摘要
目的：探讨河源地区孕妇在妊娠过程中血浆D-二聚体水平的变化趋势、 参考范围及在妊娠期糖尿病中的临床价值.方法：研究对象选取2016年2月～2017年7月来我院进行产前检查的孕妇,其中260例早期妊娠（孕周小于12周）,226例中期妊娠（孕周13～27周）,212例晚期妊娠（孕周大于28周）,202例妊娠期糖尿病（11～37周）,同时另选取同期在我院就诊的正常体检人群204例为正常对照组.所有对象均空腹采集外周血,应用免疫比浊法测定血浆D-二聚体水平,动态观察健康人群及正常妊娠孕妇血浆D-二聚体变化趋势,并确定相应的参考区间.结果：D-二聚体水平在正常妊娠孕妇人群中随着孕周增加而上升,产前达到最高峰,其水平在正常人群及早、 中、晚期正常妊娠分别为0.566±0.071ug/ml、0.578±0.092ug/ml、1.045±0.109ug/ml、4.287±0.387ug/ml,而妊娠期糖尿病组为3.007±0.267ug/ml,与正常对照组相比,中、 晚期正常妊娠组统计学差异有统计学意义（P〈0.05）,与早期正常妊娠相比,中、 晚期正常妊娠组统计学差异有统计学意义（P〈0.05）,中期与晚期正常妊娠组间同样具有统计学差异（P〈0.05）,而早期正常妊娠组与正常人群之间无统计学差异（P〉0.05）,妊娠期糖尿病组D-二聚体水平比正常人群、 早、 中期妊娠组高,而比晚期妊娠组低,且统计学有差异（P〈0.05）.结论：孕妇外周血D-二聚体水平随孕周增加而不断上升,因此建立不同孕周D-二聚体生物参考区间具有重要的临床价值.此外,检测妊娠期糖尿病患者血浆D-二聚体水平在妊娠期糖尿病的预后判断、 病情发展中同样具有重要临床价值.
Objective： To investigate the tendency and establish the reference value of plasma D-dimer level and its clinical significance in patients with gestational women in Heyuan area. Methods： 1104 pregnant women were selected who went to our hospital for prenatal examination from February 2016 -2017 year in July, including 260 early pregnancy （gestational age less than 12 weeks）, 226 midtrimester pregnancy （gestational age 13-27 weeks）, 212 late pregnancy （gestational age of more than 28 weeks）, 202 gestational diabetes mellitus, and 204 healthy people as control group at the same time. Peripheral blood were collected under fasting and D-dimer was measured by immunoturbidimetry. Finally, the tendency of D-dimer in pregnant women was investigated, and the corresponding reference value was established. Results： The levels of D-dimer in normal pregnant women were upregulated accompany with the increased gestational age, which peaked to prenatal, and its level in the normal population of early, middle, late stage of pregnancy and gestational diabetes mellitus group were 0.566 ±0.071ug/ml, 0.578 ±0.092ug/ml, 1.045 ±0.109ug/ml, 4.287 ±0.387ug/ml and 3.007 ±0.267ug/ml respectively. In addition, among all of the five groups, the statistical differences in plasma D-dimer levels were significant （P〈0.05）, except between the control group and the early stage of pregnancy. Conclusion： The level of D-dimer in pregnant women was increased with gestational age and in patients with gestational diabetes mellitus. Therefore, establishment of the D-dimer reference value at different gestational ages in our laboratory, which have clinical significance.
作者
刘平
陈贻继
LIU Ping;CHEN Yi-ji(Department of Clinical laboratory,Heyuan Women ＆ Children＇s Hospital and Health Institute of Guangdong Province,Heyuan,517000)
出处
《医学检验与临床》
2018年第7期17-19,共3页
Medical Laboratory Science and Clinics
关键词
D二聚体
免疫比浊法
孕妇
河源
参考区间
妊娠期糖尿病
D-dimer
Immunoturbidimetry
Pregnant women
Heyuan
Reference value
Gestational diabetes mellitus
