分析不同检测手段对复发性流产的诊断价值

Analyze the diagnostic value of different detection methods for recurrent miscarriage

目的 分析不同检测手段对复发性流产的诊断价值。方法 选择2020年6月至2021年6月在石家庄市妇幼保健院接受治疗的非孕状态下215例复发性自然流产患者为观察组,根据流产次数分为流产3次组92例,流产4次组76例,流产次数≥5次组47例,同时选取160例正常体检的健康未孕育龄期妇女为对照组。分析观察组和对照组血栓弹力图(TEG)参数和血小板相关参数,同时比较观察组不同流产次数组血栓弹力图参数和血小板相关参数。采用ROC曲线分析存在统计学差异的指标对复发性流产的诊断价值。结果 观察组血栓弹力图参数MA值、CI值、α角高于对照组,K值、R值低于对照组(P<0.05);与流产3次和4次组比较,流产次数≥5次组MA值升高(P<0.05),CI值、α角、K值、R值无统计学差异(P>0.05)。观察组血小板相关参数血小板分布宽度(PDW)、血小板平均体积(MPV)、血小板聚集率水平上升,血小板压积(PCT)、血小板计数(PLT)水平降低(P<0.05);与流产3次和4次组比较,流产次数≥5次组PLT水平下降,MPV和血小板聚集率上升(P<0.05),PCT、PDW水平无统计学差异(P>0.05)。ROC曲线分析显示,血栓弹力图MA值对复发性流产诊断的灵敏度和特异度较高。结论 复发性流产患者血栓弹力图和血小板异常,其中血栓弹力图MA值对复发性流产诊断灵敏度和特异性较高,可作为临床复发性流产的诊断指标。

Objective To analyze the diagnostic value of different detection methods for recurrent miscarriage.Methods 215patients with recurrent spontaneous abortion who were treated in our hospital from June 2020to June 2021in a non-pregnant state were selected as the observation group,According to the number of abortions,92cases were divided into the 3abortion group,76cases in the 4abortion group,and 47cases in the abortion frequency≥5times group.At the same time,160healthy non-pregnant women with normal physical examination were selected as the control group.Observe and compare the thromboelastogram(TEG)parameters and platelet-related parameters of the observation group and the control group.Comparison of thromboelastogram parameters and platelet related parameters in the observation group with different times of miscarriage.Use ROC curve to analyze the diagnostic value of statistically different indicators for recurrent miscarriage.Results The values of MA value,CI value andαangle of thromboelastogram in the observation group were higher than those in the control group,and the K value and R value were lower than those in the control group(P<0.05);compared with the 3and 4abortions group,the number of abortions was≥5times group The MA value increased(P<0.05),and the CI value,αangle,K value,and R value were not statistically different(P>0.05).In the observation group,platelet-related parameters platelet distribution width(PDW),mean platelet volume(MPV),platelet aggregation rate increased,and platelet packed product(PCT)and platelet count(PLT)levels decreased(P<0.05);compared with the 3and 4abortions group,the PLT level of the abortion ≥5times group decreased,the MPV and platelet aggregation rate increased(P<0.05),and there was no statistical difference in the PCT and PDW levels(P>0.05).ROC curve analysis shows that the MA value of thromboelastogram is more sensitive and specific for the diagnosis of recurrent miscarriage.Conclusion Thromboelastogram and platelet abnormalities in patients with recurrent miscarriage,among which thromboelastogram has high sensitivity and specificity for the diagnosis of recurrent miscarriage,and can be used as a clinical diagnostic index for recurrent miscarriage.