发育医学电子杂志2026，Vol.14Issue(1)：13-19,7.DOI:10.3969/j.issn.2095-5340.2026.01.003
AT-Ⅲ、D-二聚体和血小板聚集率联合维生素D在复发性流产中的预测价值
Predictive value of antithrombin-Ⅲ,D-dimer,platelet aggregation rate and vitamin D in the recurrent spontaneous abortion
摘要
Abstract
Objective To explore the predictive value of prethrombotic state markers antithrombin-Ⅲ(AT-Ⅲ),D-dimer(D-D),platelet aggregation rate,and vitamin D in patients with recurrent spontaneous abortion(RSA).Methods A prospective study was conducted in 100 patients with RSA,who visited Hengshui People's Hospital from July 2023 to July 2024,were selected as the RSA group,including 32 cases with successful pregnancy maintenance(Group A),and 68 cases with failed pregnancy maintenance(Group B).Additionally,100 healthy pregnant women with no history of miscarriage who underwent physical examination during the same period were selected as the control group.The general information of the subjects were collected,the levels of AT-Ⅲ,D-D,platelet aggregation rate and vitamin D were detected,and the diagnostic value of each indicator for miscarriage in RSA patients was evaluated.Pearson correlation analysis was used to evaluate the correlation between AT-Ⅲ,D-D,platelet aggregation rate,vitamin D and miscarriage in RSA patients.The risk factors for miscarriage in RSA patients were analyzed by univariate and multivariate Logistic regression analysis.The predictive value of the combination of AT-Ⅲ,D-D,platelet aggregation rate,and vitamin D for miscarriage in RSA patients was evaluated using receiver operating characteristic(ROC)curve.Statistical analysis was performed using t-test,Kruskal-Wallis test and χ2 test.Results The levels of D-D and platelet aggregation rate in the RSA group were higher than those in the control group[(184.12±22.87)µg/L vs(123.16±23.91)µg/L,and(82.19±25.45)%vs(55.23±20.89)%,respectively;t values were 0.142 and 3.191,all P<0.05].The levels of AT-Ⅲand vitamin D in the RSA group were lower than those in the control group[(101.82±9.11)%vs(117.91±17.21)%,(22.15±1.86)µg/L vs(36.25±3.87)µg/L,respectively;t values were 7.241 and 4.522,all P<0.05].The levels of D-D and platelet aggregation rate in Group A were lower than those in the Group B[(152.24±28.34)µg/L vs(192.42±25.93)µg/L,(63.21±21.49)%vs(83.22±23.82)%;t values were 0.942 and 2.931,respectively,all P<0.05].The levels of AT-Ⅲ and vitamin D in Group A were higher than those in the Group B[(112.42±8.27)%vs(94.25±9.29)%,(26.51±1.32)µg/L vs(21.22±1.82)µg/L;t values were 2.142 and 1.423,respectively,all P<0.05].The results of multivariate Logistic regression analysis showed that AT-Ⅲ,D-D,platelet aggregation rate,and vitamin D were the risk factors for miscarriage in RSA patients(all P<0.05).The results of Pearson correlation analysis showed that D-D levels and platelet aggregation rate were significantly positively correlated with miscarriage in RSA patients(r values were 0.742 and 0.821,respectively,all P<0.05),while the levels of AT-Ⅲ and vitamin D were significantly negatively correlated with miscarriage in RSA patients(r values were-0.842 and-0.572,respectively,all P<0.05).The results of ROC curve analysis showed that AT-Ⅲ,D-D,platelet aggregation rate,and vitamin D levels had independent predictive value for miscarriage in RSA patients,especially when used in combination of four indicators(the area under the curve was 0.923,95%CI:0.881-0.965,P<0.001).Conclusion AT-Ⅲ,D-D,platelet aggregation rate,and vitamin D levels all provide strong support for miscarriage risk assessment in RSA patients,and the combined application of these indicators can further improve predictive accuracy.关键词
复发性流产/抗凝血酶-Ⅲ/D-二聚体/血小板聚集率/维生素DKey words
Recurrent spontaneous abortion/Antithrombin-Ⅲ/D-dimer/Platelet aggregation rate/Vitamin D引用本文复制引用
王娇,李素叶,焦艳,王磊,崔家璐,冀雪霞,张聪祎..AT-Ⅲ、D-二聚体和血小板聚集率联合维生素D在复发性流产中的预测价值[J].发育医学电子杂志,2026,14(1):13-19,7.基金项目
衡水市2023年度科技计划(2023014072Z) （2023014072Z）
