[1]张 燕,朱俊美,崔 静.血栓弹力图检查参数与胎盘早剥严重程度关系及对胎儿窘迫的预测价值研究[J].陕西医学杂志,2023,52(5):553-557.[doi:DOI:10.3969/j.issn.1000-7377.2023.05.013]
　ZHANG Yan,ZHU Junmei,CUI Jing.Relationship between thromboelastography parameters and severity of placental abruption and its predictive value for fetal distress[J].,2023,52(5):553-557.[doi:DOI:10.3969/j.issn.1000-7377.2023.05.013]
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血栓弹力图检查参数与胎盘早剥严重程度关系及对胎儿窘迫的预测价值研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年5期
页码:
553-557
栏目:
临床研究
出版日期:
2023-05-05

文章信息/Info

Title:
Relationship between thromboelastography parameters and severity of placental abruption and its predictive value for fetal distress
作者:
张 燕1; 朱俊美2; 崔 静3
(1.西安国际医学中心医院产二科,陕西 西安 710100; 2.陕西省康复医院妇产科,陕西 西安 710061; 3.西安经开妇幼医院产科,陕西 西安 710018)
Author(s):
ZHANG Yan; ZHU Junmei; CUI Jing
(The Second Department of Obstetrics,Xi'an International Medical Center Hospital,Xi'an 710100,China)
关键词:
胎盘早剥;  严重程度;  血栓弹力图;  胎儿窘迫;  分娩出血量;  预测
Keywords:
Placental abruption;  Degree of severity;  Thrombelastography;  Fetal distress;  Blood loss during delivery;  Prediction
分类号:
R 714.43
DOI:
DOI:10.3969/j.issn.1000-7377.2023.05.013
文献标志码:
A
摘要:
目的:分析血栓弹力图检查参数与胎盘早剥严重程度的关系及对胎儿窘迫的预测价值。方法:选择102例胎盘早剥孕妇(观察组)作为研究对象,其中轻型57例、重型45例; 另选同期的102例正常妊娠孕妇作为对照组。检测两组血栓弹力图检查参数[凝血反应时间(R值)、凝血时间(K值)、血细胞凝集块形成速率(α角)、血栓最大弹力度(MA值)、凝血综合指数(CI值)],分析血栓弹力图检查参数与分娩出血量的关系,使用受试者工作特征(ROC)曲线分析血栓弹力图检查参数对胎儿窘迫的预测价值。结果:观察组R值、K值均长于对照组,α角、MA值、CI值均小于对照组(均P<0.05); 在观察组中,重型胎盘早剥孕妇R值、K值均长于轻型胎盘早剥孕妇,α角、MA值、CI值均小于轻型胎盘早剥孕妇(均P<0.05); 经Pearson相关性分析,胎盘早剥孕妇分娩出血量与R值、K值呈正相关(P<0.05),与α角、MA值、CI值呈负相关(P<0.05); 经多因素Logistic回归分析,血栓弹力图中R值、K值均是胎盘早剥孕妇发生胎儿窘迫的独立预测因素(均P<0.05); 经ROC曲线分析,胎盘早剥孕妇血栓弹力图中R值联合K值预测胎儿窘迫的ROC曲线下面积(AUC)为0.924。结论:胎盘早剥孕妇血栓弹力图检查参数明显异常,与病情严重程度密切相关,在血栓弹力图中R值联合K值预测胎儿窘迫的效能更佳。
Abstract:
Objective:To analyze the relationship between thrombelastography parameters and the severity of placental abruption and its predictive value for fetal distress.Methods:A total of 102 pregnant women with placental abruption(observation group)were selected as the research subjects,including 57 mild cases and 45 severe cases.Another 102 normal pregnant women were selected as the control group.The thrombelastography parameters [coagulation reaction time(R value),coagulation time(K value),hemagglutination block formation rate(α Angle),maximum thromboelastic force(MA value),coagulation comprehensive index(CI value)]of the two groups were detected,and the relationship between thrombelastography parameters and labor blood loss was analyzed.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of thrombelastography parameters for fetal distress.Results:The R and K values of the observation group were longer than those of the control group,and the α angle,and MA and CI values were lower than those of the control group(all P<0.05).In the observation group,the R and K values of severe placental abruption women were longer than those of mild placental abruption women,and the α angle,MA and CI values were lower than those of mild placental abruption women(all P<0.05).Pearson correlation analysis showed that the amount of blood loss was positively correlated with R value and K value,and negatively correlated with α angle,MA value and CI value(all P<0.05).Multivariate Logistic regression analysis showed that R value and K value in thromboelastography were independent predictors of fetal distress in pregnant women with placental abruption(all P<0.05).According to ROC curve analysis,the area under ROC curve(AUC)of R value combined with K value for predicting fetal distress in thromboelastography of pregnant women with placental abruption was 0.924.Conclusion:The parameters of thromboelastography in pregnant women with placental abruption are obviously abnormal,which is closely related to the severity of the disease.The R value combined with K value in thromboelastography is better in predicting fetal distress.

