子痫前期孕妇子宫动脉SD、THBS1与凝血功能障碍的相关性

张霞; 徐晓敏

doi:10.16766/j.cnki.issn.1674-4152.003293

子痫前期孕妇子宫动脉SD、THBS1与凝血功能障碍的相关性

doi: 10.16766/j.cnki.issn.1674-4152.003293

张霞^1, ,,
徐晓敏²

1.
舟山市妇女儿童医院产科，浙江舟山 316000
2.
温州市人民医院妇产科，浙江温州 325000

基金项目:

浙江省基础公益研究计划项目 LQ21H040007

舟山市级公益类计划项目 2023C1307

详细信息

通讯作者:
张霞，E-mail：417935597@qq.com

中图分类号: R714.24 R446
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- 文章访问数: 99
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- 被引次数: 0
出版历程
- 收稿日期: 2023-08-22

Correlation between uterine artery SD, THBS1 and coagulation dysfunction in pregnant women with pre-eclampsia

ZHANG Xia^{1
, ,},
XU Xiaomin²

1.
Department of Obstetrics and Gynaecology, Zhoushan Women' s and Children' s Hospital, Zhoushan, Zhejiang 316000, China

摘要

摘要: 目的通过测定子痫前期孕妇子宫动脉收缩期峰值流速/舒张末期流速(SD)、血小板凝血酶蛋白1(THBS1)、凝血指标变化，探究其相关性，为子痫前期的治疗提供一定的帮助。方法随机选取2020年3月1日—2022年5月31日舟山市妇女儿童医院产科诊治的60例子痫前期孕产妇作为研究对象，根据病情严重程度分为轻度组(25例)及重度组(35例)，选取健康孕产妇60例为对照组。检测子宫动脉SD、THBS1及凝血功能指标水平，分析子宫动脉SD、THBS1与凝血功能间的关系及患者凝血功能障碍的影响因素。结果随着病情的加重，患者SD、D-二聚体(D-D)水平明显升高，THBS1水平明显降低，凝血酶原时间(PT)、凝血酶时间(TT)明显缩短(均P < 0.05)。Pearson分析显示，SD与PT(r=-0.627，P=0.014)、TT(r=-0.412，P=0.023)呈负相关关系，与D-D(r=0.556，P=0.030)呈正相关关系；THBS1与PT(r=0.833，P=0.001)、TT(r=0.680，P=0.008)呈正相关关系，与D-D(r=-0.324，P=0.037)呈负相关关系。Logistic分析显示，SD升高及D-D升高为子痫前期患者发生凝血功能障碍的独立危险因素，THBS1升高、PT延长、TT延长为独立保护因素(均P＜0.05)。结论子痫前期孕妇存在子宫动脉SD、THBS1及凝血功能异常，且上述指标间存在相关关系，有望成为评估患者凝血功能障碍的指标。
- 子痫前期 /
- 子宫动脉收缩期峰值流速/舒张末期流速 /
- 血小板凝血酶蛋白1 /
- 凝血功能障碍 /
- 相关性
Abstract: Objective To explore the relationship that may help in the treatment of pre-eclampsia by measuring the peak systolic flow rate/end-diastolic flow rate (SD) of uterine arteries in pregnant women with pre-eclampsia, platelet thrombin protein 1 (THBS1), and changes in coagulation indices. Methods A total of 60 cases of pregnant women with pre-eclampsia who received consultation and treatment at the Obstetrics Department of Zhoushan Women' s and Children' s Hospital from March 1, 2020 to May 31, 2022 were randomly selected as study subjects. According to the condition, there were 25 cases in the mild group and 35 cases in the severe group, and 60 cases of healthy pregnant women were selected as the control group. The levels of uterine artery SD, THBS1 and coagulation function indexes were determined. The relationship between uterine artery SD, THBS1 and coagulation function and the influencing of patients' coagulation dysfunction were analyzed. Results As the worsened, the patients' SD and D-Dimer (D-D) levels were significantly increased, THBS1 levels were significantly decreased, and prothrombin time (PT) and trombin time (TT) were significantly shortened (all P < 0.05). On Pearson' s analysis, SD was negatively correlated with PT (r=-0.627, P=0.014) and TT (r=-0.412, P=0.023), and positively correlated with D-D (r=0.556, P=0.030); THBS1 was positively correlated with PT (r=0.833, P=0.001) and TT (r=0.680, P=0.008), and negatively correlated with D-D (r=-0.324, P=0.037). Logistic analysis, increased SD and increased SD were the patients with pre-eclampsia who developed coagulation dysfunction independent risk factors, and increased THBS1, prolonged PT, and prolonged TT were independent protective factors (all P < 0.05). Conclusion Pregnant women with pre-eclampsia have abnormal uterine artery SD, THBS1, coagulation function, and there is a significant relationship between these indicators, which are expected to become indicators for assessing coagulation dysfunction in patients.
- Pre-eclampsia /
- Uterine artery peak systolic velocity/end diastolic velocity /
- Platelet thrombin protein 1 /
- Coagulation disorders /
- Correlation
利益冲突 无

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表 1 子痫前期患者及对照组孕产妇子宫动脉SD、THBS1水平比较(x±s)

Table 1. A comparison of uterine artery SD and THBS1 levels between preeclampsia patients and a control group(x±s)

组别	例数	SD	THBS1(ng/mL)
对照组	60	2.97±1.12	1.71±0.20
轻度组	25	3.74±1.35^a	1.46±0.16^a
重度组	35	4.45±1.47^b	1.24±0.14^b
F值		15.120	80.340
P值		< 0.001	< 0.001
注：与对照组比较，^aP＜0.05；与轻度组比较，^bP＜0.05。

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表 2 子痫前期患者及对照组孕产妇凝血功能指标比较(x±s)

Table 2. Comparison of coagulation indexes between preeclampsia patients and a control group(x±s)

组别	例数	PT(s)	TT(s)	D-D(μg/mL)
对照组	60	12.81±2.84	17.29±2.67	1.12±0.35
轻度组	25	10.32±1.64^a	14.57±1.24^a	2.60±0.49^a
重度组	35	9.24±1.14^b	12.27±1.05^b	5.93±1.41^b
F值		30.920	67.610	372.490
P值		< 0.001	< 0.001	< 0.001
注：与对照组比较，^aP＜0.05；与轻度组比较，^bP＜0.05。

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表 3 子宫动脉SD、THBS1与凝血功能的相关性分析

Table 3. Correlation analysis of uterine artery SD, THBS1, and coagulation function

项目	SD		THBS1
项目	r值	P值	r值	P值
PT	-0.627	0.014	0.833	0.001
TT	-0.412	0.023	0.680	0.008
D-D	0.556	0.030	-0.324	0.037

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表 4 子痫前期患者凝血功能障碍影响因素的logistic分析

Table 4. Multifactorial logistic regression analysis of factors influencing coagulation dysfunction in patients with preeclampsia

变量	B	SE	Wald χ²	P值	OR值	95% CI
SD	1.712	0.123	7.857	0.020	5.540	4.353~7.050
THBS1	-1.185	0.508	5.575	0.018	0.306	0.113~0.828
PT	-2.125	0.682	9.670	0.002	0.119	0.031~0.455
TT	-3.098	0.921	11.302	0.001	0.045	0.007~0.274
D-D	1.234	0.774	7.125	0.012	3.435	0.753~15.659

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