摘要
Abstract
Objective To investigate the predictive value of thromboelastography(TEG)parameters com-bined with serum 25-hydroxyvitamin D[25(OH)D]and P-selectin for lower extremity deep venous thrombo-sis(DVT)in pregnant women with hypertensive disorder complicating pregnancy(HDCP).Methods A total of 144 pregnant women with HDCP admitted to the hospital from June 2021 to June 2023 were selected as the HDCP group.All pregnant women were divided into the lower extremity DVT group and the non-lower ex-tremity DVT group according to whether the pregnant women with HDCP were complicated with lower ex-tremity DVT.Another 144 healthy pregnant women who underwent physical examination in the hospital dur-ing the same period were selected as the control group.Multivariate Logistic regression was used to analyze the influencing factors of lower extremity DVT in pregnant women with HDCP.The receiver operating char-acteristic(ROC)curve was drawn to analyze the predictive value of serum 25(OH)D,P-selectin and coagula-tion comprehensive index(CI)for HDCP pregnant women complicated with lower extremity DVT.Results The HDCP group had a significantly lower serum level of 25(OH)D and a significantly higher level of P-selectin than the control group(P<0.05).There were 41 patients lower extremity DVT group,and 103 patients in non-lower extremity DVT group.The serum 25(OH)D level,coagulation reaction time(R)and clot dynamic value(K)in the lower extremity DVT group were lower than those in the non-lower extremity DVT group,and the P-selectin level,α Angle,maximum clot strength(MA)and CI were higher than those in the non-lower extremity DVT group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that increased 25(OH)D level was proticitive factor for lower extremity DVT in pregnant women with HDCP,and the increased CI,stage of HDCP(eclampsia and preeclampsia)and increased P-selectin level were risk factors for lower extremity DVT in pregnant women with HDCP(P<0.05).The results of ROC curve analysis showed that the area under curve(AUC)of serum 25(OH)D,P-se-lectin,and CI combined to predict HDCP pregnant women complicated with lower extremity DVT was 0.939,which was greater than the AUC of the three alone(0.850,0.807,0.791),and the differences were statistical-ly significant(Z=2.141,3.248,3.589,P<0.05).Conclusion The decrease of serum 25(OH)D level and the increase of P-selectin level in pregnant women with HDCP are related to the development of lower extremity DVT.The combined detection of serum 25(OH)D,P-selectin and CI has a high predictive value for the devel-opment of lower extremity DVT in pregnant women with HDCP.关键词
妊娠期高血压疾病/下肢/深静脉血栓形成/血栓弹力图/25-羟基维生素D/P-选择素/预测价值Key words
hypertensive disorder complicating pregnancy/lower limbs/deep venous thrombosis/thromboelastography/25-hydroxyvitamin D/P-selectin/predictive value分类
医药卫生
