摘要
目的:分析前置胎盘剖宫产产妇产后出血量与胎盘附着部位及前列腺素E1(PGE1)、谷胱甘肽过氧化物酶-1(GPX1)、血清甲胎蛋白(AFP)、肌酸激酶(CK)及人绒毛膜促性腺激素(HCG)水平的关系。方法:选取2019年10月—2022年10月山东大学第二医院成武分院收治的87例剖宫产前置胎盘产妇,以容积法及称重法计算产妇产后出血量,按照出血量的差异分为大出血组(产后出血量≥1000 mL)40例及无大出血组(产后出血量<1000 mL)47例。对比两组胎盘附着部位及PGE1、GPX1水平,血清AFP、CK及HCG水平,血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)以及白细胞介素-8(IL-8)水平。采用受试者工作特征(ROC)曲线分析PGE1、GPX1水平预测前置胎盘剖宫产产妇产后大出血的效能。结果:大出血组胎盘附着部位为前壁人数占比相较于无大出血组更高,而血清PGE1、GPX1水平均低于无大出血组,差异有统计学意义(P<0.05);大出血组血清AFP、CK及HCG水平均高于无大出血组,差异有统计学意义(P<0.05);大出血组血清IL-6、TNF-α以及IL-8水平均高于无大出血组,差异有统计学意义(P<0.05);ROC曲线分析结果显示,PGE1、GPX1水平联合预测前置胎盘剖宫产产妇产后大出血的效能优于两项指标单独预测(P<0.05)。结论:前置胎盘剖宫产产妇产后出血量与胎盘附着部位以及血清PGE1、GPX1、AFP、CK及HCG水平均有关。
Objective To study the relationship between postpartum blood loss and placental attachment site,levels of prostaglandin E1(PGE1),glutathione peroxidase 1(GPX1),serum alpha-fetoprotein(AFP),creatine kinase(CK)and human chorionic gonadotropin(HCG)in women with placenta previa cesarean section and analyze the relationship.Methods 87 women with placenta previa who received cesarean section in Chengwu Branch of The Second Hospital of Shandong University from October 2019 to October 2022 were selected.The postpartum blood loss was calculated by volumetric method and weighing method,and was divided into 40 cases in the hemorrhagic group(postpartum blood loss≥1000 mL)and 47 cases in the non-hemorrhagic group(postpartum blood loss<1000 mL)according to the difference in the amount of blood loss.The placental attachment sites,PGE1 and GPX1 levels,serum AFP,CK and HCG levels,and serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and interleukin-8(IL-8)levels were compared between the two groups.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of PGE1 and GPX1 in predicting postpartum massive hemorrhage in women with placenta previa cesarean section.Results The proportion of people with placenta attachment site in the anterior wall in the hemorrhagic group was higher than the non-hemorrhagic group.The serum PGE1 and GPX1 levels compared with the group without major bleeding were lower(all P<0.05).The levels of serum AFP,CK and HCG in the hemorrhagic group compared with the group without major bleeding were higher(all P<0.05).The serum levels of IL-6,TNF-αand IL-8 in the massive hemorrhage group were higher than that in the group without major bleeding(all P<0.05).ROC curve analysis showed that the combined PGE1 and GPX1 levels were better than the above two indexes alone in predicting postpartum massive hemorrhage in women with placenta previa cesarean section(all P<0.05).Conclusion Postpartum blood loss of women with placenta previa cesarean section is related to placenta attachment site
作者
王丽
WANG Li(Department of Obstetrics,Chengwu Branch of the Second Hospital of Shandong University<Chengwu County People’s Hospital>,Heze,Shandong 274200,China)
出处
《医药前沿》
2022年第31期4-7,共4页
Journal of Frontiers of Medicine
