhilan, Xu Haijing, Zhao Aimin
Department of Obstetrics and Gynecology, Ren Ji Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China.
Int J Gynaecol Obstet. 2017 Sep;138(3):283-287. doi: 10.1002/ijgo.12213. Epub 2017 Jun 21.
To establish a statistical model to predict thrombophilia in patients with unexplained recurrent pregnancy loss (URPL).
A retrospective case-control study was conducted at Ren Ji Hospital, Shanghai, China, from March 2014 to October 2016. The levels of D-dimer (DD), fibrinogen degradation products (FDP), activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen (Fg), and platelet aggregation in response to arachidonic acid (AA) and adenosine diphosphate (ADP) were collected. Receiver operating characteristic curve analysis was used to analyze data from 158 UPRL patients (≥3 previous first trimester pregnancy losses with unexplained etiology) and 131 non-RPL patients (no history of recurrent pregnancy loss). A logistic regression model (LRM) was built and the model was externally validated in another group of patients.
The LRM included AA, DD, FDP, TT, APTT, and PT. The overall accuracy of the LRM was 80.9%, with sensitivity and specificity of 78.5% and 78.3%, respectively. The diagnostic threshold of the possibility of the LRM was 0.6492, with a sensitivity of 78.5% and a specificity of 78.3%. Subsequently, the LRM was validated with an overall accuracy of 83.6%.
The LRM is a valuable model for prediction of thrombophilia in URPL patients.
建立一种统计模型以预测不明原因复发性流产（URPL）患者的易栓症。
2014年3月至2016年10月在中国上海仁济医院进行了一项回顾性病例对照研究。收集了D-二聚体（DD）、纤维蛋白原降解产物（FDP）、活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）、凝血酶时间（TT）、纤维蛋白原（Fg）以及花生四烯酸（AA）和二磷酸腺苷（ADP）诱导的血小板聚集水平。采用受试者工作特征曲线分析对158例URPL患者（既往有≥3次孕早期不明原因流产史）和131例非复发性流产（RPL）患者（无复发性流产史）的数据进行分析。构建了逻辑回归模型（LRM），并在另一组患者中对该模型进行了外部验证。
LRM包括AA、DD、FDP、TT、APTT和PT。LRM的总体准确率为80.9%，敏感性和特异性分别为78.5%和78.3%。LRM可能性的诊断阈值为0.6492，敏感性为78.5%，特异性为78.3%。随后，LRM的验证总体准确率为83.6%。
LRM是预测URPL患者易栓症的一个有价值的模型。
