产前凝血功能指标对妊娠期高血压疾病产后出血的预测价值分析

Analysis of the predictive value of prenatal coagulation function index for postpartum hemorrhage in hypertensive diseases during pregnancy

目的 分析产前凝血功能指标对妊娠期高血压疾病产后出血的预测价值。方法 回顾性分析98例妊娠期高血压疾病患者的临床资料,依据产后出血量不同分为对照组(55例)与出血组(43例)。对比两组凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(Fib),分析PT、TT、APTT、Fib与产后出血的相关性,凝血指标对妊娠期高血压产后出血的预测价值。结果 出血组患者PT、TT、APTT指标均短于对照组,Fib水平高于对照组,差异有统计学意义(P<0.05)。经Spearman相关性分析,PT、TT、APTT指标与产后出血呈负相关(r=-0.889、-0.899、-0.952,P<0.05),Fib水平与产后出血呈正相关(r=0.854,P<0.05)。各凝血指标联合检测预测产后出血的敏感度、特异度均高于各指标单独检测的敏感度与特异度,差异均有统计学意义(P<0.05)。结论 产前凝血功能指标对妊娠期高血压疾病产后出血预测价值较高。

Objective To analyze the predictive value of prenatal coagulation function index for postpartum hemorrhage in hypertensive diseases during pregnancy. Methods The clinical data of 98 hypertensive patients during pregnancy were retrospectively analyzed and divided into control group(55 cases) and hemorrhage group(43 cases) according to postpartum blood loss. The prothrombin time(PT), thrombin time(TT), activated partial prothrombin time(APTT) and fibrinogen(Fib)were compared between the two groups. To analyze the correlation between PT, TT, APTT, Fib and postpartum hemorrhage, and the value of coagulation index in predicting postpartum hemorrhage of hypertensive pregnancy. Results PT, TT and APTT in hemorrhage group were lower than those in control group, while Fib level was higher than that in control group, the difference was statistically significant(P<0.05). Spearman correlation analysis showed that PT, TT and APTT were negatively correlated with postpartum hemorrhage(r=-0.889,-0.899,-0.952, P<0.05), and Fib level was positively correlated with postpartum hemorrhage(r=0.854, P<0.05). The sensitivity and specificity of the combined detection of each coagulation index in predicting postpartum hemorrhage were higher than that of the single detection of each index, and the differences were statistically significant(P<0.05).Conclusion The index of prenatal coagulation function is of high value in predicting postpartum hemorrhage with pregnancyinduced hypertension.