新型血栓标志物t-PAIC、PIC、TM、TAT水平对ITP产妇凝血功能相关不良母婴结局的影响

摘要/Abstract

摘要： 目的探讨新型血栓标志物组织型纤溶酶原激活抑制复合物（t-PAIC）、纤溶酶-抗纤溶酶复合物（PIC）、血栓调节蛋白（TM）、凝血酶抗凝酶复合物（TAT）在预测原发免疫性血小板减少症（ITP）产妇凝血功能相关不良母婴结局中的应用价值。方法选取2021年1月—2023年1月西安市第三医院诊断为ITP妊娠的32⁺⁶~34⁺⁶周产妇83例,依据是否发生不良母婴事件,分为不良结局组（Bad End Group,BE组,n=22）及对照组（Control Group,CG组,n=61）。所有研究对象于孕35⁺⁶周采用ELISA方法进行血清t-PAIC、PIC、TM、TAT测定。搜集一般基线资料及母婴结局事件,采用受试者工作特征曲线（ROC）分析血清t-PAIC、PIC、TM、TAT在预测ITP产妇凝血功能相关不良母婴结局的潜在诊断效能。结果 83例ITP产妇产后凝血功能相关不良母婴结局发生率为26.51%。BE组血清t-PAIC、PIC、TM、TAT高于对照组,ROC曲线分析提示,t-PAIC、PIC、TM、TAT是预测ITP产妇凝血功能相关不良母婴风险结局的可靠指标（P<0.05）,各指标截断值分别为t-PAIC 9.283 ng/mL、PIC 1.075 μg/mL、TM 7.285 TU/mL、TAT 3.737 ng/mL,4个指标同时诊断的联合效能较单个指标预测能力更优[AUC=0.901（0.823,0.979）,P<0.001]。结论血清t-PAIC、PIC、TM、TAT可有效预测ITP产妇凝血功能相关不良母婴结局,联合检测能够有效提高诊断准确率,有望成为预测ITP产妇凝血功能相关不良母婴结局的潜在血液生化标志物。

关键词: 原发免疫性血小板减少症, 新型血栓标志物, 凝血功能相关不良母婴结局, 受试者曲线, 诊断分析

Abstract: Objective To investigate the application value of new thrombosis markers tissue plasminogen activation inhibitory complex (t-PAIC), plasmin antiplasmin complex (PIC), thrombomodulin (TM) and thrombin-antithrombin complex (TAT) in predicting coagulation-related adverse maternal and infant outcomes in pregnant women with primary immune thrombocytopenia (ITP). Methods A total of 83 women with ITP who were 32⁺⁶ to 34⁺⁶ weeks pregnant and diagnosed at the Third Hospital of Xi'an from January 2021 to January 2023 were selected. They were divided into the adverse outcome group (Bad End Group, BE group, n=22) and the control group (Control Group, CG group, n=61) based on whether adverse maternal and neonatal events occurred. All subjects were tested for serum t-PAIC, PIC, TM, TAT at 35⁺⁶ weeks of gestation using the ELISA method. General baseline data and maternal and neonatal outcome events were collected. The receiver operating characteristic curve (ROC) was used to analyze the potential diagnostic efficacy of serum t-PAIC, PIC, TM, and TAT in predicting the adverse maternal and infant outcomes related to coagulation function in ITP pregnant women. Results The incidence of adverse maternal and infant Outcomes related to coagulation function in 83 women with ITP was 26.51%. The serum levels of t-PAIC, PIC, TM, TAT in the BE group were higher than those in the control group. ROC curve analysis suggested that t-PAIC, PIC, TM, TAT are reliable indicators for predicting adverse maternal and neonatal outcomes of infant outcomes related to coagulation function women with ITP (P<0.05 for all). The cut-off values for each indicator were t-PAIC 9.283 ng/mL, PIC 1.075μg/mL, TM 7.285 TU/mL, TAT 3.737 ng/mL, and the combined diagnostic efficiency of the four indicators was superior to the predictive ability of a single indicator (AUC=0.901(0.823,0.979), P<0.001). Conclusion Serum t-PAIC, PIC, TM, TAT can effectively predict adverse maternal and neonatal outcomes of infant outcomes related to coagulation function in women with ITP. The combined detection can effectively improve the diagnostic accuracy and is expected to become a potential blood biochemical marker for predicting adverse maternal and neonatal outcomes of infant outcomes related to coagulation function in women with ITP.

Key words: primary immunologic thrombocytopenic purpura, novel thrombotic markers, adverse maternal and neonatal outcomes of infant outcomes related to coagulation function, receiver operating characteristic curve, diagnostic analysis

中图分类号:

R446.11

闫芳, 丁盛华, 岳瑞, 黄露杰, 王咪, 张邢航, 刘博心. 新型血栓标志物t-PAIC、PIC、TM、TAT水平对ITP产妇凝血功能相关不良母婴结局的影响[J]. 中华养生保健, 2025, 43(1): 13-17.

YAN Fang, DING Sheng-hua, YUE Rui, HUANG Lu-jie, WANG Mi, ZHANG Xing-hang, LIU Bo-xin. The Impact of Novel Thrombotic Markers t-PAIC, PIC, TM, TAT Levels on Adverse Maternal and Infant Outcomes Related to Coagulation Function in Pregnant Women with ITP[J]. ZHONGHUA YANGSHENG BAOJIAN, 2025, 43(1): 13-17.

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