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凝血功能及D-二聚体对妊娠期高血压疾病妊娠结局的预测价值

Predictive value of coagulation function and D-dimer for pregnancy outcome in pregnancy-induced hypertension.

作者信息

Zhang Yan, Li Huan, Guo Wenting, Zhao Haixia, Zheng Ning, Huang Yongmei

机构信息

Second Department of Obstetrics, Xi'an International Medical Center Hospital No. 777, Xitai Road, Chang'an District, Xi'an 710117, Shaanxi, China.

Obstetrical Department, Xi'an Gaoxin Hospital No. 16, Tuanjie South Road, Yanta District, Xi'an 710075, Shaanxi, China.

出版信息

Am J Transl Res. 2023 Feb 15;15(2):1150-1158. eCollection 2023.

Abstract

OBJECTIVE

To observe the predictive values of plasma prothrombin time (PT), fibrinogen (FIB), activated partial thromboplastin time (APTT) and D-dimer (DD) levels for pregnancy outcome in parturients with hypertensive disorder complicating pregnancy (HDCP).

METHODS

A retrospective analysis was conducted on 107 parturients with gestational hypertension admitted to Xi'an International Medical Center Hospital from April 2018 to April 2021 (research group) and on 50 healthy parturients who underwent physical examination in the same period (control group). PT, FIB, APTT, and DD values of all parturients included in the study were examined at admission, and pregnancy outcomes were recorded. The working curve (ROC) of the relationship between coagulation function test indicators and pregnancy outcomes of parturients in the research group was analyzed.

RESULTS

Compared to the control group, PT and APTT values of parturients in the research group were lower, while FIB and DD levels were markedly higher (P < 0.05). Correlation analysis showed APTT and PT were negatively correlated with the severity of disease (both P < 0.001), while the expression of FIB and DD were positively correlated with it (both P < 0.001). Parturients were divided into an adverse outcome group and a normal outcome group. Logistic regression analysis showed that pre-pregnancy body mass index, PT, APTT, FIB, DD and other indicators were all risk factors for adverse outcome in HDCP parturients. ROC curve analysis showed that the area under the curve of these combined risk factors for predicting adverse outcome was 0.971.

CONCLUSION

Levels of PT, FIB, APTT, and DD are abnormal in parturients with different degrees of HDCP. Regular coagulation function tests can effectively detect HDCP, enabling improvement of pregnancy outcome.

摘要

目的

观察血浆凝血酶原时间(PT)、纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)及D-二聚体(DD)水平对妊娠期高血压疾病(HDCP)产妇妊娠结局的预测价值。

方法

回顾性分析2018年4月至2021年4月在西安国际医学中心医院收治的107例妊娠期高血压产妇(研究组)以及同期进行体检的50例健康产妇(对照组)。检测纳入研究的所有产妇入院时的PT、FIB、APTT及DD值,并记录妊娠结局。分析研究组产妇凝血功能检测指标与妊娠结局之间关系的工作曲线(ROC)。

结果

与对照组相比,研究组产妇的PT及APTT值较低,而FIB及DD水平明显较高(P<0.05)。相关性分析显示,APTT和PT与疾病严重程度呈负相关(均P<0.001),而FIB和DD的表达与疾病严重程度呈正相关(均P<0.001)。将产妇分为不良结局组和正常结局组。Logistic回归分析显示,孕前体重指数、PT、APTT、FIB、DD等指标均为HDCP产妇不良结局的危险因素。ROC曲线分析显示,这些联合危险因素预测不良结局的曲线下面积为0.971。

结论

不同程度HDCP产妇的PT、FIB、APTT及DD水平均异常。定期进行凝血功能检测可有效检测HDCP,改善妊娠结局。

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