血清凝血指标表达水平与妊娠期高血压疾病的相关性

Correlation between serum coagulation index expression level of pregnant women and their pregnancy induced hypertension

目的:探究血清凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体等凝血功能指标及血小板参数与妊娠期高血压疾病的相关性。方法:选取2018年1月—2019年12月本院收治的妊娠期高血压患者80例为高血压组,产前检查健康孕妇80例为对照组。检测两组血小板参数及血清凝血功能指标并分析与妊娠高血压病情的相关性。结果:高血压组血小板平均体积(MPV)、血小板分布宽度(PDW)、FIB、D-二聚体高于对照组,血清PT、APTT低于对照组(均P<0.05);两组血小板计数(PLT)无差异(P>0.05)。MPV、PDW、FIB、D-二聚体与妊娠高血压病情程度呈正相关(r=0.529、0.478、0.554、0.551,P<0.05),PT及APTT与妊娠高血压病情程度呈负相关(r=-0.574、-0.625,P<0.05)。多因素logistic逐步线性回归分析显示,FIB及D-二聚体水平升高是妊娠高血压的独立危险因素(P<0.05)。受试者工作曲线显示,诊断妊娠高血压的曲线下面积(AUC)FIB为0.824、临界值为3.85g/L,D-二聚体AUC为0.821、临界值为0.27mg/L。结论:孕妇血小板参数及凝血功能指标与妊娠高血压病情程度有密切关联,FIB及D-二聚体水平可作为妊娠高血压早期诊断的血清标志物。

Objective:To explore the correlation between the values of serum prothrombin time(PT),activated partial thrombin time(APTT),fibrinogen(FIB),D-dimer,and blood platelet parameters of pregnant women and their pregnancy induced hypertension(PIH).Methods:From January 2018 to December 2019,80 pregnant women with PIH were selected in study group,and 80 healthy pregnant women who received routine prenatal examination were randomly selected in control group.The platelet parameters and serum coagulation function indexes of the women in the two groups were detected,and the correlation between the levels of the platelet parameters and serum coagulation function indexes of the women and their situation of PIH was analyzed.Results:The values of mean platelet volume(MPV)and platelet distribution width(PDW),and the levels of FIB and D-dimer of the women in the study group were significantly higher than those of the women in the control group,while the serum PT and APTT levels of the women in the study group were significantly lower than those of the women in the control group(all P<0.05).There was no significant difference in the platelet(PLT)count of the women between the two groups(P>0.05).The values of MPV and PDW,and the levels of FIB and D-dimer of the women with PIH were positively correlated with the severity of their PIH(r=0.529,0.478,0.554,0.551,P<0.05),and the PT and APTT levels of the women with PIH were negatively correlated with the severity of their PIH(r=-0.574,-0.625,P<0.05).Multivariate logistic stepwise linear regression analysis showed that the increased FIB and D-dimer levels were the independent risk factors of PIH(P<0.05).Receiver operating characteristic curve analysis showed that the area under the curve(AUC)and the critical value of the FIB level for diagnosing PIH were 0.824 and 3.85 g/L,while the AUC and the critical value of the D-dimer level for diagnosing PIH were 0.821 and 0.27 mg/L.Conclusion:The platelet parameters and coagulation function indexes of the pregnant women with PIH are closely related to the severity of PIH,and the levels of FIB and D-dimer of the women can be used as the serological indexes for diagnosing PIH early.