Lou Zheng, Huang Yizhou, Xu Hongyan, Cen Xiaoping, Zhang Yue, Xu Yan, Luo Zhou, Li Chunming, Chen Caiwei, Shi Shuyi, Su Chang, Lin Xi, Ma Linjuan, Zhou Jianhong
Department of Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, China.
Int J Gynaecol Obstet. 2025 Apr;169(1):232-239. doi: 10.1002/ijgo.16042. Epub 2024 Nov 28.
This study aimed to compare the coagulation and platelet parameters in women with spontaneous premature ovarian insufficiency (POI) with those in age-matched controls.
This case-control study recruited 202 women with POI and 202 age-matched women with benign gynecological diseases as controls. Coagulation parameters, including prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), and thrombin time (TT), fibrinogen, and platelet parameters, including platelet count (PLT), mean platelet volume (MPV), plateletcrit (PCT), and platelet distribution width (PDW), were compared between women with POI and controls. Factors associated with coagulation and platelet parameters were also analyzed in women with POI.
In women with POI, higher fibrinogen levels and PDW, lower PLT, MPV, and PCT levels, and shorter TT were observed (p < 0.001). Linear regression analysis further revealed that women with POI were more likely to exhibit increased serum fibrinogen levels (β = 0.465, 95% confidence interval [CI] 0.366-0.564) and PDW (β = 0.340, 95% CI 0.300-0.379), decreased TT (β = -1.101, 95% CI -1.233--0.969), PLT (β = -50.985, 95% CI -65.087--36.882), MPV (β = -1.498, 95% CI -1.875 to -1.120), PCT levels (β = -0.084, 95% CI -0.095--0.973). Additionally, follicle-stimulating hormone levels were positively associated with fibrinogen levels in women with POI. There were no statistically significant differences in PT, INR, and APTT between women with POI and controls.
Women with POI exhibited decreased platelet numbers, abnormal platelet morphology, and elevated fibrinogen concentrations, potentially implicating POI's etiopathogenesis or contributing to an increased risk of cardiovascular disease in women with POI. No coagulation abnormalities were observed in women with POI.
本研究旨在比较自发性卵巢早衰(POI)女性与年龄匹配的对照组女性的凝血和血小板参数。
本病例对照研究招募了202例POI女性和202例年龄匹配的患有良性妇科疾病的女性作为对照。比较了POI女性和对照组之间的凝血参数,包括凝血酶原时间(PT)、国际标准化比值(INR)、活化部分凝血活酶时间(APTT)和凝血酶时间(TT)、纤维蛋白原,以及血小板参数,包括血小板计数(PLT)、平均血小板体积(MPV)、血小板压积(PCT)和血小板分布宽度(PDW)。还分析了POI女性中与凝血和血小板参数相关的因素。
在POI女性中,观察到纤维蛋白原水平和PDW较高,PLT、MPV和PCT水平较低,TT较短(p < 0.001)。线性回归分析进一步显示,POI女性更有可能表现出血清纤维蛋白原水平升高(β = 0.465,95%置信区间[CI] 0.366 - 0.564)和PDW升高(β = 0.340,95% CI 0.300 - 0.379),TT降低(β = -1.101,95% CI -1.233 - -0.969),PLT降低(β = -50.985,95% CI -65.087 - -36.882),MPV降低(β = -1.498,95% CI -1.875至 -1.120),PCT水平降低(β = -0.084,95% CI -0.095 - -0.973)。此外,POI女性中促卵泡生成素水平与纤维蛋白原水平呈正相关。POI女性和对照组之间的PT、INR和APTT无统计学显著差异。
POI女性表现出血小板数量减少、血小板形态异常和纤维蛋白原浓度升高,这可能与POI的发病机制有关,或导致POI女性心血管疾病风险增加。未观察到POI女性存在凝血异常。