血清AT-Ⅲ、FIB、NO水平联合检测在剖宫产产后出血诊断中的效能

Efficiency of combined detection of serum AT-III,FIB and NO levels in diagnosis of postpartum hemorrhage after cesarean section

目的:分析血清抗凝血酶-Ⅲ(AT-Ⅲ)、纤维蛋白原(FIB)、一氧化氮(NO)水平联合检测在剖宫产产后出血诊断中的效能。方法:选取2022年1月至2023年9月该院收治的90例剖宫产产后出血患者进行横断面研究,设为观察组,根据产后出血量将其分为普通出血(出血量<2000 mL)患者56例和严重出血(出血量≥2000 mL)患者34例。另选取同期90例剖宫产产后未出血产妇设为对照组。比较两组及不同出血量剖宫产产后出血患者血清AT-Ⅲ、FIB、NO水平,分析AT-Ⅲ、FIB、NO水平与剖宫产产后出血患者出血量的相关性,绘制受试者工作特征(ROC)曲线分析血清AT-Ⅲ、FIB、NO水平单项及联合检测诊断剖宫产产后出血的效能。结果:观察组血清AT-Ⅲ、FIB水平均低于对照组,NO水平高于对照组,差异有统计学意义(P<0.05);严重出血患者血清AT-Ⅲ、FIB水平均低于普通出血患者,NO水平高于普通出血患者,差异均有统计学意义(P<0.05);血清AT-Ⅲ、FIB水平与剖宫产产后出血患者出血量呈负相关(r<0,P<0.05),NO水平与剖宫产产后出血患者出血量呈正相关(r>0,P<0.05);绘制ROC曲线结果显示,血清AT-Ⅲ、FIB、NO水平单项及联合检测诊断剖宫产产后出血的曲线下面积分别为0.836、0.778、0.816、0.935,联合检测诊断剖宫产产后出血的效能高于三者单项检测。结论:血清AT-Ⅲ、FIB、NO水平联合检测诊断剖宫产产后出血的效能高于三者单项检测。

Objective:To analyze efficiency of combined detection of serum antithrombin-III(AT-III),fibrinogen(FIB)and nitric oxide(NO)levels in diagnosis of postpartum hemorrhage after cesarean section.Methods:A total of 90 patients with postpartum hemorrhage after cesarean section in this hospital from January 2022 to September 2023 were selected for the cross-sectional study and were set as the observation group.According to the amount of postpartum hemorrhage,they were divided into common hemorrhage(56 patients,<2000 mL)and with severe hemorrhage(34 patients,≥2000 mL).Another 90 cases of non-bleeding women after cesarean section in the same period were selected as the control group.The levels of serum AT-III,FIB and NO were compared between the two groups and the patients with postpartum hemorrhage after cesarean section different amounts of bleeding.The correlations among the levels of AT-III,FIB,NO and the amount of bleeding in the patients with postpartum hemorrhage after cesarean section were analyzed.The receiver operating characteristic(ROC)curve was drawn to analyze the efficiencies of single and combined detection of serum AT-III,FIB and NO levels in the diagnosis of postpartum hemorrhage after cesarean section.Results:The levels of serum AT-III and FIB in the observation group were lower than those in the control group,the level of NO was higher than that in the control group,and the differences were statistically significant(P<0.05).The levels of serum AT-III and FIB in the patients with severe hemorrhage were lower than those in the patients with common hemorrhage,the level of NO was higher than that in the patients with common hemorrhage,and the differences were statistically significant(P<0.05).The levels of serum AT-III and FIB were negatively correlated with the amount of bleeding in the patients with postpartum hemorrhage after cesarean section(r<0,P<0.05),and the level of NO was positively correlated with the amount of bleeding(r>0,P<0.05).The ROC curve showed that the area under the curve of single and combined detection of the serum AT-III,FIB and NO levels in the diagnosis of postpartum hemorrhage after cesarean section were 0.836,0.778,0.816 and 0.935,respectively,and the efficiency of combined detection in the diagnosis of postpartum hemorrhage after cesarean section was higher than that of single detection.Conclusions:The efficiency of combined detection of serum AT-III,FIB and NO levels in the diagnosis of postpartum hemorrhage after cesarean section is higher than that of single detection of the three.