Division of Clinical Laboratory Medicine, Tottori University Hospital, Yonago, Tottori, Japan.
Department of Multidisciplinary Internal Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori, Japan.
Ann Clin Biochem. 2023 Jul;60(4):279-285. doi: 10.1177/00045632231160667. Epub 2023 Mar 7.
Pregnancy is a risk factor for venous thromboembolism (VTE) due to increased coagulation factor activity and decreased protein S activity. However, thrombosis markers for predicting VTE in pregnancy remain controversial. This study aimed to investigate the relationship between VTE risk and thrombosis markers in pregnant women and to identify markers related to VTE risk.
Archived plasma samples from 107 pregnant women were used in this study, and the concentrations of D-dimer, fibrin monomer complex (FMC), plasmin-plasmin inhibitor complex, prothrombin time, activated partial thromboplastin time, and fibrinogen were measured. VTE risk was scored according to the Royal College of Obstetricians and Gynaecologists green-top guidelines and the patients were divided into low- or high-risk groups.
The median (range) of risk score for deep vein thrombosis was 2 (0-8), and we defined the high-risk group included those with a score of ≧3. D-dimer and FMC concentrations were significantly higher in the high-risk group than in the low-risk group (D-dimer 4.5 vs 2.6 μg/mL, = 0.008; FMC 14.6 vs 3.4 μg/mL, < 0.001). Although D-dimer concentration significantly increased with gestational age (Spearman's correlation coefficient [] = 0.317, < 0.001), FMC concentration did not ( = -0.081, = 0.409). The area under the receiver operating characteristic curve values of D-dimer, FMC, and both D-dimer and FMC for the high-risk group were 0.656, 0.713, and 0.738, respectively.
FMC may be a thrombosis marker related to VTE risk in pregnancy and is potentially preferable over D-dimer concentrations.
由于凝血因子活性增加和蛋白 S 活性降低，妊娠是静脉血栓栓塞症（VTE）的一个危险因素。然而，用于预测妊娠期间 VTE 的血栓形成标志物仍存在争议。本研究旨在探讨孕妇 VTE 风险与血栓标志物之间的关系，并确定与 VTE 风险相关的标志物。
本研究使用了 107 例孕妇的存档血浆样本，并测量了 D-二聚体、纤维蛋白单体复合物（FMC）、纤溶酶-纤溶酶抑制剂复合物、凝血酶原时间、活化部分凝血活酶时间和纤维蛋白原的浓度。根据皇家妇产科医师学院的绿色指南对 VTE 风险进行评分，并将患者分为低风险或高风险组。
深静脉血栓形成的风险评分中位数（范围）为 2（0-8），我们将评分≧3 定义为高风险组。高风险组的 D-二聚体和 FMC 浓度明显高于低风险组（D-二聚体 4.5 对 2.6μg/mL， = 0.008；FMC 14.6 对 3.4μg/mL， < 0.001）。尽管 D-二聚体浓度随妊娠周数显著增加（Spearman 相关系数 [] = 0.317， < 0.001），但 FMC 浓度没有变化（ = -0.081， = 0.409）。D-二聚体、FMC 以及 D-二聚体和 FMC 对高风险组的受试者工作特征曲线下面积值分别为 0.656、0.713 和 0.738。
FMC 可能是与妊娠期间 VTE 风险相关的血栓形成标志物，其优于 D-二聚体浓度。
Zotero 插件