J Thromb Haemost:血小板计数可作为产后出血的危险因素

2021-08-02 MedSci原创 MedSci原创

不同程度的血小板减少与SPPH的发生独立相关。尽管血小板参数与SPPH有关,除了血小板计数外,血小板压积和PDW≥23%的附加价值有限。

严重的产后出血(SPPH)是全球孕产妇死亡和发病的主要原因。血小板异常在妊娠期间经常发生。然而,它们在SPPH的病因学中的作用仍未明确。

近日,血栓和凝血疾病权威杂志Journal of Thrombosis and Haemostasis上发表了一篇研究文章,该研究旨探讨血小板参数与SPPH之间的关系。

该回顾性单中心队列研究纳入了2009年至2017年期间的妊娠女性。SPPH定义为分娩后24小时内失血量≥1000ml。在分娩前72小时内测量血小板参数。研究人员对缺失的数据进行了多次归并,同时对产妇年龄、多胎妊娠、巨大儿、引产、子痫前期和HELLP(溶血、肝酶升高和血小板减少)综合征的比值比进行了调整。

该研究纳入了23205例分娩女性。2402名(10.4%)孕妇出现血小板减少(<150*109/L),10.3%的孕妇出现了SPPH,而在血小板计数正常的女性中,这一比例为7.6% (aOR为1.34, 95%CI为1.14-1.59)。与血小板计数正常的对照组相比,血小板计数<50*109/L的女性风险最大(aOR为2.24 (1.01-4.94));血小板为50~99*109/L组aOR为1.22 (0.77-1.93),血小板为100~149*109/L组aOR为1.31(1.10~1.56)。血小板压积与SPPH相关(每降低0.05%的aOR为1.15(1.08-1.21)),尽管血小板分布宽度(PDW)≥23% (n=22)也增加了SPPH的发生几率(aOR为6.05(2.29-16.20))。

由此可见,不同程度的血小板减少与SPPH的发生独立相关。尽管血小板参数与SPPH有关,除了血小板计数外,血小板压积和PDW≥23%的附加价值有限。

 原始出处:
 
Wobke E.M. van Dijk.et al.Platelet count and -indices as postpartum haemorrhage risk factors: a retrospective cohort study.Journal of Thrombosis and Haemostasis.2021.https://onlinelibrary.wiley.com/doi/10.1111/jth.15481

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    2022-03-23 changfy
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    2021-08-04 gous
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    2021-08-03 仁术2021

    不错,学习了

    0

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