Diagnostic value of D-dimer,four indicators of thrombophilia and thromboelastography in recurrent miscarriage
[Objective]To investigate the changes of D-dimer,four indicators of thrombophilia and thrombelastography(TEG)parameters in recurrent spontaneous abortion(RSA)patients with different number of abortions.To provide valuable indicators for diagnosis,treatment and prevention of RSA.[Methods]A retrospective analysis was performed on 125 patients with RSA who received treatment in Luoyang Maternal and Child Health Hospital from March 2021 to December 2022.Patients in the observation group were divided into two groups(group A,two miscarriages,75 cases;group B,three or more miscarriages,50 cases)according to the number of abortions,and 60 normal pregnant women who received pregnancy examination in the hospital during the same period were selected as the control group.The difference in general data,D-dimer(D-D),protein C(PC),protein S(PS),lupus anticoagulant(LA1,LA2),LA1/LA2 ratio,TEG parameters(R value,K value,α angle,MA value,CI value)among three groups were compared and analyzed.Receiver operating characteristic(ROC)curve was used to analyze statistically significant indicators and analyze their predictive value for the recurrence of miscarriage in patients with RSA.[Results]D-D,LAI,LA2,LA1/LA2,MA value,α angle and CI value of thrombus elasticity graph in observation group A and group B were significantly higher than those in control group(P＜0.05),while PC,PS,K value and R value were significantly lower than those in control group(P＜0.05).In the observation group,D-D,MA value,CI value,LA1 and LA1/LA2 in group A were significantly lower than those in group B(P＜0.05),while K value and R value in group A were significantly higher than those in group B(P＜0.05).ROC curve analysis showed that the sensitivity of D-D,K value,R value,MA value,α angle,CI value to predict recurrence of abortion in RSA patients were 0.888,0.864,0.752,0.672,0.656,0.912,respectively.The specificity were 0.933,0.533,0.783,0.867,0.617,0.883,respectively.The optimal cut-off values were 0.52 μg/mL,1.77 min,5.15 min,65.88 mm,62.31°,3.21,respectively.The area under curve(AUC)values were 0.941,0.743,0.833,0.827,0.640,0.964,respectively,and the AUC value of combined diagnosis was 0.998.[Conclusion]The parameters of thrombologram are closely related to RSA.The more the number of abortion,the higher the blood coagulation.R value,K value,MA value,α angle,CI value,D-D value and four indicators of thrombophilia can be used as evaluation indexes of recurrent abortion in RSA patients.The combined evaluation of multiple indexes is helpful to improve the efficacy of distinguishing prethrombotic status in patients with RSA.
万方数据
维普
