| 低危妊娠女性孕晚期D-二聚体和纤维蛋白原的参考值范围及意义 |
| 投稿时间：2017-01-04 修订日期：2017-01-13 点此下载全文 |
| 引用本文：郑园园,徐晓敏,张翔,王叶平.低危妊娠女性孕晚期D-二聚体和纤维蛋白原的参考值范围及意义[J].医学研究杂志,2017,46(10):166-170 |
| DOI：
10.11969/j.issn.1673-548X.2017.10.041 |
| 摘要点击次数: 855 |
| 全文下载次数: 635 |
|
|
| 中文摘要:目的 建立低危妊娠女性孕晚期D-二聚体和纤维蛋白原的参考区间，并探讨其临床意义。方法 搜集2013年1月~2016年6月在温州市人民医院住院分娩的健康产妇共21788例（28~42周），分别统计其分娩前1周内的血浆D-二聚体和纤维蛋白原浓度，分析其与年龄、孕周的关系。D-二聚体参考区间采用百分位数（P95）表示参考区间的单侧上限，纤维蛋白原参考区间采用双侧百分位数法表示（P2.5~P97.5）。并以此评估618例产后出血和5例围生期静脉血栓的病例。结果 孕晚期女性D-二聚体随着孕周增加而逐渐上升（r=0.07，P=0.000）而纤维蛋白原浓度水平随孕周逐渐下降（r=-0.09，P=0.000）。D-二聚体和纤维蛋白原浓度水平均与女性分娩年龄呈正相关（r分别为0.05和0.02，P=0.000）。孕晚期女性血浆D-二聚体参考区间为≤ 3.16mg/L，纤维蛋白原参考区间为3.23~6.06g/L。高于此D-二聚体参考区间或低于此纤维蛋白原参考区间的病例中，产后出血的比例明显增加，差异有统计学意义（P<0.05）。评估的5例围生期静脉血栓病例，4例阳性。结论 建立低危妊娠女性孕晚期D-二聚体和纤维蛋白原的参考值范围，指导临床医生正确认识孕晚期D二聚体升高对孕产妇的意义，对预防产后出血及围生期静脉血栓具有指导意义。 |
| 中文关键词:孕妇 D-二聚体 纤维蛋白原 参考值 |
| |
| Initial Establishment of D-dimer and Fibrinogen Reference Range and Its Clinical Significance in Low Risk Pregnant Women during Third Trimester |
|
|
| Abstract:Objective To establish D-dimer and fibrinogen reference range in Low risk pregnant women during third trimester, and explore its clinical significance. Methods D-dimer and fibrinogen levels were measured in 21788 pregnant women (gestational age 28-42weeks) from January 2013 to June 2016 in Wenzhou People's Hospital. D-dimer and fibrinogen were measured antepartum(less than one week before delivery).The normal reference intervals(one tails) of D-dimer reference range were established by using 95%percentile method, while fibrinogen were defined as 2.5%-97.5%.We analyzed the clinical significance of the reference range for predicting the postparturn hemorrhage And the results of 5 patients were used to validate the established normal values. Results D-dimer increased physiologically with gestational age in late pregnancy(r=0.07,P=0.000),while fibrinogen decreased with gestational age(r=-0.09,P=0.000).The levels of D-dimer and fibrinogen had a positive correlation with the age of the pregnant women.Reference intervals of D-dimer and fibrinogen at late pregnancy in healthy pregnant women were as following:the D-dimer levels were ≤ 3.16mg/L,the fibrinogen levels were 3.23-6.06g/L.The incidence rate of postpartum hemorrhage was higher in group with abnormal D-dimer and fibrinogen. And four of five patients with venous thrombosis showed positive results with the D-dimer normal value. Conclusion The establishment of reference intervals for D-dimer and fibrinogen in late pregnancy will help to distinguish abnormal D-dimer and fibrinogen in late pregnancy,which will improve the use of the value of D-dimmer and fibrinogen in pregnancy and the D-D.The fibrinogen levels in the third trimester could be helpful to predict postpartum hemorrhage, and venous thrombosis. |
| keywords:Pregnant women D-dimer Fibrinogen Reference values |
| 查看全文 查看/发表评论 下载PDF阅读器 |
