摘要
目的探讨妊娠晚期下肢静脉血栓的影响因素及早期诊断方法。方法回顾性选择2015年2月至2017年1月间于确诊的下肢静脉血栓孕妇患者62例(VTE组),并选择同时期健康孕妇106例(对照组),观察两组孕妇一般资料、英国皇家妇产科医师学院(RCOG)评分和实验室检查间的差异,分析妊娠晚期下肢静脉血栓的相关危险因素,并评价应用危险因素单独和联合预测下肢血栓形成的诊断效能。结果 VTE组孕妇的年龄、孕次、产次、BMI、RCOG评分、高敏C反应蛋白(hs-CRP)和D二聚体(DD)水平显著高于对照组(P<0.05),WBC、Hb、PLT、TG、TC等水平无统计学差异(P>0.05)。Logistic回归分析RCOG评分、hs-CRP和DD是妊娠晚期发生下肢静脉血栓的独立危险因素(P<0.05)。ROC曲线显示,应用3种指标单独诊断时,RCOG评分的AUC最高(AUC=0.808),DD次之(AUC=0.749),hs-CRP最低(AUC=0.695);联合预测的AUC(AUC=0.919)明显高于三者单独预测(P<0.05)。应用ROC曲线最佳截点,联合预测的敏感性(96.77%)和阴性预测值(97.65%)均明显高于三种指标单独诊断(P<0.05)。结论RCOG评分、hs-CRP和DD是妊娠晚期下肢静脉血栓的独立危险因素;hs-CRP≥4.0 mmol/L、RCOG评分≥4和DD≥557.6μg/L可作为早期诊断的最佳截点。
Objective To investigate the influencing factors and early diagnosis of venous thrombosis in lower in third trimester of pregnancy.Methods Sixty-two pregnant women(VTE group)with lower extremity venous thrombosis diagnosed in our hospital from February 2015 to January 2017 were enrolled and 106 healthy pregnant women(control group)were selected during the same period.The general information of pregnant women,RCOG score and laboratory tests were analyzed for risk factors associated with venous thrombi in the third trimester of pregnancy,the diagnostic efficacy of the risk factor alone and in combination for prediction of VTE were evaluated.Results The age,pregnancy time,delivery time,BMI,RCOG score,hs-CRP and DD levels in pregnant women in VTE group were significantly higher than those in control group(P<0.05),but there was no significant difference in WBC,Hb,PLT(P>0.05).Logistic regression analysis showed that RCOG score,hs-CRP and DD were independent risk factors for VTE in late pregnancy(P<0.05).The ROC curve showed that the AUC was the highest(AUC=0.808),followed by DD(AUC=0.749)and lowest hs-CRP(AUC=0.695),the AUC of joint was significantly higher than the three alone predicted(P<0.05).The sensitivity of joint prediction(96.77%)and negative predictive value(97.65%)were significantly higher than those of 3 indicators(P<0.05).Conclusion RCOG score,hs-CRP and DD are independent risk factors for VTE in late pregnancy,and the best cut-off point for early diagnosis is hs-CRP≥4.0 mmol/L,RCOG score≥4 and DD≥557.6μg/L.
作者
曾慧琳
邓宇芳
盛霞玲
ZENG Hui-lin;DENG Yu-fang;SHENG Xia-ling(Department of Gynecology and Obstetrical,Huizhou Maternal and Child Health Care Center for Family Planning,Huizhou Guangdong 516001,China)
出处
《临床和实验医学杂志》
2018年第8期859-861,共3页
Journal of Clinical and Experimental Medicine
基金
惠州市科技计划项目(编号:20160804)
