2026 年第 5 期 第 21 卷

血浆血小板因子4和趋化因子CX3C受体1对重度子痫前期患者剖宫产术后深静脉血栓形成的预测价值

Predictive value of plasma platelet factor 4 and chemokine CX3C receptor 1 for deep vein thrombosis after cesarean section in patients with severe preeclampsia

作者：杨彩霞李俊霞李佳蓉谢瑞萍

英文作者：Yang Caixia Li Junxia Li Jiarong Xie Ruiping

单位：山西省儿童医院（山西省妇幼保健院）妇产科，太原030013

英文单位：Department of Obstetrics and Gynecology Shanxi Children′s Hospital (Shanxi Women and Children Hospital) Taiyuan 030013 China

关键词：度子痫前期；剖宫产；深静脉血栓形成；血小板因子4；趋化因子CX3C受体1

英文关键词：Severepreeclampsia;Cesareansection;Deepveinthrombosis;Plateletfactor4;ChemokineCX3Creceptor1

• 摘要：

• 目的 探讨血浆血小板因子4（PF4）和趋化因子CX3C受体1（CX3CR1）对重度子痫前期患者剖宫产术后深静脉血栓形成（DVT）的预测价值。方法 前瞻性选取2020年3月至2024年12月于山西省儿童医院行剖宫产手术治疗的重度子痫前期患者302例。根据术后2周内是否发生DVT将患者分为DVT组（72例）和无DVT组（230例）。所有患者于术前检测血浆PF4和CX3CR1水平，收集和比较临床资料及纤维蛋白原、D-二聚体等实验室指标。采用Pearson相关性分析方法分析PF4和CX3CR1与纤维蛋白原、D-二聚体的相关性。采用多因素Logistic回归方法分析影响重度子痫前期患者剖宫产术后DVT的因素。采用受试者工作特征（ROC）曲线分析PF4、CX3CR1预测重度子痫前期患者剖宫产术后DVT的价值。结果 DVT组体重指数、妊娠期糖尿病比例、因保胎而长期卧床比例、纤维蛋白原、D-二聚体水平均高于无DVT组（均P＜0.05）。DVT组患者血浆PF4和CX3CR1水平均显著高于无DVT组［（6.3±1.9）μg/L比（3.0±0.7）μg/L、（82±16）ng/L比（43±10）ng/L］（t=22.274、25.139，均P＜0.001）。DVT组患者血浆PF4和CX3CR1水平与纤维蛋白原、D-二聚体均呈正相关（均P＜0.001）。多因素Logistic回归分析结果显示妊娠期糖尿病、高体重指数、高PF4、高CX3CR1均是重度子痫前期患者剖宫产术后DVT的危险因素（均P＜0.05）。PF4和CX3CR1分别预测重度子痫前期患者剖宫产术后DVT的曲线下面积均高于妊娠期糖尿病、体重指数分别预测，PF4和CX3CR1联合预测的曲线下面积高于各指标单独预测（均P＜0.05）。结论 重度子痫前期患者剖宫产术前血浆PF4、CX3CR1水平较高与术后DVT的发生有关，联合PF4和CX3CR1在术后DVT风险预测中具有较高的价值。

• Objective To investigate the predictive value of plasma platelet factor 4 (PF4) and chemokine CX3C receptor 1 (CX3CR1) for deep vein thrombosis (DVT) after cesarean section in patients with severe preeclampsia. Methods A total of 302 patients with severe preeclampsia who underwent cesarean section at Shanxi Children′s Hospital from March 2020 to December 2024 were prospectively enrolled. According to the occurrence of DVT within 2 weeks after operation, the patients were divided into DVT group (72 cases) and non-DVT group (230 cases). Plasma levels of PF4 and CX3CR1 were measured preoperatively in all patients, and clinical data as well as laboratory indicators including fibrinogen and D-dimer were collected and compared. Pearson correlation analysis method was used to analyze the correlation of PF4 and CX3CR1 with fibrinogen and D-dimer. Multivariate Logistic regression analysis was performed to identify the risk factors of DVT after cesarean section in patients with severe preeclampsia. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of PF4 and CX3CR1 for postoperative DVT. Results Body mass index, proportion of gestational diabetes mellitus, proportion of prolonged bed rest for fetal preservation, fibrinogen and D-dimer levels in DVT group were significantly higher than those in non-DVT group (all P<0.05). Plasma levels of PF4 and CX3CR1 in DVT group were significantly higher than those in non-DVT group ［(6.3±1.9)μg/L vs (3.0±0.7)μg/L, (82±16)ng/L vs (43±10)ng/L］(t=22.274, 25.139, both P<0.001). Plasma levels of PF4 and CX3CR1 were positively correlated with fibrinogen and D-dimer in DVT group (all P<0.001). Multivariate Logistic regression analysis showed that gestational diabetes mellitus, high body mass index, high PF4 and high CX3CR1 were independent risk factors for DVT after cesarean section in patients with severe preeclampsia (all P<0.05). The area under the curve (AUC) of PF4 and CX3CR1 alone for predicting postoperative DVT was higher than that of gestational diabetes mellitus and body mass index, respectively, and the AUC of the combined prediction of PF4 and CX3CR1 was higher than that of each single indicator (all P<0.05). Conclusions High preoperative plasma levels of PF4 and CX3CR1 are associated with the occurrence of postoperative DVT in patients with severe preeclampsia. The combination of PF4 and CX3CR1 has high value in predicting the risk of postoperative DVT.