Test results of coagulation seven items and platelets in patients with threatened abortion during early pregnancy
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摘要: 目的 探究妊娠早期先兆流产患者凝血7项和血小板(PLT)变化及其临床意义。方法 选取2018年9月—2020年9月就诊的97例妊娠早期先兆流产患者作为研究组，同期体检的90例妊娠早期健康孕妇作为对照组。所有孕妇均测定凝血7项及PLT水平，比较2组孕妇凝血7项及PLT水平。研究组依据患者妊娠结局分为继续妊娠组及妊娠中断组，比较2组患者凝血7项及PLT水平，并分析其临床意义。结果 研究组孕妇凝血酶原时间(PT)、抗凝血酶Ⅲ(AT-Ⅲ)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)显著低于对照组；纤维蛋白(原)降解产物(FDP)、纤维蛋白原(Fg)、D-二聚体(D-D)、PLT显著高于对照组(P< 0.05)；Pearson相关性分析显示，PT、AT-Ⅲ、TT、APTT与PLT呈负相关(P< 0.05)，FDP、Fg、D-D与PLT呈正相关(P< 0.05)；中断妊娠组患者PT、AT-Ⅲ、TT、APTT显著低于继续妊娠组；FDP、Fg、D-D、PLT显著高于继续妊娠组(P< 0.05)；受试者工作特征曲线显示，PT、AT-Ⅲ、TT、APTT、FDP、Fg、D-D、PLT用于预测研究组患者妊娠结局曲线下面积分别为0.606、0.645、0.457、0.858、0.759、0.669、0.789、0.815。结论 妊娠早期先兆流产患者凝血7项及PLT指标异常，可以作为患者妊娠结局预测的重要指标，指导患者后续治疗。Abstract: Objective To explore the changes and clinical significance of coagulation seven items and platelets in patients with threatened abortion during early pregnancy.Methods A total of 97 patients with threatened abortion during early pregnancy(study group) and 90 healthy pregnant women(control group) were enrolled in this study between September 2018 and September 2020. All were tested for coagulation seven items and platelets. The levels of coagulation seven items and platelet in the two groups were compared. The pregnant women in the study group were divided into continued pregnancy group and pregnancy termination group according to the pregnancy outcome. The levels of coagulation seven items and PLT in the two groups were compared, and their clinical significance was analyzed.Results The prothrombin time, antithrombin Ⅲ, thrombin time, and activated partial thromboplastin time in study group were significantly lower than those in control group, while fibrin(fibrinogen) degradation products, fibrinogen, D-dimer(D-D) and platelets were significantly higher than those in control group(P< 0.05). Pearson correlation analysis showed that prothrombin time, antithrombin Ⅲ, thrombin time and activated partial thromboplastin time was negatively correlated with platelet level(P< 0.05), while fibrin(fibrinogen) degradation products, fibrinogen and D-D were positively correlated with platelet level(P< 0.05). The prothrombin time, antithrombin Ⅲ, thrombin time and activated partial thromboplastin time in pregnancy termination group were significantly lower than those in pregnancy continuation group, while fibrin(fibrinogen) degradation products, fibrinogen, D-D and platelets were significantly higher than those in pregnancy continuation group(P< 0.05). The receiver operating characteristic curves showed that area under the curve values of prothrombin time, antithrombin Ⅲ, thrombin time, activated partial thromboplastin time, fibrin(fibrinogen) degradation products, fibrinogen, D-D and platelets for predicting pregnancy outcomes were 0.606, 0.645, 0.457, 0.858, 0.759, 0.669, 0.789 and 0.815, respectively.Conclusion The coagulation seven items and platelet indexes are abnormal in the patients with threatened abortion during early pregnancy, which could be applied as important indexes for predicting pregnancy outcomes to guide the follow-up treatment.
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Key words:
- early pregnancy /
- threatened abortion /
- coagulation seven items /
- platelet
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表 1 2组孕妇凝血7项与PLT水平比较
X±S 指标 研究组(n=97) 对照组(n=90) t P PT/s 9.81±1.94 13.94±1.26 17.120 < 0.001 AT-Ⅲ/% 80.76±4.95 96.88±8.24 16.350 < 0.001 TT/s 13.29±0.76 17.58±1.28 28.102 < 0.001 APTT/s 29.81±1.79 37.84±2.21 27.391 < 0.001 FDP/(mg·L-1) 6.28±1.43 2.76±0.84 20.322 < 0.001 Fg/(g·L-1) 4.86±0.92 3.24±0.67 13.675 < 0.001 D-D/(mg·L-1) 0.64±0.19 0.39±0.09 11.355 < 0.001 PLT/(×1012·L-1) 269.34±49.82 206.81±69.53 18.473 < 0.001 
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表 2 凝血7项与PLT水平相关性分析
指标 r P PT -0.723 < 0.001 AT-Ⅲ -0.438 0.039 TT -0.635 0.001 APTT -0.528 0.012 FDP 0.627 0.003 Fg 0.394 0.045 D-D 0.509 0.025
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表 3 不同妊娠结局研究组患者凝血7项与PLT水平比较
X±S 指标 妊娠继续组(n=65) 妊娠中断组(n=32) t P PT/s 10.58±2.16 8.25±1.98 5.131 < 0.001 AT-Ⅲ/% 83.26±16.82 75.68±15.49 2.141 0.035 TT/s 14.68±3.85 10.47±2.26 5.711 < 0.001 APTT/s 31.29±5.28 26.80±4.58 4.106 < 0.001 FDP/(mg·L-1) 5.56±1.24 7.74±2.14 6.346 < 0.001 Fg/(g·L-1) 4.56±1.14 5.47±1.04 3.802 < 0.001 D-D/(mg·L-1) 0.58±0.11 0.76±0.14 6.911 < 0.001 PLT/(×1012·L-1) 258.86±24.86 290.63±28.94 5.602 < 0.001
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表 4 凝血7项与PLT对研究组患者妊娠结局分析
指标 截断值 AUC 敏感度/% 特异度/% 95%CI P PT 9.31 0.606 72.3 46.9 0.482~0.729 0.091 AT-Ⅲ 80.26 0.645 84.6 46.9 0.522~0.768 0.020 TT 12.34 0.457 36.2 86.9 0.276~0.595 0.495 APTT 28.64 0.858 90.8 65.6 0.780~0.931 < 0.001 FDP 6.17 0.759 81.5 71.9 0.646~0.871 < 0.001 Fg 5.08 0.669 60.0 71.9 0.557~0.782 0.007 D-D 0.68 0.789 80.0 71.9 0.691~0.888 < 0.001 PLT 270.24 0.815 90.8 59.4 0.723~0.907 < 0.001
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