摘要
目的分析产后发生静脉血栓栓塞症(venous thromboembolism,VTE)的临床流行病学特征及常用实验室检验指标与产后VTE的相关性,探讨其对VTE发生风险的预测价值。方法选择2015年1月1日至2019年12月31日在华中科技大学同济医学院附属协和医院分娩且发生产后VTE的孕妇为研究对象,以年龄和孕周匹配对照,回顾性研究产后VTE发生的流行病学特点及实验室数据。结果5年总体妊娠相关VTE发病率为0.376%,其中孕期VTE发病率为0.121%,产后VTE发病率为0.255%。产后新发VTE主要发生在分娩后2~4d,以远端下肢静脉血栓形成为主要临床类型。产后较低的血红蛋白与白蛋白比值、D二聚体差值升高与产后VTE的发生相关,产后血红蛋白/白蛋白比值每降低1,发生VTE风险增减3.61倍(P=0.008)。产前产后D二聚体的差值每增加1mg/L,发生VTE风险增加1.31倍(P=0.013),差异有统计学意义。结论产后血红蛋白和血清白蛋白比值降低、D二聚体的差值增加与VTE有密切相关性,可能作为VTE新的预测指标。
Objective The aim of this study was to analyze epidemiological characteristics of postpartum venous thromboembolism(VTE)and evaluate the value of routine laboratory test indicators in predicting postpartum VTE.Methods Pregnant women diagnosed postpartum VTE in Union Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 1,2015 to December 31,2019,were enrolled in the case group.Age-matched and gestational age-matched pregnant women without postpartum VTE were selected as control group.A retrospective study was conducted between the two groups.Results(1)The incidence rate of VTE related to pregnancy was 0.376%in5 years,while the incidence of VTE was 0.121%during pregnancy and 0.255%after delivery.The onset of postpartum VTE was mainly on the 2 nd-4 th day after delivery.Thrombosis in lower extremity vein was the most common clinical type of postpartum VTE;(2)Low level of hemoglobin/albumin ratio in postpartum and increased difference of D-dimer after and before delivery were related to postpartum VTE.There was 3.61-fold increased risk of VTE when every unit reduction in the hemoglobin/albumin ratio happened(P=0.008).The risk of postpartum VTE increased 1.31 times for every 1 mg/l increase in D-dimer difference after and before delivery(P=0.013).Conclusion The decrease in ratio of postpartum hemoglobin/albumin and increase in D-dimer difference after and before delivery were closely related to postpartum VTE,which may be the new predictors for postpartum VTE.
作者
张雯
杨慧
罗青清
刘晓夏
吴迪
陶惠
吴梦滢
邹丽
周燕
ZHANG Wen;YANG Hui;LUO Qing-qing;LIU Xiao-xia;WU Di;TAO Hui;WU Meng-ying;ZOU Li;ZHOU Yan(Department of Obstetrics and Gynecology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;Yiling Hospital,Yichang 443100,China;Wuhan Children’s Hospital(Wuhan Maternal and Children’s Healthcare Hospital),Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430000,China)
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2021年第1期117-121,共5页
Chinese Journal of Practical Gynecology and Obstetrics
基金
国家自然科学基金(81703242,81873844)。
关键词
静脉血栓栓塞症
产后
发病率
实验室指标
venous thromboembolism
postpartum
incidence rate
laboratory test indicators
