Duan Lian, He Guo-Lin
Department of Obstetrics, West China Second University Hospital, Chengdu 610041, China.
Key Laboratory of Women and Children's Disease and Birth Defects of the Ministry of Education, Sichuan University , Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2022 May;53(3):543-548. doi: 10.12182/20220560302.
Plasma D-dimer, a special cross-linked fibrin derivative, is produced when fibrin is degraded by plasminase. During pregnancy, D-dimer increases along with the increase of gestational age, and the reference value of plasma D-dimer (≤0.5 mg/L) traditionally used for the screening of venous thrombosis in the normal population is not applicable to the pregnant population. Due to the lack of uniform D-dimer detection methods or measurement units, there is currently no unified D-dimer reference values for pregnancy or puerperium. Each region or laboratory should establish its own pregnancy D-dimer reference value for different gestational weeks through blood coagulation function testing of large numbers of samples of different gestational periods. More and more studies have been conducted to investigate the association between D-dimer and venous thromboembolism (VTE) during pregnancy, gestational hypertensive disorders (GHD) and pregnancy outcome. We reviewed, herein, the generation and measurement of D-dimer, the reference values of D-dimer during normal pregnancy, and the association between D-dimer and some pathological pregnancies, intending to help clinicians develop a more thorough understanding of D-dimer during pregnancy.
血浆D-二聚体是一种特殊的交联纤维蛋白衍生物,当纤维蛋白被纤溶酶降解时产生。在孕期,D-二聚体随着孕周增加而升高,传统上用于正常人群静脉血栓筛查的血浆D-二聚体参考值(≤0.5mg/L)不适用于孕妇人群。由于缺乏统一的D-二聚体检测方法或测量单位,目前尚无针对孕期或产褥期的统一D-二聚体参考值。各地区或实验室应通过对大量不同孕周样本进行凝血功能检测,建立各自针对不同孕周的孕期D-二聚体参考值。越来越多的研究致力于探讨孕期D-二聚体与静脉血栓栓塞症(VTE)、妊娠期高血压疾病(GHD)及妊娠结局之间的关联。在此,我们综述了D-二聚体的产生与检测、正常孕期D-二聚体的参考值,以及D-二聚体与一些病理妊娠之间的关联,旨在帮助临床医生更全面地了解孕期D-二聚体。