多囊卵巢综合征患者妊娠早期血栓弹力图特征与不良妊娠结局

Characteristics of Thromboelastography in Early Pregnancy and Adverse Pregnancy Outcomes in Patients with Polycystic Ovary Syndrome

目的:探讨多囊卵巢综合征(PCOS)患者妊娠早期血栓弹力图(TEG)特征,早期自然流产妇女的胰岛素相关指标与TEG参数的相关性。方法:从2020年1—12月江西省妇幼保健院行产检的PCOS妊娠的妇女中回顾性选取成功妊娠和早期自然流产的各40例,另选本院同期产检的健康孕妇40例作为对照组,孕早期均采集血清测定胰岛素相关指标[空腹胰岛素(FINs)、空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR)],并行TEG检查,对比三组胰岛素相关指标、TEG参数差异,并分析早期自然流产组胰岛素相关指标与TEG参数之间的相关性。结果:早期自然流产组FPG、FINs、HOMA-IR均高于成功妊娠组与对照组,且成功妊娠组FINs、HOMA-IR均较对照组高,差异均有统计学意义(P<0.05),早期自然流产组、成功妊娠组反应时间(R值)、凝血时间(K值)均低于对照组,α角、血小板聚集功能(MA值)、凝血指数(CI)均高于对照组,而早期自然流产组MA值高于成功妊娠组,差异均有统计学意义(P<0.05);早期自然流产组FINs、HOMA-IR与MA值呈正相关(P<0.05)。结论:PCOS早期妊娠TEG中α角、R值、CI、K值、MA值均出现异常,不良妊娠结局者MA值增加明显,且其与FINs、HOMA-IR存在相关性。

Objective:To investigate the characteristics of thromboelastography(TEG)in women with polycystic ovary syndrome(PCOS)in the first trimester,and the correlation between insulin related indicators and TEG parameters in women with early spontaneous abortion.Method:From January to December 2020,40 cases of successful pregnancy and 40 cases of early spontaneous abortion with PCOS in pregnancy who underwent prenatal examination in Jiangxi Maternal and Child Health Hospital were retrospectively selected,and 40 healthy pregnant women in the same period were selected as the control group.Serum samples were collected to determine insulin related indexes[fasting insulin(FINs),fasting plasma glucose(FPG),homeostasis model assessment of insulin resistance(HOMA-IR)],and TEG test.Insulin related indexes and TEG parameters of the three groups were compared,and the correlation between insulin related indexes and TEG parameters of the early spontaneous abortion group was analyzed.Result:FPG,FINs and HOMA-IR in the early spontaneous abortion group were higher than those in the successful pregnancy group and the control group,and FINs and HOMA-IR in the successful pregnancy group were higher than those in the control group,the differences were statistically significant(P<0.05).R and K values in the early spontaneous abortion group and the successful pregnancy group were lower than those in the control group,αangle,MA value and CI were higher than those in the control group,the MA value of the early spontaneous abortion group was higher than that of the successful pregnancy group,the differences were statistically significant(P<0.05).FINs and HOMA-IR were positively correlated with MA in the early spontaneous abortion group(P<0.05).Conclusion:Theαangle,R value,CI value,K value and MA value of TEG in the early pregnancy of PCOS were abnormal,MA value increased significantly in adverse pregnancy outcome,and it was correlated with FINs and HOMA-IR.