参考文献/References:

[1] 孟秋霞,苏 静,刘赛超.多普勒超声检测不同类型胎盘早剥的影像特点及诊断价值探究[J].重庆医学,2020,49(8):1297-1301.
[2] 蒋永悟.妊娠期高血压患者尿蛋白和血常规水平分析及对妊娠结局的影响[J].陕西医学杂志,2019,48(1):128-13.
[3] 谢 宁,李红岩,韩晓云.加味杞菊地黄汤联合西药治疗子痫前期疗效及对患者外周血sFlt/PIGF和妊娠结局的影响[J].陕西中医,2021,42(9):1189-1192.
[4] Han M,Liu D,Zeb S,et al.Are maternal and neonatal outcomes different in placental abruption between women with and without preeclampsia[J].Placenta,2019,85(15):69-73.
[5] Yuan T,Wang Y,Sun S.Thromboelastography parameters in diagnosing periprosthetic joint infection and predicting reimplantation timing[J].BMC Musculoskeletal Disorders,2021,22(1):1-8.
[6] 中华医学会妇产科学分会产科学组.胎盘早剥的临床诊断与处理规范(第1版)[J].中华妇产科杂志,2012,47(12):957-958.
[7] 马永琴,郑 玲,杨爱君,等.不同脐动脉血流S/D值联合胎心监测对胎儿窘迫的诊断价值研究[J].陕西医学杂志,2019,48(6):744-747.
[8] 郝淑娟,韩建存,常晓丹.胎盘早剥新生儿的纤维蛋白原、D-D、APTT、PT水平指标变化对患儿凝血功能的早期监测价值研究[J].中国妇幼保健,2019,34(17):3990-3993.
[9] Su J,Yang Y,Cao Y,et al.The predictive value of pre-delivery laboratory test results for the severity of placental abruption and pregnancy outcome[J].Placenta,2021,103(1):220-225.
[10] 吴 笛,龚 晨,兰 晶,等.胎盘早剥产妇妊娠期止血功能变化特征及其预测产后出血的价值[J].临床检验杂志,2019,37(9):661-665.
[11] Ye X,Li Z,Li Y,et al.Reduced mechanical function of the left atrial predicts adverse outcome in pregnant women with clustering of metabolic risk factors[J].BMC Cardiovascular Disorders,2021,21(1):1-9.
[12] 龚 利,段楚瑶,任 野.凝血功能指标水平与胎盘早剥严重程度的关系及对产后大出血的预测价值研究[J].中国性科学,2021,30(7):54-57.
[13] Karaszi K,Szabo S,Juhasz K,et al.Increased placental expression of placental protein 5(PP5)/tissue factor pathway inhibitor-2(TFPI-2)in women with preeclampsia and HELLP syndrome:Relevance to impaired trophoblast invasion[J].Placenta,2019,15(76):30-39.
[14] 孙 磊,米立芬,夏亚静,等.影响胎盘早剥患者剖宫产产后出血的危险因素分析及相应预防对策研究[J].中国病案,2021,22(12):60-63.
[15] Almendros I,Martinez-Ros P,Farre N,et al.Placental oxygen transfer reduces hypoxia/reoxygenation swings in fetal blood in a sheep model of gestational sleep apnea[J].Journal of Applied Physiology,2019,127(496):745-752.
[16] 林 琳,陈艳红,杜丽丽,等.单胎妊娠发生胎盘早剥的危险因素及母儿结局分析——一项9年的回顾性临床研究[J].中国妇幼健康研究,2020,31(12):1585-1591.
[17] Ohira S,Motoki N,Shibazaki T,et al.Alcohol Consumption during pregnancy and risk of placental abnormality:The Japan environment and children's study[J].Scientific Reports,2019,9(1):10259.
[18] Ohkuchi A,Ichihara A.Tight control of blood pressure in pregnant women with nonsevere hypertension:Expectations for decreasing adverse maternal and fetal pregnancy outcomes[J].Hypertension Research,2022,45(5):926-928.
[19] 牛梓涵,张培培,武玺宁,等.超声微血管成像评价胎盘灌注与胎儿生长发育关系的初步研究[J].中华超声影像学杂志,2021,30(8):691-696.
[20] 范建华,高艳多,何 莎,等.胎盘早剥的产前超声诊断价值及妊娠结局分析[J].中国妇幼保健,2020,35(12):2177-2180.

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备注/Memo

备注/Memo:
基金项目:陕西省自然科学基础研究计划项目(2018JM7135)
更新日期/Last Update: 2023-05-05