孕妇血浆纤维蛋白原D-二聚体含量测定及临床意义

Clinical significance of plasma level changes of D-dimer and fibrinogen in pregnant women

目的 探讨孕妇血高凝状态相关因子纤维蛋白原 (Fib)、D 二聚体含量的变化及发生弥漫性血管内凝血 (DIC)高危风险可能阈值范围。方法 2 0 0 1年 12月至 2 0 0 3年 3月采用免疫散射比浊法和Clauss法分别检测孕妇组 2 672例孕妇和对照组 2 0 4例非孕妇女的D 二聚体和Fib水平 ,并对孕妇组中 2 0 19例晚期孕妇进行DIC追踪研究。结果 孕妇组的D 二聚体、Fib明显高于对照组 ,其中D 二聚体和Fib随着妊娠时间的延长而逐渐升高。早、中、晚孕各组相比 (P <0 0 1) ;晚期孕妇中共 6例发生DIC ,19例D 二聚体和Fib都分别高于 5mg/L和5g/L ,有 4例发生DIC ,2例D 二聚体 >5mg/L ,Fib <1 5g/L ;2例Fib >5g/L ,D 二聚体 <0 5mg/L ,各发生DIC 1例。结论 D 二聚体 >5mg/L和Fib >5g/L同时存在 ,或者两个指标明显失衡呈分离状态 ,可作为孕妇发生DIC高危阈值 。

Objective To explore the changes of plasma levels of Fib and D-dimers and explore the risk range of DIC and thrombosis in pregnant wome n. Methods Plasma levels of D-dimers and Fib were measured by means o f immunoturbidimetric method and Clauss method. Results The plasma levels of D-dimer and Fib of pregnant women wer e higher than those of nonpregnant women(P<0\^01).The levels of D-dimer and F ib increased with the progress of pregnancy.There were 6 cases who developed DIC in late-term pregnancy and 19 cases whose D-dimer and Fib levels were more th an 5mg/L and 5g/L;4 cases developed DIC in these 19 cases;2 cases were with D-d i mer>5mg/L and Fib<1\^5g/L and 2 cases with Fib>5g/L and D-dimer<0\^5mg/L,and 1 case occured DIC,respectively. Conclusion D-dimer and Fib levels that are more than 5mg/L and 5g/ L are hi gh-risk threshold values,and it is also dangerous when the two levels have larg e discrepancy.