doi:10.3969/j.issn.1673-8640.2026.03.010

Abstract

CLC Number:

R446.11

Figures/Tables 7

References 22

[1]	SEKIYA A, HAYASHI T, KADOHIRA Y, et al. Thrombosis prediction based on reference ranges of coagulation-related markers in different stages of pregnancy[J]. Clin Appl Thromb Hemost, 2017, 23(7):844-850. DOI URL
[2]	SZECSI P B, JØRGENSEN M, KLAJNBARD A, et al. Haemostatic reference intervals in pregnancy[J]. Thromb Haemost, 2010, 103(4):718-727. DOI URL
[3]	中华医学会妇产科学分会产科学组. 妊娠期及产褥期静脉血栓栓塞症预防和诊治专家共识[J]. 中华妇产科杂志, 2021, 56(4):236-243.
[4]	TOWNSLEY D M. Hematologic complications of pregnancy[J]. Semin Hematol, 2013, 50(3):222-231. DOI PMID
[5]	KOVAC M, MIKOVIC Z, RAKICEVIC L, et al. The use of D-dimer with new cutoff can be useful in diagnosis of venous thromboembolism in pregnancy[J]. Eur J Obstet Gynecol Reprod Biol, 2010, 148(1):27-30. DOI PMID
[6]	蔡眉, 沈虹, 唐振华. 上海地区孕晚期血浆D-二聚体参考范围的建立及其预测产后出血的意义[J]. 诊断学理论与实践, 2015(2):126-130.
[7]	HEDENGRAN K K, ANDERSEN M R, STENDER S, et al. Large D-dimer fluctuation in normal pregnancy:a longitudinal cohort study of 4 117 samples from 714 healthy Danish women[J]. Obstet Gynecol Int, 2016, 2016:3561675.
[8]	FU M, LIU J, XING J, et al. Reference intervals for coagulation parameters in non-pregnant and pregnant women[J]. Sci Rep, 2022, 12(1):1519. DOI PMID
[9]	CUI C, YANG S, ZHANG J, et al. Trimester-specific coagulation and anticoagulation reference intervals for healthy pregnancy[J]. Thromb Res, 2017, 156:82-86. DOI PMID
[10]	SUEMITSU C, FUDABA M, KITADA K, et al. Changes of coagulation and fibrinolytic status detected by thromboelastography(TEG6s)in pregnancy,labor,early postpartum,postpartum hemorrhage and heparin treatment for perinatal venous thrombosis[J]. Healthcare(Basel), 2022, 10(10):2060.
[11]	HUISMAN M V, KLOK F A. Diagnostic management of acute deep vein thrombosis and pulmonary embolism[J]. J Thromb Haemost, 2013, 11(3):412-422. DOI PMID
[12]	PULIVARTHI S, GURRAM M K. Effectiveness of D-dimer as a screening test for venous thromboembolism:an update[J]. N Am J Med Sci, 2014, 6(10):491-499. DOI URL
[13]	GROSSMAN K B, ARYA R, PEIXOTO A B, et al. Maternal and pregnancy characteristics affect plasma fibrin monomer complexes and D-dimer reference ranges for venousthromboembolism in pregnancy[J]. Am J Obstet Gynecol, 2016, 215(4):466.e1-e8.
[14]	KARA H, BAYIR A, DEGIRMENCI S, et al. D-dimer and D-dimer/fibrinogen ratio in predicting pulmonary embolism in patients evaluated in a hospital emergency department[J]. Acta Clin Belg, 2014, 69(4):240-245. DOI PMID
[15]	GONG C, JIANG H, SU Y, et al. Changes in fibrinogen and D-dimer during complicated and uncomplicated pregnancy[J]. Int J Lab Hematol, 2025, 47(1):156-165. DOI PMID
[16]	HAJSADEGHI S, KERMAN S R, KHOJANDI M, et al. Accuracy of D-dimer:fibrinogen ratio to diagnose pulmonary thromboembolism in patients admitted to intensive care units[J]. Cardiovasc J Afr, 2012, 23(8):446-456. DOI PMID
[17]	ZHOU W, QU C, LIU X, et al. Diagnostic value of D-dimer to fibrinogen ratio for pulmonary embolism in postpartum women[J]. BMC Pregnancy Childbirth, 2024, 24(1):482. DOI
[18]	王霞红, 朱玉婷, 徐先明. 血栓弹力图在产科应用的研究进展[J]. 上海医学, 2022, 45(11):801-804.
[19]	杜小雨, 李辉, 贺小红, 等. 抗凝血酶Ⅲ、蛋白C、蛋白S结合血栓弹力图参数在妊娠晚期孕妇凝血功能状态评估中的应用[J]. 中国实用医刊, 2024, 51(21):73-77.
[20]	GALAMBOSI P J, GISSLER M, KAAJA R J, et al. Incidence and risk factors of venous thromboembolism during postpartum period:a population-based cohort-study[J]. Acta Obstet Gynecol Scand, 2017, 96(7):852-861. DOI URL
[21]	ZHOU Z H, CHEN Y, ZHAO B H, et al. Early postpartum venous thromboembolism:risk factors and predictive index[J]. Clin Appl Thromb Hemost, 2019, 25:1076029618818777. DOI URL
[22]	MAHMOUD A, SANDBLAD K G, LUNDBERG C E, et al. Prepregnancy overweight and obesity and long-term risk of venous thromboembolism in women[J]. Sci Rep, 2023, 13(1):14597. DOI

