瘢痕子宫再次妊娠时血栓弹力图及RDW-CV、NLR、MLR、SII等指标变化情况

Changes of indices of thromboelastography and RDW-CV、NLR、MLR、and SII in re-pregnancy of scarred uterus

目的 本研究旨在分析瘢痕子宫再次妊娠时血栓弹力图(thromboelasmography,TEG)及红细胞分布宽度变异系数(red blood cell distribution width coefficient of variation,RDW-CV)、中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、单核细胞/淋巴细胞比值(monocyte lymphocyte ratio,MLR)以及全身免疫炎症指数(systemic immune-inflammation index,SII)等指标的变化情况,探讨凝血相关指标及炎症相关指标对瘢痕子宫再次妊娠风险预测价值。方法 回顾2021年3月1日至2024年3月1日在延安市人民医院产科住院的孕妇临床资料168例。比较瘢痕子宫不同妊娠阶段TEG及RDW-CV、NLR、MLR、SII等炎症指标的变化;比较瘢痕子宫孕妇与健康孕妇TEG及RDW-CV、NLR、MLR、SII等炎症指标的变化情况。结果 瘢痕子宫孕妇中,与中孕组相比,晚孕组孕妇TEG中的R值增加,Angle角、MA值减少(均P<0.05);NLR、MLR增高(P<0.05)。瘢痕子宫孕妇与健康孕妇相比,瘢痕子宫TEG中的R值、K值、Angle角、MA值的差异无统计学意义(均P>0.05);NLR、MLR差异有统计学意义(P<0.05)。结论 瘢痕子宫再次妊娠对TEG及部分炎症指标有影响,随着孕周数增加TEG指标与炎症指标有所变化;TEG及炎症指标联合检测可对瘢痕子宫再次妊娠风险作出预测。

Objective To analyze the changes of thromboelastography(TEG)and indicators such as red blood cell distribution width coefficient of variation(RDW-CV)、neutrophil to lymphocyte ratio(NLR)、monocyte lymphocyte ratio(MLR)and systemic immune-inflammation index(SII)during the re-pregnancy of scarred uterus,and to explore the predictive value of coagulation-related indicators and inflammation-related indicators on the risk of the re-pregnancy of scarred uterus.Methods The clinical data of 168 pregnant women hospitalized in the Department of Obstetrics and Gynaecology of Yan′an People′s Hospital from March 1,2021 to March 1,2024 were reviewed.The changes in TEG and inflammatory indicators such as RDW-CV,NLR,MLR,and SII at different pregnancy stages in keloid uterus were compared;the changes in TEG and inflammatory indicators such as RDW-CV,NLR,MLR,and SII were compared between pregnant women with keloid uterus and healthy pregnant women. Results Amongthe pregnant women with scarred uterus, the R value in TEG of the pregnant women in the late pregnancy groupwas increased and the Angle angle and MA value were decreased compared with those in the middle pregnancygroup (both P<0. 05);NLR and MLR were increased (P<0. 05). Compared with healthy pregnant women, thedifferences in R value, K value, Angle angle, and MA value in TEG of scarred uterus were not significant (allP>0. 05);the differences in NLR and MLR were statistically significant (P<0. 05). Conclusion Re-pregnancy inscarred uterus has an effect on TEG and some inflammation indexes, and TEG and inflammation indexes changewith the increase of gestational weeks;the combined detection of TEG and inflammation indexes can make aprediction of the risk of re-pregnancy in scarred uterus.