摘要
目的探讨产前血D-二聚体水平对不良妊娠结局的预测价值。方法回顾性分析2019年1月至2019年6月广西壮族自治区人民医院接治的612例孕产妇的病历资料,以发生不良妊娠结局的263例孕产妇作为研究组,另349例妊娠结局良好的孕产妇作为对照组。比较两组产前血D-二聚体水平,并进一步比较不良妊娠结局者中产后出血组、胎盘早剥组、重度子痫前期组及其他组(包括除重度子痫前期外的子痫前期、妊娠期高血压、胎膜早破、早产、小于胎龄儿及新生儿窒息)之间产前血D-二聚体水平。应用受试者工作特征(ROC)曲线分析产前血D-二聚体预测不良妊娠结局的价值。结果研究组产前血D-二聚体水平显著高于对照组(P<0.05)。其他组产前血D-二聚体水平显著低于产后出血组、胎盘早剥组和重度子痫前期组(P<0.05);产前血D-二聚体水平在产后出血组、胎盘早剥组和重度子痫前期组间比较差异无统计学意义(P>0.05)。ROC曲线分析结果显示,产前血D-二聚体预测不良妊娠结局的ROC曲线下面积为0.743(95%CI:0.706~0.777,P=0.000);截断值为1.41 mg/L,其对应的灵敏度为80.20%,特异度为53.93%。结论产前血D-二聚体水平可作为预测不良妊娠结局的指标。对于产前血D-二聚体异常增高的孕产妇,需更加警惕产后出血、胎盘早剥、重度子痫前期的发生。
Objective To investigate the value of prenatal blood D-dimer level in predicting adverse pregnancy outcomes.Methods The data of medical records of 612 pregnant women admitted to the People′s Hospital of Guangxi Zhuang Autonomous Region from January 2019 to June 2019 were retrospectively analyzed,among whom 263 pregnant women with adverse pregnancy outcomes were selected as the study group,and 349 pregnant women with good pregnancy outcomes were selected as the control group.The prenatal level of blood D-dimer was compared between the two groups,and in the patients with adverse pregnancy outcomes,the prenatal levels of blood D-dimer were further compared among the postpartum hemorrhage group,placental abruption group,severe preeclampsia group and other groups(including preeclampsia except severe preeclampsia,hypertension during pregnancy,premature rupture of membranes,premature delivery,infants small than gestational age and neonatal asphyxia).The value of prenatal blood D-dimer in prediction of adverse pregnancy outcomes was analyzed by using receiver operating characteristic(ROC)curve.Results The prenatal blood D-dimer level of the study group was significantly higher than that of the control group(P<0.05).The prenatal blood D-dimer levels of other groups were significantly lower than those of the postpartum hemorrhage group,the placental abruption group and the severe preeclampsia group(P<0.05);there was no significant difference in the prenatal blood D-dimer level among the postpartum hemorrhage group,the placental abruption group and the severe preeclampsia group(P>0.05).The results of ROC curve analysis showed that the area under the ROC curve for prenatal blood D-dimer to predict adverse pregnancy outcomes was 0.743(95%CI:0.706-0.777,P=0.000);the cut-off value was 1.41 mg/L,whose corresponding sensitivity and specificity were 80.20%and 53.93%,respectively.Conclusion The prenatal level of blood D-dimer can be used as an indicator to predict adverse pregnancy outcomes.For the pregnant women with abnormally high prenatal levels of blood D-dimer,more attention should be paid to the occurrence of postpartum hemorrhage,placental abruption and severe preeclampsia.
作者
韦海棠
邬华
龚天柳
WEI Hai-tang;WU Hua;GONG Tian-liu(Department of Obstetrics, the People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China)
出处
《中国临床新医学》
2021年第12期1217-1220,共4页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
基金
广西卫生健康委科研课题(编号:Z20180712)。
关键词
不良妊娠结局
妊娠晚期
D-二聚体
Adverse pregnancy outcomes
Third trimester of pregnancy
D-dimer
