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华西医学  2013 

弥散性血管内凝血诊断评分标准在产科的应用评价

DOI: 10.7507/1002-0179.20130591, PP. 1872-1876

Keywords: 弥散性血管内凝血,诊断标准,评价,孕产期

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Abstract:

目的 采用已有的4种国际非孕弥散性血管内凝血(DIC)诊断评分标准对产科DIC的诊断进行评估,探索更适合产科DIC诊断的“金标准”。方法 选择2009年6月-2012年6月期间产科拟诊DIC的孕产妇为研究对象,用日本卫生福利部(JMHW)提出的JMHW、日本危重病协会(JAAM)提出的JAAM、国际血栓与止血委员会(ISTH)提出的ISTH显性和ISTH非显性4种诊断评分标准联合诊断和构建“金标准”,以此评价4种诊断标准对产科DIC诊断的特性。结果 受试者工作特征(ROC)曲线分析显示ISTH非显性标准、ISTH显性标准、JMHW、JAAM的ROC曲线下面积分别为0.939、0.865、0.867、0.867,ISTH非显性标准灵敏度和特异度与“金标准”在不同诊断界值时较一致,同时优于其他3种诊断标准。结论 ISTH非显性标准较适合作为临床产科DIC诊断,其对产科这一特殊发病人群的DIC诊断具有更科学的临床诊断价值。

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