Tang Juxian, Lin Yihui, Mai Huachao, Luo Yiping, Huang Renwei, Chen Qi, Xiao Duan
Department of Hematology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics·Guangdong Province), Guangzhou, Guangdong 510630, China.
Department of Neurology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics·Guangdong Province), Guangzhou, Guangdong 510630, China.
Taiwan J Obstet Gynecol. 2019 Jan;58(1):29-35. doi: 10.1016/j.tjog.2018.11.004.
Previously reported haemostatic reference intervals in normal pregnancy displayed considerable contradictions to establish convince gestational age-related haemostatic reference values. 30 clinical reports were recruited to collect and assemble existing clinical reports from the database D-dimer levels increased progressively with gestational ages and exceeded conventional value of 1 mg/L after 29-36 weeks, and reached a peak at 24 h postpartum with mean value of 6.44 mg/L [95% confidence interval (CI): 5.84 to 7.05] and returned to 0.79 mg/L (95% CI: 0.43 to 1.16) at 1-8 weeks postpartum. Analogously, the level of fibrinogen gradually increased throughout the pregnancy, and peaked at 48-72 h after birth, with mean value of 9.05 g/L (95% CI: 2.22 to 15.89) and then returned to 3.62 g/L (95% CI: 3.03 to 4.20) at 1-8 weeks postpartum. However, in the middle trimester, asynchronously prothromb in fragments 1 + 2 (F1+2) level elevated and reached a peak at 28-36 weeks with mean value of 3.05 nmol/L (95% CI: 2.41 to 3.70), and then decreased in the later trimester, and reached 1.92 nmol/L (95% CI: 0.58 to 3.27) at 48-72 h post-partum, close to normal levels. Previously reported gestational age-related haemostatic reference intervals in pregnancy could not be used as a standard.
先前报道的正常妊娠止血参考区间存在相当大的矛盾，难以确立令人信服的与孕周相关的止血参考值。招募了30篇临床报告，从数据库中收集和汇总现有临床报告，D - 二聚体水平随孕周逐渐升高，在29 - 36周后超过1mg/L的传统值，并在产后24小时达到峰值，平均值为6.44mg/L [95%置信区间(CI)：5.84至7.05]，产后1 - 8周降至0.79mg/L (95% CI：0.43至1.16)。类似地，纤维蛋白原水平在整个孕期逐渐升高，并在出生后48 - 72小时达到峰值，平均值为9.05g/L (95% CI：2.22至15.89)，然后在产后1 - 8周降至3.62g/L (95% CI：3.03至4.20)。然而，在孕中期，凝血酶原片段1 + 2 (F1+2)水平异步升高，在28 - 36周达到峰值，平均值为3.05nmol/L (95% CI：2.41至3.70)，然后在孕晚期下降，产后48 - 72小时降至1.92nmol/L (95% CI：0.58至3.27)，接近正常水平。先前报道的与孕周相关的妊娠止血参考区间不能用作标准。
