2026 年第 10 期 第 21 卷

不同程度妊娠期高血压疾病产妇凝血功能及纤维蛋白降解产物水平变化及其对疾病严重程度的预测效能分析

Analysis of changes in coagulation function and fibrin degradation product levels in parturients with different degrees of hypertensive disorders of pregnancy and their predictive efficacy for disease severity

作者：杨丽珺1孙涛1刘静2

英文作者：Yang Lijun1 Sun Tao1 Liu Jing2

单位：1首都医科大学附属北京妇产医院/北京妇幼保健院内科，北京100021；2首都医科大学附属北京妇产医院/北京妇幼保健院围产医学部，北京100021

英文单位：1Department of Internal Medicine Beijing Obstetrics and Gynecology Hospital Capital Medical University Beijing Maternal and Child Health Care Hospital Beijing 100021 China; 2Department of Perinatal Medicine Beijing Obstetrics and Gynecology Hospital Capital Medical University Beijing Maternal and Child Health Care Hospital Beijing 100021 China

关键词：妊娠期高血压疾病；凝血功能；纤维蛋白降解产物；产妇

英文关键词：Hypertensivedisordersofpregnancy;Coagulationfunction;Fibrindegradationproduct;Parturients

• 摘要：

• 目的  探究不同程度妊娠期高血压疾病产妇凝血功能及纤维蛋白降解产物（FDP）水平变化及其对疾病严重程度的预测效能。方法 选取2023年1月至2024年12月首都医科大学附属北京妇产医院收治的453例妊娠期高血压疾病产妇为研究对象。根据病情严重程度分为轻度组（妊娠期高血压，172例）、中度组（轻度子痫前期，151例）及重度组（重度子痫前期，130例）。对比3组凝血四项及FDP水平；采用Spearman 相关性分析方法分析疾病严重程度与凝血、纤维蛋白溶解指标的关联，绘制受试者工作特征曲线评价各指标对疾病严重程度的预测效能。结果 纤维蛋白原（FIB）、FDP随病情程度加重逐渐升高，凝血酶时间（TT）随病情程度加重逐渐缩短。重度组FIB、FDP高于轻度组和中度组，TT、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）短于轻度组和中度组，差异均有统计学意义［（5.6±0.6）g/L比（4.3±0.6）、（4.9±0.6）g/L，（21.8±3.5）mg/L比（17.9±2.5）、（18.6±2.7）mg/L，（12.0±0.7）s比（14.3±0.8）、（13.8±0.8）s，（9.6±0.8）s比（10.3±0.9）、（10.2±0.9）s，（27.1±3.9）s比（29.0±2.1）、（29.8±2.3）s］（均P＜0.05）。妊娠期高血压疾病产妇病情严重程度与FIB、FDP呈正相关，与TT、PT、APTT呈负相关（均P＜0.05）。以4 g/L为临界值，FIB预测不同病情严重程度妊娠期高血压疾病产妇的曲线下面积最大，敏感度、特异度分别为68.09%、87.50%。结论 妊娠期高血压疾病产妇随病情加重凝血-纤维蛋白溶解平衡紊乱加剧，FIB、FDP 与疾病严重程度密切相关，FIB 对病情严重程度预测价值最优。

• Objective To investigate the changes in coagulation function and fibrin degradation product (FDP) levels in parturients with different degrees of hypertensive disorders of pregnancy and their predictive efficacy for disease severity. Methods A total of 453 parturients with hypertensive disorders of pregnancy admitted to Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2023 to December 2024 were enrolled. According to disease severity, the patients were divided into mild group (gestational hypertension, 172 cases), moderate group (mild pre-eclampsia, 151 cases) and severe group (severe pre-eclampsia, 130 cases). Four coagulation indexes and FDP levels were compared among the three groups. Spearman correlation analysis was used to analyze the correlation between disease severity and coagulation-fibrinolysis indicators, and receiver operating characteristic curves were plotted to evaluate the predictive efficacy of each indicator for disease severity. Results Fibrinogen (FIB) and FDP gradually increased with the aggravation of disease, while thrombin time (TT) gradually shortened. The severe group had higher FIB and FDP levels, and shorter TT, prothrombin time (PT) and activated partial thromboplastin time (APTT) compared with the mild and moderate groups ［(5.6±0.6)g/L vs (4.3±0.6), (4.9±0.6)g/L; (21.8±3.5)mg/L vs (17.9±2.5), (18.6±2.7)mg/L; (12.0±0.7)s vs (14.3±0.8), (13.8±0.8)s; (9.6±0.8)s vs (10.3±0.9), (10.2±0.9)s; (27.1±3.9)s vs (29.0±2.1), (29.8±2.3)s］(all P<0.05). Disease severity of parturients with hypertensive disorders of pregnancy was positively correlated with FIB and FDP, and negatively correlated with TT, PT and APTT (all P＜0.05). With the cut-off value of 4 g/L, FIB had the largest area under the curve for predicting disease severity, with a sensitivity of 68.09% and specificity of 87.50%. Conclusion The disturbance of coagulation-fibrinolysis balance aggravates as disease progresses in parturients with hypertensive disorders of pregnancy. FIB and FDP are closely related to disease severity, and FIB exhibits the optimal predictive value for disease severity.