摘要
目的建立各孕期D-Dimer、FIB的参考区间,探讨D-Dimer水平在静脉栓塞及产后出血中的作用。方法收集孕妇2 176例,育龄非孕妇80例,静脉栓塞8例及产后出血合并凝血功能障碍75例。按孕龄分为早孕(890例)、中孕(641例)、晚孕组(645例)。采用P95表示D-Dimer参考区间的单侧上限,采用P2.5~P97.5表示FIB参考区间的上下限。通过参考区间评估8例静脉栓塞和75例产后出血的D-Dimer、FIB水平,验证本研究建立参考区间的有效性。利用ROC曲线评价及分析D-Dimer、FIB水平在产后出血的诊断效率,并确定最佳cutoff值。结果各孕期D-Dimer参考区间单侧上限分别为0.77,1.72,2.44μg/mL。各孕期FIB参考区间分别为2.79~5.38,2.85~5.77,3.02~6.02 g/L;采用上述参考区间评估8例静脉栓塞的D-Dimer、FIB水平,D-Dimer均为阳性结果。D-Dimer水平为2.55μg/mL作为预测产后出血的最佳cutoff值。结论本研究初步建立了孕妇凝血功能参考区间,提高了凝血功能在妊娠期的应用价值;D-Dimer为2.55μg/mL对产后出血有预测价值。
Objective To Establish a reference interval for D-Dimer and FIB during pregnancy,and ex-plore the effect of D-Dimer levels in venous embolization and postpartum hemorrhage.Methods A total of 2176 healthy women,80 healthy non pregnant women,8 cases of venous thromboembolism and 75 cases of postpartum hemorrhage complicated with coagulation disorders were included in this study.They were divided into three groups according to gestational week:the first trimester(n=890),the second trimester(n=641);the third trimester(n=645).The normal values of D-dimer were established by using percentile(P95).The normal values of fibrino-gen were established by using bilateral percentile(P2.5~P97.5).The results of 8 cases of venous thromboembo-lism and 75 cases of postpartum hemorrhage complicated with coagulation disorders were used to validate the estab-lished normal values.ROC curve was used to evaluate and analyze the diagnostic efficiency of D-dimer and fibrino-gen levels in postpartum hemorrhage,and to determine the best cutoff value.Results The reference interval of D-Dimer in first,second third trimester were≤0.79,≤1.72,≤2.44μg/mL,And the reference interval of fibrino-gen in first,second third trimester were 2.79~5.38,2.85~5.77,3.02~6.02 g/L.The above reference intervals were used to evaluate the levels of D-Dimer and fibrinogen in 8 cases of venous thromboembolism and proved posi-tive.The level of D-Dimer 2.55μg/mL could be considered as the best cutoff value prediction of postpartum hemor-rhage.Conclusion This study established a primary reference interval for coagulation function in pregnant wom-en,which improved the application value of coagulation function in pregnancy.D-Dimer has a predictive value for postpartum hemorrhage of 2.55μg/mL.
作者
樊凤娇
吴秉毅
杨辉
郭跃文
吕伟标
宋睿
于新发
FAN Fengjiao;WU Bingyi;YANG Hui;GUO Yuewen;LYU Weibiao;SONG Rui;YU Xinfa(Department of Hematology,Shunde Hospital,Southern Medical University,Foshan 528300,China)
出处
《实用医学杂志》
CAS
北大核心
2018年第22期3736-3740,3744,共6页
The Journal of Practical Medicine
