摘要
目的探讨既往流产史妇女孕早期血栓弹力图指标水平特点。方法选择就诊于兰州大学第二医院既往流产史妇女351例。根据既往流产次数、是否就诊1周内发生胚胎停育、妊娠结局进行分组分析。测定所有患者早孕期血清R、K、Angle、MA、LY30、EPL、CL指标水平。使用单因素方差分析、独立样本t检验比较各组间孕早期血栓弹力图水平差异。结果在既往流产≥3次组中,R值(5.78±1.55)、CL值(0.66±2.11)与既往流产1次组相比存在显著差异(P<0.05);MA为与其他两组相比均存在统计学差异,但并未随着既往流产次数增加呈正相关趋势。就诊1周内胚胎停育组与正常妊娠组相比,R值(4.84±1.26)、K值(1.73±0.56)降低,Angle(65.55±6.95)、CL(1.24±1.81)升高,差异具有统计学意义(P<0.05)。根据妊娠结局分组分析,两组间各指标均差异无统计学意义。结论对既往流产史妇女应行TEG监测评估母体凝血功能,尤其是R、MA、CL值的动态变化,提示早期胚胎停育可能,但孕早期凝血改变无法预测本次妊娠结局。
Objective This study aimed to investigate the characteristics of thromboelastography indicators in early pregnancy among women with a history of miscarriage.Methods A total of 351 women with a history of miscarriage who visited Lanzhou University Second Hospital were selected.The groups were analyzed based on the number of previous miscarriages,embryo arrest within one week of consultation,and pregnancy outcomes.The levels of serum indicators R,K,Angle,MA,LY30,EPL,and CL were measured in early pregnancy for all patients.One-way analysis of variance and independent sample t-tests were used to compare the differences in thromboelastography levels between groups.Results In the group with history of≥3 miscarriages.the R value(5.78±1.55)and CL value(0.66±2.11)showed significant differences compared to the group with history of one miscarriage(P<0.05).The MA value showed statistical differences compared to the other two groups,but did not show a positive correlation with the number of previous miscarriages.The group with early fetal demise within one week of consultation showed lower R value(4.84±1.26)and K value(1.73±0.56),and higher Angle(65.55±6.95)and CL(1.24±1.81)compared to the normal pregnancy group,with statistically significant differences(P<0.05).According to the analysis based on pregnancy outcomes,there were no statistical differences in each indicator between the two groups.Conclusion Thromboelastography monitoring and evaluation of maternal coagulation function should be performed on women with a history of miscarriage,especially the dynamic changes in R,MA,and CL values,which may indicate early fetal demise.However,changes in coagulation in early pregnancy cannot predict the outcome of the current pregnancy.
作者
赵梦妮
何田
玉王芳
ZHAO Mengni;HE Tianyu;WANG Fang(Lanzhou University Second Hospital,Lanzhou,Gansu 730000,China)
出处
《中国优生与遗传杂志》
2023年第12期2501-2506,共6页
Chinese Journal of Birth Health & Heredity
基金
国家自然科学基金资助项目(81960515)
兰州大学医学教育创新发展项目(lzuyxcx-2022-137)。
关键词
凝血
妊娠丢失
血栓弹力图
blood clotting
pregnancy loss
thromboelastogram
