Nolan T E, Smith R P, Devoe L D
Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta 30912-3345.
Am J Obstet Gynecol. 1993 Aug;169(2 Pt 1):265-8; discussion 268-9. doi: 10.1016/0002-9378(93)90074-s.
Our purpose was to evaluate a rapid latex agglutination slide test for D-dimer, a byproduct of clot lysis, in the prediction of abruptio placentae.
Four groups were studied: (1) 15 patients with normal pregnancies at 40 weeks' gestation, (2) 17 participants with preeclamptic pregnancies, (3) 14 patients with preterm labor, and (4) 15 patients with confirmed abruptio placentae. The latex agglutination slide test was performed with positive and negative reference solutions and plasma dilutions of 1:1, 1:2, 1:4, and 1:8. A test was considered positive if, at 2 minutes, agglutination was present at dilutions of > or = 1:2 (> or = 1.0 micrograms/ml fibrin equivalent units). Test results were compared in patient groups with and without abruptio placentae by means of the chi 2 test.
The likelihood of a positive D-dimer test result was not significantly different among patients in the non-abruptio placentae groups (p = 0.454). Patients in the abruptio placentae group were significantly more likely to have a positive D-dimer slide test result than those in the non-abruptio placentae groups (p = 0.0001). The D-dimer test conferred sensitivity, specificity, positive predictive value, and negative predictive value of 67%, 93%, 91%, and 48%, respectively. In contrast, other laboratory measures of coagulation (e.g., platelet count, prothrombin time, partial thromboplastin time, and fibrinogen levels) yielded no better than a 20% sensitivity for abruptio placentae.
The D-dimer slide test may be a superior rapid method to improve early diagnosis of abruptio placentae.
我们的目的是评估一种用于检测D - 二聚体（凝血块溶解的副产物）的快速乳胶凝集玻片试验在预测胎盘早剥方面的作用。
研究分为四组：（1）15例妊娠40周的正常孕妇，（2）17例先兆子痫孕妇，（3）14例早产患者，（4）15例确诊胎盘早剥的患者。使用阳性和阴性参考溶液以及1:1、1:2、1:4和1:8的血浆稀释液进行乳胶凝集玻片试验。如果在2分钟时，稀释度≥1:2（≥1.0微克/毫升纤维蛋白当量单位）出现凝集，则试验被视为阳性。通过卡方检验比较有胎盘早剥和无胎盘早剥患者组的试验结果。
在无胎盘早剥组的患者中，D - 二聚体试验结果为阳性的可能性无显著差异（p = 0.454）。胎盘早剥组患者D - 二聚体玻片试验结果为阳性的可能性显著高于无胎盘早剥组患者（p = 0.0001）。D - 二聚体试验的敏感性、特异性、阳性预测值和阴性预测值分别为67%、93%、91%和48%。相比之下，其他凝血实验室指标（如血小板计数、凝血酶原时间、部分凝血活酶时间和纤维蛋白原水平）对胎盘早剥的敏感性均不超过20%。
D - 二聚体玻片试验可能是一种用于改善胎盘早剥早期诊断的更优快速方法。
