孕妇D-二聚体、纤维蛋白(原)降解产物及抗凝血酶参考区间的建立

Establishment on the reference ranges of D-dimer,fibrin (fibrinogen) degradation products and antithrombin in pregnant women

目的对正常孕妇不同孕期时的D-二聚体(DD)、纤维蛋白(原)降解产物(FDP)、抗凝血酶(AT)进行连续跟踪检测,观察其变化特点,建立不同孕期孕妇DD、FDP、AT的参考区间。方法选取正常妊娠妇女140名,于孕早期(<21孕周)和孕晚期(>32孕周)分别检测血浆DD、FDP和AT水平;以非妊娠妇女90名作为对照组。采用免疫比浊法检测DD、FDP,发色底物法检测AT。结果孕妇血浆DD、FDP、AT水平与年龄无关。妊娠组孕晚期血浆DD和FDP水平明显高于孕早期(P<0.05),且明显高于对照组(P<0.05)。妊娠组孕晚期血浆AT水平与孕早期和对照组比较,差异均无统计学意义(P>0.05)。孕早期妇女血浆DD、FDP的参考区间分别为<0.92 mg/L、<6.00 mg/L,孕晚期妇女血浆DD、FDP的参考区间分别为<4.14 mg/L、<13.83 mg/L;孕早期和孕晚期妇女血浆AT使用同一参考区间:70%~125%。结论孕妇血浆DD、FDP水平随孕期增加明显上升,与年龄无关,AT无明显变化。初步建立了孕早期和孕晚期妇女血浆DD、FDP及AT的参考区间。

Objective To determine the levels of D-dimer（DD）,fibrin（fibrinogen）degradation products（FDP）and antithrombin（AT）in healthy pregnant women with different periods of pregnancy, and to establishthe gestational week-specific reference ranges of DD,FDP and AT by continuous follow-up determinations.Methods A total of 90 non-pregnant women were enrolled as control group,and 140 healthy pregnant women were enrolled. In early pregnancy（〈21 gestational weeks） and late pregnancy（〉32 gestational weeks）,the levels of plasma DD and FDP were determined by immunoturbidimetry,and the levels of AT were determined by chromogenic substrate method. Results The levels of plasma DD,FDP and AT in pregnant women were not related to ages. The levels of plasma DD and FDP in late pregnancy group were higher than those in early pregnancy group（P〈0.05） and control group（P〈0.05）. There was no statistical significance for the levels of AT in late pregnancy group compared with those in early pregnancy andcontrol groups（P〉0.05）. The reference ranges of plasma DD,FDP and AT in early pregnancy were 〈0.92 mg/L,〈6.00 mg/L and 70%-125%. The reference ranges of plasma DD,FDP and AT in late pregnancy were 〈4.14 mg/L,〈13.83 mg/L and 70%-125%. Conclusions The levels of plasma DD and FDP in pregnant women increase with gestational weeks,and are not related to ages,but there was no change for the levels of AT. The reference ranges of plasma DD,FDP and AT in early and late pregnancy have been established preliminarily.