妊娠晚期孕妇D-二聚体水平异常升高的因素分析

Analysis on the factors of abnormal increase of D-dimer level in late pregnancy

目的探讨引起妊娠晚期孕妇D-二聚体水平异常升高的病理性及生理性因素。方法连续纳入2019年1-3月于该院产科住院并分娩的妊娠晚期孕妇457例,回顾性分析其分娩信息。根据检验项目参考区间制订的相关要求,分为异常升高组与对照组,比较两组生理性及病理性资料。结果健康妊娠晚期孕妇第95%位点的D-二聚体的水平为1319μg/L。与对照组比较,异常升高组妊娠期高血压、双胎妊娠、体外受精-胚胎移植术后、复发性流产史的发生率及三酰甘油的水平升高(P<0.05),纤维蛋白原水平降低(P<0.05)。双胎妊娠(P<0.001,OR=5.262)、复发性流产史(P=0.044,OR=6.115)是引起D-二聚体水平异常升高的独立危险因素。结论妊娠晚期孕妇D-二聚体水平应有其特定的参考区间,临床应重视D-二聚体水平异常升高孕妇的产前监测,以进行早期干预,尽可能避免不良妊娠的发生,保护母婴健康。

Objective To investigate the pathological and physiological factors of abnormal increase of D-dimer in late pregnancy.Methods A total of 457 pregnant women in the third trimester of pregnancy who were hospitalized and delivered in a hospital from January to March in 2019 were enrolled in this study.According to the relevant requirements of the reference interval of the test items,the patients were divided into the abnormal elevation group and the control group,and the physiological and pathological data of the two groups were compared.Results The D-dimer level of 95%locus in healthy pregnant women was 1319μg/L.Compared with the control group,the incidences of gestational hypertension,twin pregnancy,in vitro fertilization embryo transfer,recurrent abortion history,triglyceride level and fibrinogen level in the abnormal elevated group were increased(P<0.05),while the fibrinogen level was decreased(P<0.05).Twin pregnancy(P<0.001,OR=5.262)and recurrent abortion history(P=0.044,OR=6.115)were independent risk factors for abnormal increase of D-dimer level.Conclusion The D-dimer in late pregnancy should have its specific reference range.We should pay attention to the prenatal monitoring of pregnant women with abnormal increase of D-dimer level in order to carry out early intervention,avoid the occurrence of adverse pregnancy as far as possible,and protect maternal and infant health.