妊娠期女性血浆抗凝血酶Ⅲ和D-二聚体参考区间的建立

Establishing reference intervals of plasma antithrombin Ⅲ and D-dimer in healthy pregnant women

目的建立该实验室不同孕期健康孕妇血浆抗凝血酶Ⅲ（AT-Ⅲ）和D-二聚体（D-D）参考区间。方法选取该院2 850例不同孕期健康孕妇及同期260例非妊娠期健康女性,采用法国STA-R Evolution全自动血凝仪及配套试剂,检测所有研究对象的AT-Ⅲ活性及D-D浓度,参照美国临床和实验室标准化协会（CLSI）C28-A3文件,建立该实验室各指标的参考区间。结果非妊娠健康女性血浆AT-Ⅲ及D-D参考区间分别为84.7%-123.3%,≤0.52μg/mL。≤13孕周、〉13-27孕周、〉27孕周的孕妇血浆AT-Ⅲ的参考区间分别为81.8%-115.8%、77.7%-112.1%、68.1%-113.1%。≤13孕周、〉13-20孕周、〉20-27孕周、〉27孕周的孕妇血浆DD的参考区间分别为：≤0.75、≤1.04、≤2.14、≤3.24μg/mL。结论建立该实验室健康孕妇不同孕期血浆AT-Ⅲ及D-D的参考区间,有助于临床评价妊娠期女性凝血、抗凝及纤溶功能。

Objective To establish our lab′s reference intervals of plasma antithrombinⅢ and D-dimer in different gestational periods of healthy pregnant women.Methods 2 850 pregnant women within different gestational periods and 260non-pregnant women were enrolled.The antithrombinⅢ（AT-Ⅲ）and D-dimer（D-D）were detected by STA-R evolution automatic coagulation analyzer and original reagents.According to CLSI guideline C28-A3,our lab′s reference intervals were established.Results The reference intervals of plasma antithrombinⅢ and D-dimer in healthy non-pregnant women were 84.7%-123.3%,≤0.52μg/mL,respectively.The reference intervals of plasma AT-Ⅲ at gestational weeks≤13,〉13-27,〉27were 81.8%-115.8%,77.7%-112.1% and 68.1%-113.1%,respectively.The reference ranges of D-dimer concentration were≤0.75μg/mL,≤1.04μg/mL,≤2.14μg/mL,≤3.24μg/mL in group of≤13weeks,〉13-20 weeks,〉20-27 weeks and 〉27weeks,respectively.ConclusionThe reference values of plasma AT-Ⅲ and D-dimer are determined for each gestational period of pregnancy in our lab,which may assist clinicians in making accurate clinical evaluation of coagulation,anticoagulation and fibrinolysis function for pregnancy women.