3P实验及D-二聚体定量检测在产科疾病合并DIC诊断中的临床应用

The Clinical Application of 3P Test and D-dimer Quantification to the Diagnosis of Obstetric Disease Complicated with DIC

目的探讨3P实验和D-二聚体试验在产科疾病合并DIC患者早期诊断中的意义及对预后判断的价值。方法对36例产科疾病合并DIC患者、53例非DIC产科疾病患者和50例正常健康人分别进行血D-D和3P试验测定,并与凝血三项PT、APTT和Fbg相比较,评价它们的敏感性和特异性。结果产科疾病合并DIC组有33例D-D浓度水平超过正常值上限(URL)500μg/L,诊断灵敏度为91.6%,明显高于3P(36.1%)及APTT、PT、FBG(77.8%,47.2%,80.5%);而特异性从高到低是PT、3P、APTT、FBG、D-D。结论D-D敏感性高于3P试验,D-二聚体(D-D)是一个灵敏指标,对产科疾病合并DIC的早期诊断、判断预后有一定的临床价值,而3P特异性较D-D高,故进行优化的实验组合可降低漏诊率、增加实验的有效性。

Objective To investigate 3P test and D-dimer quantification in the early diagnosis of obstetric disease complicated with DIC and the values for prognosis prediction. Methods 3P test and D-dimer quantification were examined in 139 samples. These samples include 36 cases of obstetric disease complicated with DIC and 53 cases of obstetric disease without DIC and 50 cases of healthy persons. The results were compared with that of PT, APTT and Fbg and investigate the sensitivity and specificity. Results 33 cases of D-dimer concentration levels were 500μg/L higher than URL in obstetric disease complicated with DIC group. The sensitivity was 91.6% ,which was significantly higher than that of 3P, APTT, PT and Fbg（ 36.1%, 77.8%, 47.2%, 80.5 %, respectively ）. The specificity from high to low were PT, 3P, APTY, Fbg and D-dimer. Conclusion The sensitivity of D-dimer quantification is higher than that of 3P test. D-dimer is a sensitive indicator in the early diagnosis of obstetric disease complicated with DIC and of clinical values for prognosis prediction. The specificity of 3P test is higher than that of D-dimer quantification. So do experiments of optimal combination can decrease the false negative rate and improve the efficiency of the test.