摘要
目的:观察重庆地区健康单胎孕妇的血浆D-二聚体水平变化,并建立重庆地区孕妇不同孕周的血浆D-二聚体水平及参考区间,以指导孕期管理。方法:纳入2020年3月至2020年9月在重庆医科大学附属第一医院进行常规产前检查的无合并症及并发症的健康单胎孕妇5052例,于清晨空腹采集枸橼酸钠抗凝静脉血3 ml,分离血浆检测D-二聚体水平。按照孕周进行分组,并比较不同产次、年龄、体质量指数(BMI)对血浆D-二聚体水平的影响。结果:重庆地区健康单胎孕妇的血浆D-二聚体水平随孕周而逐渐升高(r=0.3697,P<0.0001)。血浆D-二聚体水平在孕早期约为0.395 mg/L,孕中期约为0.770 mg/L,孕晚期约为1.220 mg/L,各组间水平差异有统计学意义(P<0.05)。以P_(2.5)~P_(97.5)百分位数建立参考区间,血浆D-二聚体水平在孕早期的参考区间为0.190~1.329 mg/L,孕中期为0.120~3.797 mg/L,孕晚期为0.120~4.800 mg/L。初产妇和经产妇孕期血浆D-二聚体水平变化差异无统计学意义,但年龄和BMI差异有统计学意义(P<0.05)。结论:建立重庆地区孕妇不同孕周的血浆D-二聚体参考区间,有助于评估孕妇的血液状态,尽早识别妊娠血栓相关性疾病,避免过度诊疗。
Objective:Observe the changes in plasma D-dimer levels of healthy singleton pregnant women in Chongqing,and establish the plasma D-dimer levels and reference intervals of pregnant women in Chongqing at different gestational weeks to guide pregnancy management.Methods:Enrolled 5052 healthy singleton pregnant women without comorbidities and complications in the First Affiliated Hospital of Chongqing Medical University from March 2020 to September 2020.Sodium citrate anticoagulated venous blood was collected early in the morning on an empty stomach.3 ml,separate the plasma to detect the D-dimer level.Groups were grouped according to gestational age,and the effects of different parity,age,and BMI on plasma D-dimer levels were compared.Results:The plasma D-dimer level of healthy singleton pregnant women in Chongqing area gradually increased with the gestational age(r=0.3697,P<0.0001).The plasma D-dimer level was about 0.395 mg/L in the first trimester,about 0.770 mg/L in the second trimester,and about 1.220 mg/L in the third trimester.There were statistically significant differences in levels between the groups(P<0.05).The reference interval is established based on the P_(2.5)-P_(97.5) percentile.The reference interval for plasma D-dimer levels in the first trimester is 0.190-1.329 mg/L,the second trimester is 0.120-3.797 mg/L,and the third trimester is 0.120-4.800 mg/L.Primiparous and postpartum women had no statistically significant difference on plasma D-dimer levels during pregnancy,but age and BMI is statistically significant(P<0.05).Conclusions:The establishment of plasma D-dimer reference intervals for pregnant women in different gestational weeks in Chongqing is helpful to assess the blood status of pregnant women,identify pregnancy thrombosis-related diseases as soon as possible,and avoid excessive diagnosis and treatment.
作者
刘学
肖正华
张利
李俊男
漆洪波
乔娟
LIU Xue;XIAO Zhenghua;ZHANG Li(Department of Obstetrics,Yongchuan Hospital Of Chongqing Medical University Chongqing,Chongqing 402160,China;Department of Obstetrics,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2021年第12期940-944,共5页
Journal of Practical Obstetrics and Gynecology
基金
国家自然科学基金(编号:81901508)。
