D-D、PLT、PT与子痫前期发病的关系研究

Relationship between D-D,PLT,PT and Preeclampsia

目的:探讨D-二聚体(D-D)、血小板计数(PLT)、凝血酶原时间(PT)与子痫前期(PE)发病的关系。方法:收集60例PE患者(观察组)和同期60例正常孕妇(对照组),比较两组一般资料、凝血指标[D-D、PT、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、国际标准化比值(INR)、纤维蛋白原(FIB)]、血小板参数[PLT、血小板比积(PCT)、血小板分布宽度(PDW)、血小板平均容积(MPV)]等差异;采用Logistic回归分析PE发病的独立影响因素;通过绘制受试者工作特征(ROC)曲线分析D-D、PLT、PT及三者联合诊断PE的临床价值。结果:两组年龄、孕周、体质量指数(BMI)、产次、受孕方式等一般资料比较,差异无统计学意义(P>0.05)。观察组D-D、PDW、MPV水平高于对照组(P<0.05),PT、APTT、TT、PLT水平低于对照组(P<0.05),INR、FIB及PCT水平与对照组比较,无统计学差异(P>0.05);多因素Logistic回归分析显示,D-D、PT、PLT是PE发病的独立影响因素(P<0.05);ROC曲线显示,D-D、PT、PLT诊断PE的曲线下面积(AUC)值分别为0.802、0.737、0.699,灵敏度分别为78.33%、86.67%、51.67%,特异度分别为71.67%、53.33%、80.00%,三者联合诊断PE的效能高于单一指标(P<0.05)。结论:D-D、PT、PLT与PE发病相关,三者联合对诊断PE有较高的临床价值。

Objective:To investigate the relationship between D-dimer(D-D),platelet count(PLT),prothrombin time(PT)and preeclampsia(PE).Methods:60 patients with PE(observation group)and 60 normal pregnant women(control group)were selected.The general data,coagulation indexes[D-D,PT,activated partial thromboplastin time(APTT),thrombin time(TT),international normalized ratio(INR),fibrinogen(FIB)],platelet parameters[PLT,platelet hematocrit(PCT),platelet distribution width(PDW),mean platelet volume(MPV)]were compared between the two groups.Logistic regression was used to analyze the independent influencing factors of PE,and receiver operating characteristic(ROC)curve was drawn to analyze the clinical value of D-D,PLT,PT and their combination in the diagnosis of PE.Results:There was no statistically significant difference in general data such as age,gestational age,body mass index(BMI),parity,and mode of pregnancy between the two groups(P>0.05).The levels of D-D,PDW and MPV in the observation group were higher than those in the control group(P<0.05),PT,APTT,TT,PLT levels in the observation group were lower than those in the control group(P<0.05).There was no significant difference in INR,FIB and PCT levels between the two groups(P>0.05).Multivariate Logistic regression analysis showed that D-D,PT and PLT were independent influencing factors of PE(P<0.05).ROC curve showed that the area under the curve(AUC)values of D-D,PT and PLT in the diagnosis of PE were 0.802,0.737 and 0.699,respectively.The sensitivity was 78.33%,86.67%and 51.67%,respectively.The specificity was 71.67%,53.33%and 80.00%,respectively.The efficiency of combined diagnosis of D-D,PT and PLT was higher than that of single index(P<0.05).Conclusion:D-D,PT and PLT are related to the pathogenesis of PE,and the combination of the three has high clinical value in the diagnosis of PE.