组别	例数	Fib/（g·L^-1）	DD/（mg·L^-1）	FDP/（mg·L^-1）	PLT计数/（×10⁹L^-1）
对照组	147	0.61（0.16~1.11）	0.88（0.46~2.20）	3.21（1.33~7.19）	-14.0（-59.5~26.0）
高危组	113	0.28（-0.14~0.80）^*	1.42（0.64~4.10）^*	4.29（1.88~12.76）^*	-31.0（-56.5~11.5）^*
VTE组	85	0.26（-0.10~0.63）^*	1.58（0.73~3.45）^*	4.38（2.45~10.67）^*	-22.0（-51.0~-6.0）
统计值		16.505	13.201	10.509	8.208
P值		<0.001	0.001	0.005	0.017

组别	例数	Fib/（g·L^-1）	DD/（mg·L^-1）	FDP/（mg·L^-1）	PLT计数/（×10⁹L^-1）
对照组	147	0.61（0.16~1.11）	0.88（0.46~2.20）	3.21（1.33~7.19）	-14.0（-59.5~26.0）
高危组	113	0.28（-0.14~0.80）^*	1.42（0.64~4.10）^*	4.29（1.88~12.76）^*	-31.0（-56.5~11.5）^*
VTE组	85	0.26（-0.10~0.63）^*	1.58（0.73~3.45）^*	4.38（2.45~10.67）^*	-22.0（-51.0~-6.0）
统计值		16.505	13.201	10.509	8.208
P值		<0.001	0.001	0.005	0.017

指标	β值	标准误	Wald值	P值	OR^①值（95%CI^②）
年龄	0.214	0.043	24.932	<0.001	1.238（1.139~1.347）
孕前BMI	0.281	0.061	21.148	<0.001	1.325（1.175~1.494）
分娩方式	1.702	0.318	28.555	<0.001	5.484（2.938~10.237）
产后出血量	<0.001	0.001	0.623	0.430	1.000（0.999~1.001）
新生儿体重	0.001	0.001	3.857	0.064	1.001（1.000~1.001）
高危因素	1.448	0.297	23.768	<0.001	4.256（2.378~7.619）
孕早期Fib	0.562	0.235	5.720	0.017	1.754（1.107~2.781）
孕早期PLT计数	0.008	0.003	7.850	0.005	1.008（1.002~1.014）
孕晚期Fib	-0.466	0.203	5.303	0.021	0.627（0.422~0.933）
孕晚期DD	0.277	0.074	13.975	<0.001	1.319（1.141~1.526）
孕晚期FDP	0.079	0.024	10.795	0.001	1.082（1.032~1.134）
孕晚期DRF	0.933	0.263	12.622	<0.001	2.542（1.519~4.253）
R	-0.720	0.173	17.421	<0.001	0.487（0.347~0.683）
K	-1.311	0.482	7.386	0.007	0.270（0.105~0.694）
α角	0.137	0.039	12.005	0.001	1.146（1.061~1.238）
MA	0.152	0.028	29.887	<0.001	1.165（1.103~1.230）
EPL	-0.099	0.280	0.126	0.723	0.906（0.524~1.567）
CI	0.689	0.130	27.978	<0.001	1.992（1.654~2.571）
孕期Fib差值	-0.815	0.207	15.439	<0.001	0.443（0.295~0.665）
孕期DD差值	0.279	0.077	12.997	<0.001	1.322（1.136~1.539）
孕期FDP差值	0.079	0.025	10.390	0.001	1.083（1.032~1.136）
孕期PLT计数差值	-0.004	0.003	1.991	0.158	0.996（0.991~1.001）

