D-二聚体、纤维蛋白原在子痫前期诊断中的意义

目的探讨正常妊娠孕妇、轻度子痫前期及重度子痫前期孕妇血浆D-二聚体(D-dimer,D-D)、纤维蛋白原(Fibrinogen,FIB)水平及其临床指导意义。方法选择2011年8月—2012年4月在湖南省妇幼保健院住院分娩并诊断为子痫前期患者60例为研究组,其中轻度子痫前期组30例,重度子痫前期组30例,体检正常孕妇30例作为对照组。分别用散射免疫比浊法,Clauss法测定所选对象血浆中D-D、FIB水平。观察并比较各组间浓度的差异。结果轻度子痫前期组(3.096±1.764)mg/L]及重度子痫前期组(4.686±1.123)mg/L]孕妇血浆D-D水平较正常妊娠妇女组明显偏高,差异有统计学意义(P<0.05);轻度子痫前期组孕妇血浆FIB(5.20±1.46)mg/L]水平较正常妊娠妇女组明显偏高,差异有统计学意义(P<0.05),重度子痫前期组孕妇血浆FIB水平(4.62±1.53)mg/L]较正常妊娠妇女无明显差异,差异无统计学意义(P>0.05)。结论 D-D的检测对妊娠子痫前期凝血功能障碍及纤溶系统的早期监测有重要临床意义,可作为临床实验室诊断的重要指标,有利于早期诊断、预防。FIB可作为辅助指标,对子痫前期的分期诊断有一定的参考价值。

D-Dimmer and fibrinogen in the diagnosis of preeclampsia

Objective To discuss the plasma level of D- dimer （D- D） and fibrinogen in normal pregnancies, pregnan- cies with mild preeclampsia and pregnancies with severe preeclampsia, and its clinical significance. Methods From Au- gust 2011 through April 2012, 60 women in labor who had been diagnosed as preeclampsia at Hunan provincial maternal and child health hospital were selected as the study group. Among them, 30 cases were diagnosed with mild prceclampsia, 30 with severe preeclampsia. And 30 with normal pregnancies were selected as healthy controls. The methods of latex im- munoturbidimetry and clauss assay were used to determine the plasma level of D - D and FIB, which was observed and compared in all groups. Results Compared with the normal pregnancies （control group） （2.090 ± 0. 859 ）mg/L ] , the plasma level of D - D in the other two groups （3. 096 ± 1. 764） rag/L, （4. 686 ±4. 123 ） mg/L] increased obviously, and significant difference was found between the groups （P 〈 0.05 ）. Women with mild preeelampsia had a significantly higher plasma level of FIB （5.20 ± 1.46） g/L ] than normal controls （ 4.77 ± 0.89 ） g/L ] and significant difference was found between the two groups （ P 〈 0.05 ）. There was no significant difference between pregnancies with mild preeclampsia （4. 62 ± 1.53 ）g/L] and normal controls in the plasma level of FIB （P 〉 0.05 ）. Conclusions The detection of plasma D- D is of important clinical significance to the early monitoring of blood coagulation dysfunction and fibrlnolytic system in pre- eclampsia. D - D can be an important indicator in clinical laboratory diagnosis, which is helpful to the early diagnosis and prevention. As an auxiliary indicator, FIB is conducive to the diagnosis and staging in preeclampsia.