分子标志物TAT和D-dimer早期诊断产科弥散性血管内凝血的实验研究

目的探讨分子标志物早期诊断产科弥散性血管内凝血(DIC)的意义.方法将172个检测对象分为正常非孕组、早孕组、中孕组、晚孕早期组、足月组及DIC组,分别测定其血浆凝血酶原时间(PT)、血小板(PLT)计数、纤维蛋白原(Pbg)、凝血酶-抗凝血酶Ⅲ复合物(TAT)、D-二聚体(D-dimer)含量.结果各组间PT水平差异无统计学意义(P＞0.05);DIC组与其他五组比较,PLT计数明显降低(P＜001);非孕组Fbg与各孕组比较,差异均有统计学意义(P＜0.01),早孕组与中、晚孕及DIC组比较,差异有统计学意义(P＜0.01);各组间TAT和D-dimer含量随孕周增加而显著升高,DIC组升高尤为明显,其中早、中孕组,中、晚孕组及晚孕与DIC组组间比较,差异均有统计学意义(P＜0.01).结论止凝血分子标志物TAT和D-dimer较常规检测项目PT,PLT和Fbg等在产科弥散性血管内凝血的早期诊断中更有意义,可作为早期诊断产科DIC的良好指标.

Study of determination of molecular markers for early laboratory diagnosis of disseminated intravascular coagulation in obstetrics

Objective: To explore the value of determination of molecular markers for early diagnosis of disseminated intravascular coagulation (DIC)in obstetrics. Methods: 172 women were divided into six groups: normal no-pregnant, early pregnant, middle prenant, late pregnant, uterogestation and DIC group. Their levels of prothrombin time (PT), blood platelet count (PLT), fibrinogen (Fbg), thrombin-antithrombin complex (TAT) and D-dimer were examined. Resuls: PT had no significant differences in all groups (P>0.05). Compared with others, PLT were obviously decreased (P<0.01). Fbg of pregnant groups were higher than that of non-pregnant group (P<0.01), in early pregnant group, the Fbg were lower than other pregnant groups (P<0.01). TAT and D-dimer levels had significant differences in all groups (P<0.01). Conclusions: Determination of the molecular markers of coagulation (TAT, D-dimer) are more beneficial to early diagnosis of DIC in obstetrics than that of other routine test (PT, PLT and Fbg), so TAT and D-dimer are useful indexes to early diagnosis of DIC in obstetrics.