目的:探讨子宫动脉血流参数联合血小板聚集功能预测不明原因复发性流产(URSA)的价值。方法:将2021年9月至2023年8月本院收治的94例URSA患者作为URSA组,另外将同期在本院进行产检的110例正常妊娠孕妇作为对照组。URSA患者随访至妊娠28周...目的:探讨子宫动脉血流参数联合血小板聚集功能预测不明原因复发性流产(URSA)的价值。方法:将2021年9月至2023年8月本院收治的94例URSA患者作为URSA组,另外将同期在本院进行产检的110例正常妊娠孕妇作为对照组。URSA患者随访至妊娠28周,根据妊娠结局分为正常妊娠组(n = 25)和流产组(n = 69)。比较2组患者子宫动脉血流参数、血小板聚集率;采用受试者工作特性(ROC)曲线评估子宫动脉血流参数、血小板聚集率对URSA患者妊娠结局的预测价值;采用二分类Logistic逐步回归分析探讨URSA患者妊娠结局的影响因素。结果:在搏动指数(PI)、动脉血流阻力指数(RI)、收缩期/舒张期血流速度比值(S/D)、血小板聚集率指标方面,URSA组相较于对照组更高(P P P Objective: To explore the value of the combination of uterine artery flow parameters and platelet aggregation function in predicting unexplained recurrent abortion (URSA). Methods: 94 patients with URSA from September 2021 to August 2023 were selected as the URSA group, and 110 normal pregnant women who underwent prenatal examination were selected as the control group. The URSA patients were followed up until 28 weeks of gestation and divided into the normal pregnancy group (n = 25) and the abortion group (n = 69) according to the pregnancy outcome. The uterine artery blood flow parameters and platelet aggregation rate were compared between the two groups. The predictive value of the uterine artery flow parameters and platelet aggregation rate for the pregnancy outcomes of URSA patients was evaluated by ROC. Binary Logistic stepwise regression was employed to explore the influencing factors of the pregnancy outcomes of URSA patients. Results: The indexes of the pulse index (PI), the arterial flow resistance index (RI), the systolic/diastolic blood flow velocity ratio (S/D), and the platelet aggregation rate in the URSA group were higher than those in the control group (P P P < 0.05). The ROC curve demonstrated that the area under the curve (AUC) (95% CI) of the uterine artery flow parameters, the platelet aggregation rate, and their combined prediction of the pregnancy outcomes of URSA patients were 0.858 (0.807~0.910), 0.764 (0.753~0.816), and 0.903 (0.852~0.955), respectively. Conclusion: The level of the uterine artery blood flow parameters and the increase of the platelet aggregation rate are closely associated with the pregnancy outcome of URSA patients, and the combined value of the two is highly significant in predicting the pregnancy outcome of URSA patients.展开更多
目的对AG800全自动血小板聚集仪光学比浊法检测血小板聚集功能进行评价,并测试仪器的检测性能。方法参照美国临床实验室标准化委员会(Clinical and Laboratory Standards Institute,CLSI)及《光学比浊法检测血小板聚集标准化专家共识》...目的对AG800全自动血小板聚集仪光学比浊法检测血小板聚集功能进行评价,并测试仪器的检测性能。方法参照美国临床实验室标准化委员会(Clinical and Laboratory Standards Institute,CLSI)及《光学比浊法检测血小板聚集标准化专家共识》等相关文件,使用AG800全自动血小板聚集仪和美国Chrono-log700型血小板聚集仪,从样本精密度检验、二磷酸腺苷(adenosine diphosphate,ADP)和花生四烯酸(arachidonic acid,AA)相关性及一致性检验评估两台仪器对血小板聚集功能的检测。对AG800全自动血小板聚集仪进行了性能评估,包括加样、温控及光学检测精密度检验。结果通过7 d的连续跟踪结果显示,Chrono-log700血小板聚集仪低水平样本总体检测精密度CV值为10.99%,AG800自动血小板聚集仪的低水平总体精密度为4.95%,Chrono-log700血小板聚集仪的高水平样本总体检测精密度CV值为9.00%,而AG800全自动血小板聚集仪的高水平总体精密度为4.91%。