| 李秋亚,杨井源.重度先兆子痫病人外周血凝血酶原片段 1+2、凝血酶 -抗凝血酶复合物、抗凝血酶 Ⅲ改变及其预测静脉血栓栓塞症的价值分析[J].安徽医药,2025,29(11):2245-2250. |
| 重度先兆子痫病人外周血凝血酶原片段 1+2、凝血酶 -抗凝血酶复合物、抗凝血酶 Ⅲ改变及其预测静脉血栓栓塞症的价值分析 |
| Changes in peripheral blood prothrombin fragments 1+2, thrombin-antithrombin complex, and antithrombin Ⅲ in patients with severe preeclampsia and their value in predicting venous thromboembolism |
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| DOI：10.3969/j.issn.1009-6469.2025.11.027 |
| 中文关键词: 先兆子痫 凝血酶原片段 凝血酶 -抗凝血酶复合物 抗凝血酶 Ⅲ 静脉血栓栓塞症 |
| 英文关键词: Preeclampsia Prothrombin fragments Thrombin antithrombin complex Antithrombin Ⅲ Venous thromboembolism |
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| 中文摘要: |
| 目的探讨重度先兆子痫病人外周血凝血酶原片段 1+2(F1+2)、凝血酶 -抗凝血酶复合物( TAT)、抗凝血酶 Ⅲ(AT Ⅲ)改变及其预测静脉血栓栓塞症的价值分析。方法选取 2020年 1月至 2023年 2月在赤峰学院附属医院就诊的 268例重度先兆子痫病人作为疾病组，另选择同期于该院体检并分娩的健康孕妇 268例作为健康组，检测两组外周血 F1+2、TAT、AT Ⅲ水平。根据疾病组是否并发静脉血栓栓塞症将其分为并发组和未并发组，比较两组一般资料。采用多因素 logistic回归分析探索重度先兆子痫并发静脉血栓栓塞症的影响因素，并以受试者操作特征曲线( ROC曲线)分析外周血 F1+2、TAT、AT Ⅲ单独及联合对重度先兆子痫并发静脉血栓栓塞症的预测价值。结果疾病组外周血 F1+2［385.75(315.26，464.38)pmol/L］、 TAT［( 5.73±1.43)μg/L］水平均高于健康组［ 166.75(127.93，204.42)pmol/L、(4.16±1.04)μg/L］(均 P<0.001)，AT Ⅲ［(74.73±15.68)%］低于健康组［( 90.53±19.63)%］(P<0.001)； 268例重度先兆子痫病人静脉血栓栓塞症发生率为 15.67%；并发组 42例年龄 ≥35岁(35.71%)、孕前身体质量指数( BMI)≥24 kg/m2(30.95%)、孕期喜欢久坐或卧床( 16.67%)、剖宫产( 59.52%)占比及外周血 F1+2［476.21(462.74，536.96)pmol/L］、 TAT［( 6.87±1.61)μg/L］水平均高于未并发组 226例［ 19.03%、16.37%、6.19%、41.15%、367.83(306.19，442.05)pmol/L、(5.52±1.32)μg/L］(均 P<0.05)，AT Ⅲ［(62.13±18.70)%］低于未并发组［(77.07±19.23)%］(P<0.001)；多因素 logistic回归分析显示，年龄 ≥35岁、孕前 BMI≥24 kg/m2、孕期喜欢久坐或卧床、剖宫产以及外周血 F1+2水平升高、 TAT水平升高、 AT Ⅲ降低均是重度先兆子痫并发静脉血栓栓塞症的危险因素( P<0.05)； ROC曲线分析结果显示，外周血 F1+2、TAT、AT Ⅲ联合预测重度先兆子痫并发静脉血栓栓塞症的特异度和曲线下面积分别为 94.25%、0.93，均高于各指标单独预测，其灵敏度与各指标单独预测基本一致。结论重度先兆子痫病人外周血 F1+2、TAT水平升高， AT Ⅲ降低，且均对重度先兆子痫并发静脉血栓栓塞症具有一定的预测价值，但三者联合的预测价值更高。 |
| 英文摘要: |
| Objective To explore the changes in peripheral blood prothrombin fragments 1+2 (F1+2), thrombin-antithrombin com-plex (TAT), and antithrombin Ⅲ (AT Ⅲ) in patients with severe preeclampsia and to evaluate their value in predicting venous thrombo-embolism.Methods A total of 268 patients with severe preeclampsia who were admitted to the Chifeng College Affiliated Hospitalfrom January 2020 to February 2023 were selected as the disease group, and 268 healthy pregnant women who underwent physical ex-amination and delivered at the same hospital during the same period were selected as the healthy control group. The levels of peripheralblood F1+2, TAT, and AT Ⅲ were measured in both groups. The disease group was further divided into complication group and a non-complication group based on the occurrence of venous thromboembolism, and the general characteristics of the two groups were com-pared. Multivariate logistic regression analysis was used to identify the influencing factors for venous thromboembolism in severe pre.eclampsia. The predictive value of peripheral blood F1+2, TAT, and AT Ⅲ, both individually and in combination, for venous thrombo-embolism in severe preeclampsia was analyzed using receiver operating characteristic curve (ROC curve) . Results The peripheralblood F1+2 [385.75 (315.26, 464.38) pmol/L] and TAT [(5.73±1.43) μg/L] levels in the disease group were higher than those in thehealthy group [166.75 (127.93, 204.42) pmol/L, (4.16±1.04) μg/L] (all P<0.001), while the AT Ⅲ level [(74.73±15.68)% ] was lower than that in the healthy group [(90.53±19.63)%] (P<0.001). The incidence of venous thromboembolism among 268 patients with severepreeclampsia was 15.67%. In the complication group (n=42), the proportions of patients aged ≥35 years (35.71%), with a pre-pregnancy body mass index (BMI)≥24 kg/m2 (30.95%), with a preference for sedentary activity or bed rest during pregnancy (16.67%), and who un-derwent cesarean section (59.52%), as well as the peripheral blood F1+2 [476.21 (462.74, 536.96) pmol/L] and TAT [(6.87±1.61) μg/L]levels, were all higher than those in the non-complication (n=226) [19.03%, 16.37%, 6.19%, 41.15%, 367.83 (306.19, 442.05) pmol/L, (5.52±1.32) μg/L] (all P<0.05), while the AT Ⅲ level [(62.13±18.70)% ] was lower than that in the non-complication group [(77.07± 19.23)%] (P<0.001). Multivariate logistic regression analysis showed that age≥35 years, pre-pregnancy BMI≥24 kg/m2, preference forsedentary activity or bed rest during pregnancy, cesarean section, elevated peripheral blood F1+2 and TAT levels, and decreased ATⅢ were all risk factors for venous thromboembolism in patients with with severe preeclampsia (P<0.05). ROC curve analysis showedthat the combined use of peripheral blood F1+2, TAT, and AT Ⅲ for predicting venous thromboembolism in severe preeclampsia result-ed in a specificity and area under the curve (AUC) of 94.25% and 0.93, respectively, which were higher than those obtained by each in-dicator alone, while the sensitivity was largely consistent with the individual predictions.Conclusions Patients with severe preeclamp-sia have elevated peripheral blood F1+2 and TAT levels and decreased AT Ⅲ levels. All three parameters have certain predictive valuefor venous thromboembolism in severe preeclampsia, but their combined predictive value is superior. |
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