摘要
目的比较Caprini血栓评估模型和英国皇家妇产科学院(the Royal College of Obstetricians and Gynaecologists,RCOG)指南评分对孕产妇围产期静脉血栓栓塞症(venous thromboembolism,VTE)发生风险的预测价值。方法对2014年2月—2020年2月于复旦大学附属上海市第五人民医院妇产科就诊的孕产妇资料进行回顾性分析,将围产期发生VTE的347名孕产妇纳入病例组;按1∶4的比例随机选择同期未发生VTE的1391名孕产妇纳入对照组。对两组孕产妇分别采用Caprini血栓评估模型及RCOG指南评分进行VTE风险评估,比较两者预测效果。结果Caprini血栓评估模型对入组孕产妇产前VTE等级分层的结果相较于产后评估结果明显偏低(χ^(2)=937.268,P<0.001);RCOG指南评分对入组孕产妇产前VTE等级分层的结果较产后评估结果同样偏低(χ^(2)=1324.195,P<0.001);ROC曲线显示产前Caprini血栓评估模型和RCOG指南评分的曲线下面积(area under the curve,AUC)差异无统计学意义(0.671±0.017 vs.0.689±0.018,P=0.4567);产后Caprini血栓评估模型AUC结果低于RCOG指南评分AUC(0.611±0.017 vs.0.711±0.013,P<0.0001)。结论Caprini血栓评估模型和RCOG指南评分均可预测围产期孕产妇VTE的发生,但RCOG指南评分更具针对性,准确度更高,更适用于围产期孕产妇。
Objective To compare the predictive value of Caprini thrombosis assessment model and the Royal College of Obstetricians and Gynaecologists(RCOG)guideline score for the risk of maternal perinatal venous thromboembolism(VTE).Methods A retrospective analysis was conducted in the Department of Obstetrics and Gynecology,the Fifth People’s Hospital of Shanghai,Fudan University from Feb 2014 to Feb 2020.A total of 347 maternal patients diagnosed with VTE In the perinatal period were enrolled,and a randomly selected group of 1391 maternal patients with no-VTE during the same period served as the control with a ratio of 1∶4.The risks of VTE in both groups were evaluated by Caprini thrombosis assessment model and RCOG guideline score,and the predictive effects were compare between them.Results The results of prenatal VTE stratification from Caprini thrombosis assessment model in all subjects were significantly lower than those of postnatal assessment(χ2=937.268,P<0.001).The results of prenatal VTE stratification from RCOG guideline score in all subjects were also lower than those of postnatal assessment(χ2=1324.195,P<0.001).Furthermore,the ROC curves for prenatal period showed no significant difference in the area under the curve(AUC)between Caprini thrombosis assessment model and RCOG guideline score(0.671±0.017 vs.0.689±0.018,P=0.4567).However,the AUC of Caprini thrombosis assessment model for postnatal period was smaller than that of RCOG guideline score(0.611±0.017 vs.0.711±0.013,P<0.0001).Conclusion Caprini thrombus assessment model and RCOG guideline score can predict the occurrence of perinatal maternal VTE,while RCOG guideline score is more suitable for maternity because of its pertinence and veracity.
作者
郝总
潘杰
杨文超
戴洁敏
管军华
高斌
HAO Zong;PAN Jie;YANG Wen-chao;DAI Jie-min;GUAN Jun-hua;GAO Bin(Department of Vascular Surgery,the Fifth People’s Hospital of Shanghai,Fudan University,Shanghai 200240,China;Department of Obstetrics and Gynecology,the Fifth People’s Hospital of Shanghai,Fudan University,Shanghai 200240,China;Department of Vascular Surgery,Zhongshan Hospital,Fudan University,Shanghai 200032,China)
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2023年第2期207-212,共6页
Fudan University Journal of Medical Sciences
基金
上海市闵行区自然科学研究课题(2019MHZ027)。
