CAJ | 학술논문

目的：探讨D-二聚体定量检测对妊娠期高血压疾病患者产后出血的预测价值。方法潮州市潮州医院妇产科2013年1月至2013年12月收治150例妊娠期高血压疾病患者，对其分娩前24 h内D-二聚体进行定量测定，并准确计量其分娩24 h内出血量，依出血量将其分为产后出血组及对照组。单因素方差分析其分娩前24 h内D-二聚体测量值与分娩后24 h内出血量的相关性，以ROC曲线分析其对妊娠期高血压疾病患者产后出血的预测截断值。结果产后出血组28例，产后出血发生率18.67％（28/150）。与对照组比较，产后出血组D-二聚体水平（9.56±11.97）mg/L显著高于对照组（1.96±1.06） mg/L，（F＝48.61，P＜0.01）有统计学意义。 ROC曲线下方面积为0.848，其标准误差为0.042，95％CI为0.766～0.930。最佳临界值为2.26 mg/L，此时特异度为66.4％，灵敏度为92.9％，youden指数0.593。结论 D-二聚体定量测定对妊娠期高血压疾病产后出血预测有较高价值，以2.26 mg/L作为预测截断值较为适合。
목적：탐토D-이취체정량검측대임신기고혈압질병환자산후출혈적예측개치。방법조주시조주의원부산과2013년1월지2013년12월수치150례임신기고혈압질병환자，대기분면전24 h내D-이취체진행정량측정，병준학계량기분면24 h내출혈량，의출혈량장기분위산후출혈조급대조조。단인소방차분석기분면전24 h내D-이취체측량치여분면후24 h내출혈량적상관성，이ROC곡선분석기대임신기고혈압질병환자산후출혈적예측절단치。결과산후출혈조28례，산후출혈발생솔18.67％（28/150）。여대조조비교，산후출혈조D-이취체수평（9.56±11.97）mg/L현저고우대조조（1.96±1.06） mg/L，（F＝48.61，P＜0.01）유통계학의의。 ROC곡선하방면적위0.848，기표준오차위0.042，95％CI위0.766～0.930。최가림계치위2.26 mg/L，차시특이도위66.4％，령민도위92.9％，youden지수0.593。결론 D-이취체정량측정대임신기고혈압질병산후출혈예측유교고개치，이2.26 mg/L작위예측절단치교위괄합。
Objective To investigate the predictive value of D-dimer quantitative determination on postpartum hemorrhage with hypertensive disorders in pregnancy patients .Methods One hundred and fifty cases with hypertensive disorders in pregnancy admitted to Chaozhou Hospital from January 2013 to December 2013 were retrospectively analyzed .D-dimer data of all the 150 patients were collected at the 24 hours before delivery .The patients were divided into postpartum hemorrhage group and control group .The correlation between the D-dimer measurement and a loss of blood in the postpartum period was analyzed by one-way ANOVA, and the accuracy of D-dimer predictive variables of postpartum hemorrhage was analyzed by ROC curves .Results Twenty-eight cases had postpartum hemorrhage , and the incidence rate was 18.67% ( 28/150 ) . The average value of D-dimer was ( 9.56 ±11.97 ) mg/L in the postpartum hemorrhage group, while the average value of D-dimer was (1.96 ±1.06) mg/L in the control group, with a significant difference (F=48.61, P<0.01).The area under the ROC curve was 0.848 (95% CI:0.766-0.930), standard error was 0.042.The optimal threshold was 2.26 mg/L, whose specificity, sensitivity and Youden index were 66.4%, 92.9% and 0.593,respectively.Conclusion Quantitative determination of D-dimer has a significant role in predicting postpartum hemorrhage on hypertensive disorders in pregnancy patients , the optimal threshold is 2.26 mg/L.