| 李明,段世博,徐国伟,等.血清抗凝血酶 Ⅲ、组织型纤溶酶原激活物水平与产褥期静脉窦血栓形成的关系分析[J].安徽医药,2025,29(11):2176-2180. |
| 血清抗凝血酶 Ⅲ、组织型纤溶酶原激活物水平与产褥期静脉窦血栓形成的关系分析 |
| Association between serum antithrombin Ⅲ and tissue-type plasminogen activator levels with puerperal venous sinus thrombosis |
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| DOI：10.3969/j.issn.1009-6469.2025.11.011 |
| 中文关键词: 静脉窦血栓形成 血清抗凝血酶 Ⅲ 组织型纤溶酶原激活物 logistic回归模型 预测价值 产褥期 |
| 英文关键词: Thrombosis of venous sinus Serum antithrombin Ⅲ Tissue-type plasminogen activator Logistic regression model Predictive value Puerperium |
| 基金项目:沧州市科技计划自筹经费项目( 222106096) |
| 作者 | 单位 | | 李明 | 沧州市中心医院,产科医学中心,河北沧州 061000 | | 段世博 | 沧州市中心医院,神经外科,河北沧州 061000 | | 徐国伟 | 沧州市中心医院,神经外科,河北沧州 061000 | | 李松 | 沧州市中心医院,神经外科,河北沧州 061000 | | 孙敏 | 沧州市中心医院,核磁室,河北沧州 061000 | | 侯秀真 | 沧州市中心医院,产科医学中心,河北沧州 061000 | | 金燕 | 沧州市中心医院,产科医学中心,河北沧州 061000 |
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| 中文摘要: |
| 目的探究血清抗凝血酶 Ⅲ(AT-Ⅲ)、组织型纤溶酶原激活物( t-PA)水平与产褥期静脉窦血栓形成( CVST)的相关性。方法选取 2015年 8月至 2022年 12月在沧州市中心医院诊治的产褥期 CVST病人 80例作为研究对象( CVST组)并分为低危组 40例、中危组 29例和高危组 11例，同时选取同期在该院体检健康的产妇 80例为健康组，比较健康组和 CVST组血清，AT-Ⅲ、t-PA水平。 Pearson相关性分析检验血清 AT-Ⅲ、t-PA水平与产褥期 CVST的相关性。 logistic回归模型分析影响产褥期 CVST发生的因素。受试者操作特征曲线( ROC曲线)分析血清 AT-Ⅲ、t-PA对产褥期发生 CVST的预测价值。结果与健康组相比， CVST组病人 D-二聚体、纤维蛋白原、高血压占比、糖尿病占比、产褥期感染占比、子痫占比显著升高(P<0.05)。 CVST组病人血清 AT-Ⅲ［(63.45±13.69)%］、 t-PA［(10.44±2.35)μg/L］水平比健康组［(82.71±14.25)%、(13.57±3.28)μg/L］低(均 P<0.05)。低危组、中危组和高危组病人血清 AT-Ⅲ［(69.73±12.22)%比( 59.98±11.16)%比( 49.76±10.16)%］、 t-PA［( 11.56±3.39)μg/L比( 9.91±2.75)μg/L比( 7.76±2.16)μg/L］水平依次降低(均 P<0.05)。相关性分析显示，产褥期 CVST病人血清 AT-Ⅲ、t-PA水平分别与 D-二聚体、纤维蛋白原、高血压、糖尿病呈负相关性(P<0.05)。 logistic回归分析显示， D-二聚体、纤维蛋白原、高血压、糖尿病是影响产褥期 CVST发生的危险因素， AT-Ⅲ、t-PA为保护因素( P<0.05)。 ROC曲线分析显示，血清 AT-Ⅲ、t-PA水平辅助诊断产褥期 CVST是否发生的曲线下面积( AUC)及其 95%CI分别为 0.81(0.74，0.88)、 0.80(0.73，0.86)二者联合诊断为 0.86(0.81， 0.92)。结论血清 AT-Ⅲ、t-PA水平降低与产褥期 CVST密切相关，是产褥期 CVST发生的影响因素。 |
| 英文摘要: |
| Objective To explore the association between serum antithrombin Ⅲ (AT-Ⅲ) and tissue-type plasminogen activator (t-PA) levels with puerperal cerebral venous sinus thrombosis (CVST).Methods Between August 2015 and December 2022, 80 patients withpuerperal CVST treated at Cangzhou Central Hospital were selected as the case group and divided into low-risk (40 cases), medium-risk (29 cases) and high-risk(11 cases) group. Additionally, 80 healthy postpartum women from the same period were selected as the control group. Serum AT-Ⅲ and t-PA levels were compared between the CVST and control groups. Pearson correlation analysis wasused to examine the relationship between serum AT-Ⅲ, t-PA levels and puerperal CVST. A logistic regression model was used to ana-lyze factors influencing CVST occurrence. Receiver operating characteristic curve (ROC curve) analysis was performed to evaluate thepredictive value of serum AT-Ⅲ and t-PA for puerperal CVST.Results The CVST group showed significantly higher D-dimer, fibrino-gen, hypertension, diabetes, puerperal infection, and eclampsia rates compared to the control group (P<0.05). Serum AT-Ⅲ [(63.45± 13.69)%] and t-PA [(10.44±2.35) μg/L] levels were significantly lower in the CVST group than in the control group [(82.71±14.25)%,(13.57±3.28) μg/L] (all P<0.05). A progressive decrease in serum AT-Ⅲ [(69.73±12.22)% vs. (59.98±11.16)% vs. (49.76±10.16)%] and t-PA [(11.56±3.39) μg/L vs. (9.91±2.75) μg/L vs. (7.76±2.16) μg/L] levels was observed across the low-, medium-, and high-risk groups (all P<0.05). Correlation analysis revealed significant negative correlations between serum AT-Ⅲ and t-PA levels and D-dimer, fibrino-gen, hypertension, and diabetes in puerperal CVST patients (P<0.05). Multivariate logistic analysis identified D-dimer, fibrinogen, hy-pertension, and diabetes as risk factors for puerperal CVST, while AT-Ⅲ and t-PA were protective factors (P<0.05). ROC curve analy-sis showed areas under the curve (AUC) with 95% confidence intervals for serum AT-Ⅲ and t-PA in diagnosing puerperal CVST were 0.81 (0.74, 0.88) and 0.80 (0.73, 0.86), respectively, while the combined AUC was 0.86 (0.81, 0.92).Conclusion Decreased serum AT-Ⅲ and t-PA levels are significantly associated with puerperal CVST and represent important influencing factors for its occurrence. |
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