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妊娠期高血压合并糖尿病患者血小板功能与产后出血及静脉血栓栓塞的相关性。

Correlation of Platelet Function with Postpartum Hemorrhage and Venous Thromboembolism in Patients with Gestational Hypertension Complicated with Diabetes.

机构信息

Department of Obstetrics, The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China.

Department of Obstetrics, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin 300170, China.

出版信息

Comput Math Methods Med. 2022 Jul 18;2022:2423333. doi: 10.1155/2022/2423333. eCollection 2022.

Abstract

OBJECTIVE

This study was aimed at investigating the correlation of platelet function with postpartum hemorrhage and venous thromboembolism (VTE) in gestational hypertension patients with diabetes mellitus.

METHODS

A total of 93 patients with gestational hypertension complicated with diabetes treated from March 2020 to June 2021 were selected as the research group, and 56 healthy pregnant women during the same period were selected as the control group. Platelet function-related indicators (platelet count (PLT), platelet volume distribution width (PDW), and mean platelet volume (MPV)) were compared between the two groups. The patients were divided into a severe group ( = 13), mild group ( = 28), and nonbleeding group ( = 52) according to the severity of postpartum hemorrhage, and the value of combined detection of platelet function-related indicators on the severity of postpartum hemorrhage was evaluated and analyzed. According to the occurrence of VTE, the patients were divided into a VTE group and non-VTE group to analyze the predictive value of combined detection of platelet function-related indicators for VTE occurrence in patients.

RESULTS

The PLT value of the study group was lower than that of the control group, while the PDW and MPV values were higher than those of the control group (all < 0.05). The PLT value increased with the aggravation of postpartum hemorrhage, while the PDW and MPV values decreased with the aggravation of postpartum hemorrhage among the three groups with different severities of postpartum hemorrhage (all < 0.05). The area under the curve (AUC) of PLT, PDW, and MPV combination to evaluate the severity of postpartum hemorrhage in patients with gestational hypertension combined with diabetes was greater than that of PLT alone and PDW alone (both < 0.05). The PLT value was negatively correlated with the severity of postpartum hemorrhage, while PDW and MPV values were positively correlated with the severity of postpartum hemorrhage (both < 0.05). According to the occurrence of VTE, patients were divided into the VTE group ( = 10) and non-VTE group ( = 83). The PLT value of the VTE group was higher than that of the non-VTE group, while the PDW and MPV values were lower than those of the non-VTE group (all < 0.05). The AUC of PLT, PDW, and MPV combination to predict the occurrence of VTE in patients with gestational hypertension combined with diabetes was greater than that of each index alone (all < 0.05).

CONCLUSION

Patients with gestational hypertension complicated with diabetes had abnormal platelet function, and the platelet function was related to postpartum hemorrhage and VTE.

摘要

目的

本研究旨在探讨血小板功能与妊娠高血压合并糖尿病患者产后出血和静脉血栓栓塞症(VTE)的相关性。

方法

选取 2020 年 3 月至 2021 年 6 月期间收治的 93 例妊娠高血压合并糖尿病患者为研究组,并选取同期 56 例健康孕妇作为对照组。比较两组血小板功能相关指标(血小板计数(PLT)、血小板体积分布宽度(PDW)和平均血小板体积(MPV))。根据产后出血严重程度将患者分为重度组(n=13)、轻度组(n=28)和非出血组(n=52),评估和分析血小板功能相关指标联合检测对产后出血严重程度的价值。根据 VTE 的发生情况,将患者分为 VTE 组(n=10)和非 VTE 组(n=83),分析血小板功能相关指标联合检测对妊娠高血压合并糖尿病患者 VTE 发生的预测价值。

结果

研究组 PLT 值低于对照组,PDW 和 MPV 值高于对照组(均<0.05)。三组不同产后出血严重程度患者的 PLT 值随产后出血的加重而升高,PDW 和 MPV 值随产后出血的加重而降低(均<0.05)。PLT、PDW 和 MPV 联合评估妊娠高血压合并糖尿病患者产后出血严重程度的曲线下面积(AUC)大于 PLT 单独和 PDW 单独的 AUC(均<0.05)。PLT 值与产后出血严重程度呈负相关,PDW 和 MPV 值与产后出血严重程度呈正相关(均<0.05)。根据 VTE 的发生情况,患者分为 VTE 组(n=10)和非 VTE 组(n=83)。VTE 组 PLT 值高于非 VTE 组,PDW 和 MPV 值低于非 VTE 组(均<0.05)。PLT、PDW 和 MPV 联合预测妊娠高血压合并糖尿病患者 VTE 发生的 AUC 大于各指标单独的 AUC(均<0.05)。

结论

妊娠高血压合并糖尿病患者血小板功能异常,血小板功能与产后出血和 VTE 有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6ff/9313953/7916f98c977d/CMMM2022-2423333.001.jpg

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