血栓弹力图在胎儿生长受限早期诊断中的应用意义

Application significance of Thromboelastography in the early diagnosis of fetal growth restriction

目的探讨血栓弹力图检测在胎儿生长受限(Fetal Growth Restriction,FGR)早期诊断中的应用意义。方法选择2021年1月—2023年11月本院收治的41例孕妇为研究对象,按32孕周以前是否发生FGR分为实验组(20例)和对照组(21例)两组。检测并观察所有研究对象的血栓弹力图(Thromboelastography,TEG)相关凝血参数[凝血反应时间(Reaction Time,R)、血凝块形成时间(kinetics time,K)、角度(Angle)和血栓最大振幅(Maximum Amplitude,MA)];血小板计数(Platelet Count,PLT)常规凝血指标参数[活化部分凝血活酶时间(Activated Partial Thromboplastin Time,APTT)、纤维蛋白原(Fibrinogen,Fib)、凝血酶原时间(Prothrombin Time,PT)、凝血酶时间(Thrombin Time,TT)、D-二聚体(D-dimer,D-Di)]以及标准化狼疮抗凝物比值(Normalized Lupus Anticoagulants Ratio,NLR),比较两组间各项指标差异。采用具有显著差异的凝血相关指标的受试者工作特征曲线(Receiver Operating Characteristic curve,ROC)下面积(Area Under Curve,AUC),得出凝血相关指标对早发型FGR的预测价值。结果两组各项凝血相关指标中,实验组PLT计数及MA高于对照组,差异具有统计学意义(P<0.05),其他凝血相关指标差异无统计学意义(P>0.05)。ROC曲线结果显示,MA诊断早发型FGR的曲线下面积(AUC)为0.823。实验组的MA与PLT呈正相关(r=0.5590,P=0.0104)。结论TEG检测对FGR早期诊断具有应用意义。

Objective To investigate the application significance of thromboelastography(TEG)testing in the early diagnosis of fetal growth restriction(FGR).Methods A total of 41 pregnant women treated in Daqing Oilfield General Hospital from January 2021 to November 2023 were selected as the study objects.According to whether FGR occurred before 32 weeks of gestation,patients were divided into experimental group(20)and control group(21).Thromboelastography(TEG)related coagulation parameters:Coagulation Reaction Time(R),kinetics time(K),Angle and Maximum Amplitude(MA);Platelet Count(PLT);Parameters in traditional coagulation indicators:Activated Partial Thromboplastin Time(APTT),Fibrinogen(Fib),and Prothrombin Time(PT),Thrombin Time(TT),D-dimer(D-Di),and Normalized Lupus Anticoagulants Ratio(NLR)were measured and compared.Using the Area Under Curve(AUC)of the Receiver Operating Characteristic curve(ROC)with significant differences in coagulation-related indicators,the predictive value of coagulation-related indicators for early-onset FGR was obtained.Results In the two groups,the PLT count and MA in the experimental group were significantly higher than those in the control group,the difference was statistically significant(P<0.05),there was no significant difference in other clotting related indexes(P>0.05).ROC curve results showed that the area under the curve(AUC)for MA diagnosis of early-onset FGR was 0.823.In the experimental group,MA was positively correlated with PLT(r=0.5590,P=0.0104).Conclusions TEG detection is significant in the early diagnosis for FGR.