论文部分内容阅读
目的探讨宁波地区妊娠妇女在妊娠期间血浆D-二聚体水平的变化趋势及妊娠过程中静脉血栓栓塞性疾病(VTE)的发生情况。方法选取2014年1月-2015年1月在该院进行妊娠诊断和产前检查的孕妇1 280例作为健康孕妇组,另选取同期在该院就诊的妊娠合并VTE患者10例为疾病组、同期健康育龄非孕期妇女100名为对照组。采集所有受检者空腹血标本,健康孕妇组自孕第4周起开始采血,每隔4周1次,至临产;疾病组自出现临床症状时开始采血。应用免疫比浊法检测血浆D-二聚体水平,动态观察健康孕妇血浆D-二聚体水平变化,确定相应的参考区间,并采用妊娠合并VTE患者D-二聚体水平来验证参考区间的有效性。结果健康孕妇组血浆D-二聚体随孕周增加有明显的上升趋势,至临产前达到最高值,与对照组比较,差异有统计学意义(P<0.05)。以统计资料的95%可信性得不同孕周参考值区间,采用研究所得参考区间评估10例妊娠合并VTE患者的D-二聚体水平,均为阳性。结论妊娠妇女血浆D-二聚体水平随孕周增加而不断改变,动态观察孕妇血浆D-二聚体水平所确立的参考区间对妊娠合并VTE的诊断具有一定的意义。
Objective To investigate the changes of plasma D-dimer levels and the incidence of venous thromboembolism (VTE) in pregnant women during pregnancy in Ningbo. Methods A total of 1,280 pregnant women with pregnancy diagnosis and prenatal examination in the hospital from January 2014 to January 2015 were selected as healthy pregnant women. Another 10 pregnant women with VTE during the same period were selected as the disease group. During the same period, 100 healthy non-pregnant women of childbearing age as the control group. Blood samples were collected from all subjects. Healthy pregnant women started blood sampling from the 4th week of pregnancy, once every 4 weeks, until labor; the disease group started blood sampling since the onset of clinical symptoms. The levels of plasma D-dimer were measured by immunoturbidimetry, the level of plasma D-dimer in healthy pregnant women was dynamically observed, the corresponding reference interval was determined, and the D-dimer level in pregnant women with VTE was used to verify the reference interval Effectiveness. Results Compared with the control group, the plasma D-dimer in healthy pregnant women increased significantly with the increase of gestational weeks and reached the highest before labor. The difference was statistically significant (P <0.05). The 95% confidence level of statistical data was obtained in different reference intervals of gestational age, and the D-dimer levels of 10 pregnant women with VTE were evaluated using the reference intervals of the study, and all were positive. Conclusions The level of D-dimer in pregnant women changes continuously with the increase of gestational age. It is of great significance to dynamically observe the reference interval of plasma D-dimer level in pregnant women for the diagnosis of VTE during pregnancy.