指标	β值	标准误	Wald值	P值	OR^①值（95%CI^②）
年龄	0.214	0.043	24.932	<0.001	1.238（1.139~1.347）
孕前BMI	0.281	0.061	21.148	<0.001	1.325（1.175~1.494）
分娩方式	1.702	0.318	28.555	<0.001	5.484（2.938~10.237）
产后出血量	<0.001	0.001	0.623	0.430	1.000（0.999~1.001）
新生儿体重	0.001	0.001	3.857	0.064	1.001（1.000~1.001）
高危因素	1.448	0.297	23.768	<0.001	4.256（2.378~7.619）
孕早期Fib	0.562	0.235	5.720	0.017	1.754（1.107~2.781）
孕早期PLT计数	0.008	0.003	7.850	0.005	1.008（1.002~1.014）
孕晚期Fib	-0.466	0.203	5.303	0.021	0.627（0.422~0.933）
孕晚期DD	0.277	0.074	13.975	<0.001	1.319（1.141~1.526）
孕晚期FDP	0.079	0.024	10.795	0.001	1.082（1.032~1.134）
孕晚期DRF	0.933	0.263	12.622	<0.001	2.542（1.519~4.253）
R	-0.720	0.173	17.421	<0.001	0.487（0.347~0.683）
K	-1.311	0.482	7.386	0.007	0.270（0.105~0.694）
α角	0.137	0.039	12.005	0.001	1.146（1.061~1.238）
MA	0.152	0.028	29.887	<0.001	1.165（1.103~1.230）
EPL	-0.099	0.280	0.126	0.723	0.906（0.524~1.567）
CI	0.689	0.130	27.978	<0.001	1.992（1.654~2.571）
孕期Fib差值	-0.815	0.207	15.439	<0.001	0.443（0.295~0.665）
孕期DD差值	0.279	0.077	12.997	<0.001	1.322（1.136~1.539）
孕期FDP差值	0.079	0.025	10.390	0.001	1.083（1.032~1.136）
孕期PLT计数差值	-0.004	0.003	1.991	0.158	0.996（0.991~1.001）

指标	β值	标准误	Wald值	P值	OR值（95%CI）
年龄	0.216	0.092	5.515	0.019	1.242（1.036~1.488）
分娩方式	2.384	0.758	9.897	0.002	10.844（2.456~47.881）
高危因素	3.097	0.885	12.253	<0.001	22.136（3.908~125.391）
孕前BMI	0.593	0.153	15.039	<0.001	1.810（1.341~2.443）
孕早期PLT计数	0.008	0.007	1.309	0.253	1.008（0.994~1.022）
孕晚期DD	0.191	0.167	1.305	0.253	1.210（0.872~1.680）
孕晚期FDP	0.340	0.446	0.583	0.445	1.405（0.587~3.365）
孕晚期DFR	0.791	0.273	8.374	0.004	2.206（1.291~3.769）
R	-2.572	0.693	13.773	<0.001	0.076（0.020~0.297）
K	-2.612	1.930	1.831	0.176	0.073（0.002~3.226）
α角	0.054	0.184	0.086	0.769	1.055（0.736~1.514）
MA	0.596	0.148	16.270	<0.001	1.815（1.359~2.426）
CI	0.155	0.062	6.287	0.012	1.168（1.035~1.319）
孕期Fib差值	-1.271	0.656	3.761	0.052	0.280（0.078~1.014）
孕期DD差值	0.077	0.157	0.243	0.622	1.080（0.794~1.470）
孕期FDP差值	0.039	0.049	0.634	0.426	1.039（0.945~1.143）

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 7

References 22

Related Articles 15

Recommended Articles

Metrics

变量名称	变量状态（高风险）	得分	原始β值	∣β∣	权重（∣β∣/总和）
年龄	>30.5岁	1	-0.181	0.181	0.025
孕前BMI	>21.4 kg·m^-2	1	-0.380	0.380	0.052
分娩方式	剖宫产	1	1.955	1.955	0.268
高危因素	有	1	1.622	1.622	0.223
R	<4.45 min	1	2.076	2.076	0.285
MA	>63.65 mm	1	-0.372	0.372	0.051
CI	>2.35	1	1.397	1.397	0.192
孕晚期DFR	>0.46	1	-1.745	1.745	0.239

指标	AUC（95%CI）	最佳临界值	敏感性/%	特异性/%	约登指数
分娩方式	0.651（0.571~0.730）	剖宫产	0.792	0.519	0.311
年龄	0.753（0.680~0.826）	30.5岁	0.714	0.648	0.362
孕前BMI	0.688（0.608~0.768）	21.4 kg·m^-2	0.701	0.648	0.349
高危因素	0.780（0.608~0.851）	有	0.727	0.833	0.560
孕晚期DFR	0.687（0.608~0.767）	0.46	0.610	0.769	0.379
R	0.709（0.634~0.785）	4.45 min	0.701	0.648	0.349
MA	0.750（0.681~0.820）	63.65 mm	0.805	0.565	0.373
CI	0.738（0.665~0.811）	2.35	0.727	0.639	0.366
VTE风险评分方程	0.950（0.923~0.977）		0.889	0.935	0.824

