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早孕期 INR 降低对子痫前期发生的影响:一项回顾性队列研究。

Effect of Reduced INR in Early Pregnancy on the Occurrence of Preeclampsia: A Retrospective Cohort Study.

机构信息

Department of Clinical Laboratory, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Department of Blood Transfusion, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.

出版信息

Clin Appl Thromb Hemost. 2024 Jan-Dec;30:10760296241238015. doi: 10.1177/10760296241238015.

Abstract

To investigate the effect of reduced early-pregnancy activated partial thrombin time (APTT), prothrombin time (PT), and international standardized ratio (INR) on the risk of preeclampsia. A total of 8549 pregnant women with singleton births were included. Early pregnancy APTT, PT, and INR levels, with age, birth, prepregnancy body mass index, fibrinogen (FBG), thrombin time (TT), D-dimer (DD2), antithrombin III (ATIII), fibrin degradation products (FDP) as confounders, generalized linear model of APTT, the relative risk of PT and INR when INR reduction. After adequate adjustment for confounders, the relative risk of preeclampsia was 0.703 for every 1 s increase in plasma PT results in early pregnancy, and for every 0.1 increase in plasma INR results, the relative risk of preeclampsia was 0.767. With a PT less than the P25 quantile (<11 s), the relative risk of preeclampsia was 1.328. The relative risk of preeclampsia at an INR less than the P25 quantile (<0.92) was 1.24. There was no statistical association between APTT on the risk of preeclampsia. The relative risk of preeclampsia is strongly associated with a decrease in PT and INR in early pregnancy. PT and INR in early pregnancy were a potential marker in the risk stratification of preeclampsia. Focusing on reduced PT and INR levels in early pregnancy can help to identify early pregnancies at risk for preeclampsia.

摘要

目的

探讨孕早期活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)和国际标准化比值(INR)降低对子痫前期风险的影响。

方法

共纳入 8549 例单胎妊娠孕妇。以年龄、出生体重、孕前体质量指数、纤维蛋白原(FBG)、凝血酶时间(TT)、D-二聚体(DD2)、抗凝血酶 III(ATIII)、纤维蛋白降解产物(FDP)为混杂因素,采用 APTT 的广义线性模型,分析孕早期 INR 降低时 PT 和 INR 的相对危险度。

结果

经充分校正混杂因素后,孕早期血浆 PT 每增加 1 s,子痫前期的相对危险度为 0.703;血浆 INR 每增加 0.1,子痫前期的相对危险度为 0.767。PT<第 25 百分位数(<11 s)时,子痫前期的相对危险度为 1.328;INR<第 25 百分位数(<0.92)时,子痫前期的相对危险度为 1.24。APTT 与子痫前期风险无统计学关联。

结论

孕早期 PT 和 INR 降低与子痫前期风险密切相关。孕早期 PT 和 INR 可能是子痫前期风险分层的潜在标志物。关注孕早期 PT 和 INR 水平降低有助于识别子痫前期高危孕妇。

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本文引用的文献

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