Borsi Seyed H, Shoushtari Maryam H, MalAmir Mehrdad D, Angali Kambiz A, Mavalizadeh Maryam S
Department of Pulmonology, Ahvaz Respiratory Research Center, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran.
Department of Biostatistics and Epidemiology, Ahvaz Respiratory Research Center, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran.
J Family Med Prim Care. 2020 Aug 25;9(8):4343-4347. doi: 10.4103/jfmpc.jfmpc_1070_19. eCollection 2020 Aug.
Pulmonary thromboembolism is the third most common vascular disease after coronary heart disease and stroke and is approximately 10 times more common in pregnant women compared with the nonpregnant population at the same age. The purpose of the current work is to evaluate D-dimer plasma concentration in pregnant women with or without pulmonary thromboembolism.
The present study was a cross-sectional study in which 100 pregnant women with suspected pulmonary embolism referred to Imam Khomeini Hospital in Ahwaz in 1398 were studied. After imaging and approving or rejecting a pulmonary embolism, simultaneously the D-dimer sample was taken from them; then the dimer level in each trimester was compared in positive or negative cases of pulmonary embolism. The SPSS software version 22 was used for data analysis.
The results showed that 12 patients in the study population had pulmonary embolism and 88 patients did not have pulmonary embolism. According to the results of patients with pulmonary embolism based on CT angiography results, there was no significant relationship with increasing gestational age and mean dimer level ( = 0.41). But there was a significant relationship between gestational age and mean dimer level in the group with no pulmonary embolism ( = 0.0001). There was no significant relationship between maternal age and mean dimer level in patients with pulmonary embolism ( = 0.376) and without pulmonary embolism ( = 0.1). Also, there was no significant relationship between the number of pregnancies in both groups with and without pulmonary embolism ( = 0456, = 0.392).
Concomitant use of D-dimer and Wells' criteria can help us to diagnose or rule out pulmonary thromboembolism and minimize the risk of pregnant women being exposed to X-rays; given the biodiversity of the D-dimer of every woman during a natural pregnancy, repeated D-dimer measurements in the evaluation of thromboembolic pregnancy during pregnancy have no clinical application.
肺血栓栓塞症是仅次于冠心病和中风的第三大常见血管疾病，与同年龄非孕妇人群相比，在孕妇中其发病率约高10倍。本研究的目的是评估有无肺血栓栓塞症的孕妇血浆D - 二聚体浓度。
本研究为横断面研究，对2019年转诊至阿瓦士伊玛目霍梅尼医院的100例疑似肺栓塞孕妇进行了研究。在通过影像学检查确诊或排除肺栓塞后，同时采集她们的D - 二聚体样本；然后比较肺栓塞阳性或阴性病例中各孕期的二聚体水平。使用SPSS 22软件进行数据分析。
结果显示，研究人群中有12例患者患有肺栓塞，88例患者未患肺栓塞。根据基于CT血管造影结果的肺栓塞患者情况，孕周增加与平均二聚体水平之间无显著相关性（P = 0.41）。但在无肺栓塞组中，孕周与平均二聚体水平之间存在显著相关性（P = 0.0001）。肺栓塞患者（P = 0.376）和无肺栓塞患者（P = 0.1）的母亲年龄与平均二聚体水平之间均无显著相关性。此外，有肺栓塞组和无肺栓塞组的妊娠次数之间也无显著相关性（P = 0.456，P = 0.392）。
联合使用D - 二聚体和Wells标准有助于我们诊断或排除肺血栓栓塞症，并将孕妇接受X射线照射的风险降至最低；鉴于自然妊娠期间每位女性D - 二聚体的生物多样性，在妊娠期间评估血栓栓塞性妊娠时重复进行D - 二聚体测量并无临床应用价值。
