纤维蛋白原及D-二聚体检测在子痫前期诊断中的意义

The significance of fibrinogen and D-Dimer for diagnosing preeclampsia

目的:探讨纤维蛋白原(FIB)及D-二聚体(D-D)在子痫前期诊断中的意义。方法:选择2015年12月—2017年12月本院接诊的子痫前期患者100例,其中轻度子痫前期36例,重度子痫前期64例;选择同期产检健康产妇50例作为对照组。检测3组对象血清FIB、D-D的表达,并分析其在子痫前期中的意义。结果:血清FIB、D-D检测水平重度子痫前期组>轻度子痫前期组>对照组(P<0.05);相关分析血清FIB、D-D之间呈正相关,回归分析血清FIB、D?D均是子痫前期发病的独立危险因素(P<0.05);诊断子痫前期的曲线下面积(AUC)血清FIB为0.783(95%CI:0.673~0.879),D-D为0.792(95%CI:0.680~0.902),FIB+D-D联合为0.921(95%CI:0.837~0.975),联合检测方法的AUC最高,且检测特异度、准确度(92.4%、93.8%)高于各单独检测结果(P<0.05)。结论:子痫前期患者血清FIB、D-D的表达明显升高,临床上可将其作为疾病的早期诊断指标,预测子痫前期的发生。

Objective： To study the significance of fibrinogen （FIB） and D-Dimer（D-D） for diagnosing preeclampsia. Methods： 100 pregnant women with preeclampsia who received therapy in the first Bengbu people＇s hospital of Anhui province from December 2015 to December 2017 were selected as research subjects, which included 36 cases in mild preeclampsia group and 64 cases in severe preeclampsia group. And 50 healthy pregnant women in the same hospital were selected into control group at the same time. The expression of serum FIB and D-D in three groups was detected and its significance for diagnosing preeclampsia was analyzed. Results： The levels of serum FIB and D-D of women in severe preeclampsia group and in mild preeclampsia group were significantly higher than those of women in control group（P〈0.05）, and the levels of serum FIB and D-D of women in severe preeclampsia group were significantly higher than those of women in mild preeclampsia group（P〈0.05）, the result of Pearson product difference correlation anal- ysis showed that there was a positive correlation between level of serum FIB and level of serum D-D （P〈0.05）. The results of Logistic regression analysis showed that serum FIB level or D-D level was independent risk factors for preeclampsia（P〈0.05）. The area under the curve （AUC） of serum FIB level for diagnosing preeclampsia was 0.78, and its 95 %CI was 0.67-0.88. The AUC of serum D-D level for diagnosing preeclampsia was 0.79, and its 95% CI was 0.68 -0.90. The AUC of serum FIB level combined with serum D-D level for diagnosing preeclampsia was 0.92, and its 95 % CI was 0.84-0.98. The AUC of serum FIB level combined with serum D-D level was significantly higher than that of serum FIB level or serum D-D level only. The specificity and accuracy of serum FIB level combined with serum D-D level for diagnosing preeclampsia were 92.4% and 93.8%, respectively, which were significantly higher than the those of serum FIB level or serum D-D level only （P〈0.05）. Conclusion： The level of serum FIB or D-D is significantly increased in pregnant women with preeclampsia, which involved the occurrence and development of preeclampsia, and it can be used as an early diagnostic indicator to predict the occurrence of preeclampsia.