CA125、FIB、D-D及Gas6检测在子痫前期并发胎盘早剥患者中的临床意义

Clinical Significance of Detection of CA125,FIB,D-D and Gas6 in Patients with Preeclampsia Complicated with Placental Abruption

目的:探讨血浆CA125、纤维蛋白原(fibrinogen,FIB)、D-二聚体(D-dimer,D-D)及血清生长停滞特异性蛋白6(growth arrest-specific protein 6,Gas6)检测在子痫前期并发胎盘早剥患者中的临床意义。方法:本文为回顾性研究,将2017年12月-2019年12月在笔者所在医院妇产科门诊或住院治疗的76例子痫前期并发胎盘早剥患者设为并发胎盘早剥组,将2017年12月-2019年12月在笔者所在医院妇产科门诊或住院治疗的104例子痫前期未并发胎盘早剥患者设为未并发胎盘早剥组。另选取正常妊娠且孕周满37周的30例孕妇作为对照组。比较三组血浆CA125、FIB、D-D水平、血清Gas6水平,分析子痫前期患者血浆CA125、FIB、D-D水平、血清Gas6水平异常与并发胎盘早剥情况;依据子痫前期严重程度将患者分为轻度组(n=68)和重度组(n=112),比较两组CA125、FIB、D-D、Gas6水平及并发胎盘早剥情况,采用Pearson相关性分析CA125、FIB、D-D、Gas6与子痫前期并发胎盘早剥的相关性。结果:三组血浆CA125、FIB、D-D及血清Gas6水平比较,差异均有统计学意义(P<0.001);并发胎盘早剥组和未并发胎盘早剥组血浆CA125、FIB、D-D水平均明显高于对照组,血清Gas6水平明显低于对照组(P<0.001),且并发胎盘早剥组血浆CA125、FIB、D-D水平均明显高于未并发胎盘早剥组,血清Gas6水平明显低于未并发胎盘早剥组,差异有统计学意义(P<0.001)。三项指标同时异常者,胎盘早剥发生率高达87.50%,上述4项指标同时异常者胎盘早剥发生率高达90.91%,而单一指标异常者胎盘早剥发生率较低。重度组血浆CA125、FIB、D-D水平均明显高于轻度组,血清Gas6水平明显低于轻度组,差异有统计学意义(P<0.05)。重度组血浆CA125、D-D水平及血清Gas6水平异常率及胎盘早剥发生率均高于轻度组,差异有统计学意义(P<0.01)。Pearson相关性分析显示,血浆CA125、FIB、D-D水平与子痫前期并发胎盘早剥呈正相关,血清Gas6水平与子痫前期并发胎盘早剥呈负相关(P<0.05)。结论:对于子痫前期患者,若血浆CA125、FIB、D-D水平异常升高或血清Gas6水平异常降低,应警惕胎盘早剥的可能。

Objective:To explore the clinical significance of detection of plasma CA125,fibrinogen(FIB),D-dimer(D-D)and serum growth arrest-specific protein 6(Gas6)in patients with preeclampsia complicated with placental abruption.Method:This paper was a retrospective study,76 cases of patients with preeclampsia complicated with placental abruption who were treated in the department of obstetrics and gynecology outpatient department or inpatient department of our hospital from December 2017 to December 2019 were set as the complicated with placental abruption group.A total of 104 cases of patients with preeclampsia uncomplicated with placental abruption who were treated in the department of obstetrics and gynecology outpatient department or inpatient department of our hospital from December 2017 to December 2019 were set as the uncomplicated with placental abruption group.Another 30 pregnant women with normal pregnancy and more than 37 weeks of gestation were selected as the control group.The plasma levels of CA125,FIB,D-D,the serum level of Gas6 in the three groups were compared.Abnormal levels of plasma CA125,FIB,D-D,serum Gas6 and complicated with placental abruption in preeclampsia patients were analyzed.The patients were divided into the mild group(n=68)and the severe group(n=112)according to the severity of preeclampsia,and the levels of CA125,FIB,D-D,Gas6 and complicated with placental abruption between the two groups were compared.Pearson correlation was used to analyze the correlation between CA125,FIB,D-D,Gas6 and preeclampsia complicated with placental abruption.Result:There were statistically significant differences in plasma CA125,FIB,D-D and serum Gas6 levels among the three groups(P<0.001).The levels of plasma CA125,FIB and D-D in the complicated with placental abruption group and the uncomplicated with placental abruption group were significantly higher than those in the control group,and the levels of serum Gas6 were significantly lower than those in the control group(P<0.001).The levels of plasma CA125,FIB and D-D in the complicated with placental abruption group were significantly higher than those in the uncomplicated with placental abruption group,and the level of serum Gas6 was significantly lower than that in the uncomplicated with placental abruption group,the differences were statistically significant(P<0.05).The incidence of placental abruption was as high as 87.50%in patients with three abnormal indexes,and the incidence of placental abruption was as high as 90.91%in patients with the above four abnormal indexes,while the incidence of placental abruption was lower in patients with single abnormal index.The levels of plasma CA125,FIB and D-D in the severe group were significantly higher than those in the mild group,the serum Gas6 level was significantly lower than that in the mild group,the differences were statistically significant(P<0.05).The levels of plasma CA125,D-D and the serum Gas6 abnormal rates and the incidence of placental abruption in the severe group were higher than those in the mild group,the differences were statistically significant(P<0.01).Pearson correlation analysis showed that plasma CA125,FIB and D-D levels were positively correlated with preeclampsia complicated with placental abruption,while serum Gas6 level was negatively correlated with preeclampsia complicated with placental abruption(P<0.05).Conclusion:For patients with preeclampsia,if the levels of plasma CA125,FIB,D-D are abnormally elevated or the level of serum Gas6 is abnormally decreased,the possibility of placental abruption should be vigilant.