孕晚期纤维蛋白单体与D-二聚体水平对妊娠并发症的预测价值

Predictive value of fibrin monomer and D-dimer levels in the late trimester of pregnancy for pregnancy complications

目的评估孕晚期纤维蛋白单体(FM)与D-二聚体(D-D)水平对妊娠并发症的预测价值。方法纳入2019年7—8月及2020年6—7月于华中科技大学同济医学院附属同济医院围产医学科住院并诊断存在妊娠并发症的98例孕晚期孕妇作为研究组,随机选取同期年龄匹配且无妊娠并发症的80例健康孕晚期孕妇作为对照组。比较两组孕妇FM与D-D水平,采用受试者工作特征(ROC)曲线评估FM、D-D对孕晚期孕妇妊娠并发症的预测效能,采用Logistic回归分析FM及D-D水平升高是否为妊娠并发症发生的危险因素。结果与对照组比较,研究组FM、D-D水平均升高,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,FM、D-D水平升高均为孕晚期孕妇发生妊娠并发症的危险因素(P<0.05)。ROC曲线分析结果显示,FM、D-D预测妊娠并发症的曲线下面积分别为0.769和0.698,最佳截断值分别为6.020μg/mL和1.465μg/mL,灵敏度分别为59.2%和63.3%,特异度分别为86.9%和67.3%。结论孕晚期合并妊娠并发症的孕妇FM、D-D水平升高。FM可用于预测孕晚期孕妇妊娠并发症的发生风险,帮助临床早期识别妊娠并发症,从而改善孕妇预后。

Objective To evaluate the predictive value of fibrin monomer(FM) and D-dimer(D-D) levels in the late trimester of pregnancy for pregnancy complications.Methods Include 98 pregnant women in the late trimester of pregnancy who were hospitalized in the Perinatal Medicine Department of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from July to August 2019 and June to July 2020 and diagnosed with pregnancy complications as the research group.At the same time, 80 healthy pregnant women in the late trimester of pregnancy who were age-matched and had no pregnancy complications were randomly selected as the control group.Compared the FM and D-D levels of the two groups of pregnant women.Used receiver operating characteristic(ROC) curve to evaluate the predictive efficiency of FM and D-D on pregnancy complications of pregnant women in the late trimester of pregnancy.Logistic regression was used to analyze whether the elevated levels of FM and D-D were the risk factors of pregnancy complications.Results Compared with the control group, the FM and D-D levels in the research group increased, and the differences were statistically significant(P<0.05).Logistic regression analysis showed that elevated levels of FM and D-D were risk factors for pregnancy complications of pregnant women in the late trimester of pregnancy(P<0.05).ROC curve analysis results showed that the areas under the curve for FM and D-D to predict pregnancy complications were 0.769 and 0.698 respectively, the cut-off values were 6.020 μg/mL and 1.465 μg/mL respectively, the sensitivities were 59.2% and 63.3% respectively, and the specificities were 86.9% and 67.3% respectively.Conclusion The FM and D-D levels of pregnant women with pregnancy complications in the late trimester of pregnancy elevate.FM could be used to predict the risk of pregnancy complications of pregnant women in the late trimester of pregnancy, help early identification, and thereby improve the prognosis of pregnant women.