在有遗漏流产史的妇女中凝血状况
Dandan Chen1, Junxiong Wang2, Hongchao Liu3
1Department of Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China.
曾经流产过的妇女表现出血凝功能变化,包括D-Dimer和血小板数量增加. 这些凝血标志物,特别是狼抗凝剂,PAgT和D-Dimer,可以预测遗漏的流产.
科学领域:
- 生殖医学 生殖医学
- 血液学 血液学 血液学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 流产错误是一种常见的产科并发症.
- 了解潜在的病理生理学对于早期预测和预防至关重要.
- 凝血系统的异常可能在流产中发挥作用.
研究的目的:
- 评估有遗漏流产史的妇女的凝血功能.
- 探索凝血状况与遗漏堕胎之间的关联.
- 评估凝血参数作为错过堕胎的早期预测因素.
主要方法:
- 一项大型队列研究涉及11,182名流产妇女和5298名健康对照.
- 凝血功能测试包括前热血素时间,激活的局部血栓塑时间,纤维素,D-Dimer,蛋白C,蛋白S,抗热血素III和狼抗凝剂 (LAC).
- 血小板计数和血小板聚合 (PAgT) 分别使用自动化血液学分析仪和光传输聚合计 (LTA) 进行测量.
主要成果:
- 与对照组相比,未能堕胎的妇女表现出较高的D-Dimer,dRVVT-R,PC,PAgT和血小板计数,以及较低的抗血素III (AT-III) 活性 (P <0.05).
- 狼抗凝剂 (LAC) 在13.1%的患者中呈阳性,血小板聚合率在47.4%上升.
- 多变量逻辑回归确定了D-Dimer,dRVVT-R,AT-III,PC和PAgT作为遗漏堕胎的重要预测因素.
结论:
- 有证据表明,在有遗漏流产史的妇女中,高凝血状态.
- 狼抗凝剂,PAgT和D-Dimer成为错过堕胎的最强有力的预测因素.
- 基于凝血功能测试的预测模型被开发用于遗漏堕胎.
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