ADP检测结果统计分析,Pearson相关系数r=0.9915,相关程度高。P<0.0001,表示存在显著性,Bland-Altman一致性检验统计结果显示0个点在95%一致性界限以外,符合一致性分析原则,说明两机检测ADP结果一致性好;AA检测结果统计分析,Pearson相关系数r=0.9832,相关程度高。P<0.0001,表示存在显著性;Bland-Altman一致性检验统计结果显示1个点(2.86%)在95%一致性界限以外,符合一致性分析原则,说明两机检测AA结果一致性好。性能评估结果分析,AG800全自动血小板聚集仪的加样均数(Mean)=9.99μL,均数标准误(Standard error of mean)=0.006,偏度系数(Skewness)=0.119,加样精密度CV为0.48%,离散度(平均绝对偏差,AVEDEV)为0.038μL;AG800全自动血小板聚集仪的温度均数=36.98℃,均数标准误=0.041,偏度系数=-0.293,加样精密度CV为0.93%,离散度为0.284℃;AG800全自动血小板聚集仪对低水平标本的检测均数=20.02%,均数标准误=0.099,偏度系数=0.733,加样精密度CV为4.94%,离散度为0.74%。对高水平标本检测的均数=44.13%,均数标准误=0.184,偏度系数=0.416,加样精密度CV为4.14%,离散度为1.49%。结论AG800全自动血小板聚集仪和Chrono-log700血小板聚集仪检测的ADP和AA值之间存在强线性相关性,说明两机检测结果一致性好;AG800全自动血小板聚集仪在对临床样本低水平和高水平标本的检测CV不超过5%,加样、温控及对样本的浊度变化检测精密度高,可满足临床检测的精密度要求,临床适应性好,具有自动化程度高、操作简便、人为影响因素小等优点。展开更多
文摘目的:探讨子宫动脉血流参数联合血小板聚集功能预测不明原因复发性流产(URSA)的价值。方法:将2021年9月至2023年8月本院收治的94例URSA患者作为URSA组,另外将同期在本院进行产检的110例正常妊娠孕妇作为对照组。URSA患者随访至妊娠28周,根据妊娠结局分为正常妊娠组(n = 25)和流产组(n = 69)。比较2组患者子宫动脉血流参数、血小板聚集率;采用受试者工作特性(ROC)曲线评估子宫动脉血流参数、血小板聚集率对URSA患者妊娠结局的预测价值;采用二分类Logistic逐步回归分析探讨URSA患者妊娠结局的影响因素。结果:在搏动指数(PI)、动脉血流阻力指数(RI)、收缩期/舒张期血流速度比值(S/D)、血小板聚集率指标方面,URSA组相较于对照组更高(P P P Objective: To explore the value of the combination of uterine artery flow parameters and platelet aggregation function in predicting unexplained recurrent abortion (URSA). Methods: 94 patients with URSA from September 2021 to August 2023 were selected as the URSA group, and 110 normal pregnant women who underwent prenatal examination were selected as the control group. The URSA patients were followed up until 28 weeks of gestation and divided into the normal pregnancy group (n = 25) and the abortion group (n = 69) according to the pregnancy outcome. The uterine artery blood flow parameters and platelet aggregation rate were compared between the two groups. The predictive value of the uterine artery flow parameters and platelet aggregation rate for the pregnancy outcomes of URSA patients was evaluated by ROC. Binary Logistic stepwise regression was employed to explore the influencing factors of the pregnancy outcomes of URSA patients. Results: The indexes of the pulse index (PI), the arterial flow resistance index (RI), the systolic/diastolic blood flow velocity ratio (S/D), and the platelet aggregation rate in the URSA group were higher than those in the control group (P P P < 0.05). The ROC curve demonstrated that the area under the curve (AUC) (95% CI) of the uterine artery flow parameters, the platelet aggregation rate, and their combined prediction of the pregnancy outcomes of URSA patients were 0.858 (0.807~0.910), 0.764 (0.753~0.816), and 0.903 (0.852~0.955), respectively. Conclusion: The level of the uterine artery blood flow parameters and the increase of the platelet aggregation rate are closely associated with the pregnancy outcome of URSA patients, and the combined value of the two is highly significant in predicting the pregnancy outcome of URSA patients.