[1]	ZHOU Chaoqiong, CHEN Ting, KONG Lirui, MA Chunyu. Clinical role of gene mutation types and MCV，MCH levels in patients with thalassemia in Pidu District of Chengdu City [J]. Laboratory Medicine, 2026, 41(1): 52-57.
[2]	WANG Bing, YANG Yuwei, LIU Junmei, LI Yanqiu, PENG Bi. Application of reticulocyte hemoglobin content in diagnosing thalassemia in children [J]. Laboratory Medicine, 2026, 41(1): 47-51.
[3]	WU Zhuolin, YUAN Junwei, ZHANG Ziqi, LIU Yu, XU Guanqun, WANG Xuefeng, LU Yeling. Role of vWF/ADAMTS13 ratio and vWF function in progression of immunoglobulin A nephropathy [J]. Laboratory Medicine, 2026, 41(1): 1-7.
[4]	LI Li, SHI Huaying, Zaxiyangzong , Dawazhuoma , CHEN Yanmei, YANG Chunjiao, WEN Honglin. Application of indirect method in establishing reference range of adult blood lipids in Lhasa [J]. Laboratory Medicine, 2025, 40(11): 1064-1069.
[5]	SHEN Zhiying, CHEN Ming, DONG Yueying. Correlation between serum Hcy，S100B levels and cerebral metabolite indicators and cognitive impairment in elderly AIS patients [J]. Laboratory Medicine, 2025, 40(11): 1097-1101.
[6]	CHEN Wenli, JIN Cheng, ZHOU Lulu, XU Weiyi. Role of MicroR in guiding platelet count re-examination [J]. Laboratory Medicine, 2025, 40(9): 897-900.
[7]	WANG Qiuju, XIAO Huijian, WU Shuang, ZHAO Wanting, DAI Xubo, ZHUANG Yuepeng. Role of peripheral blood lymphocyte morphological classification in curative effect judgment of critical influenza [J]. Laboratory Medicine, 2025, 40(9): 901-906.
[8]	ZHANG Hui, YUAN Jingwen, ZHANG Chi. Adult reference ranges for platelet count and platelet-related parameters using fluorescence method in Wuhan [J]. Laboratory Medicine, 2025, 40(9): 892-896.
[9]	SHI Shaoxin, CHEN Xueting, XU Xiaofeng, LU Renquan, GUO Lin, ZHUANG Yihui. Role of coagulation function in bacterial bloodstream infection among malignant tumor patients [J]. Laboratory Medicine, 2025, 40(8): 804-809.
[10]	JIANG Fengying, JIANG Yun, MI Rui, QIAN Ximing, WANG Qiubo. Changes of platelet and coagulation function indicators in elderly patients with diabetic foot ulcers [J]. Laboratory Medicine, 2025, 40(7): 708-712.
[11]	YAO Lifeng, ZHANG Ling. Research progress on clinical significance of monocyte distribution width in infection and inflammatory diseases [J]. Laboratory Medicine, 2025, 40(5): 503-507.
[12]	DAI Jingwen, YANG Shuo, WANG Chong, SUN Lin, GU Meixiu, XIAN Jingrong, PAN Baishen, WANG Beili, ZHANG Chunyan, GUO Wei. Role of preoperative mean corpuscular hemoglobin concentration for predicting postoperative recurrence in intrahepatic cholangiocarcinoma patients [J]. Laboratory Medicine, 2025, 40(4): 344-349.
[13]	ZHANG Haoyang, LU Lin, ZONG Ming, HE Long, DING Yuanyuan, FAN Lieying. Diagnostic and predictive value of white blood cell population data in patients with sepsis [J]. Laboratory Medicine, 2025, 40(3): 271-277.
[14]	ZHOU Jiakuan, GUO Ping, CAI Qi, YANG Mingkang, HUANG Zhixi, XUE Yilun, HUA Renxiang, LIN Han, LI Jiaming, WANG Jianbiao. Molecular epidemiological analysis of patients with increased stomatocytes and giant platelets in peripheral blood [J]. Laboratory Medicine, 2025, 40(2): 171-177.
[15]	WANG Chengyun, GU Ping, PAN Qiuhui, WANG Jing. Changes and clinical value of blood coagulation indexes in children with infection [J]. Laboratory Medicine, 2025, 40(2): 178-181.