【摘要】 目的 探讨具有多囊卵巢综合征（PCOS）病史的复发性流产（RSA）患者早孕期血栓弹力图（TEG）的差异性。方法 选取2021年1月至12月江西省妇幼保健院治疗的60例具有PCOS病史的RSA孕妇为研究对象，将其设为观察组，选取同时期无PCOS病史的60例RSA孕妇为对照组，并将观察组与对照组均纳入RSA组；选取同时期于江西省妇幼保健院建立生产档案的60例健康孕妇为健康对照组。观察各组孕妇的TEG检测5项参数[K值、R值、MA值、α角、凝血综合指数（CI）]，绘制ROC曲线分析TEG参数对RSA的评估价值，采用Spearman秩相关分析探讨RSA患者PCOS病史与TEG参数的关系。结果 RSA组的R值、K值均短于健康对照组，α角、MA值、CI均大于健康对照组，差异有统计学意义（P<0.05）。绘制ROC曲线结果显示，R值、K值、α角、MA值、CI评估RSA的AUC分别为0.999、0.945、0.791、0.798、0.941，均具有一定的价值。观察组和对照组的R值、K值均短于健康对照组，α角、MA值、CI均大于健康对照组，差异有统计学意义（P<0.05）。观察组的MA值大于对照组，差异有统计学意义（P<0.05）；观察组和对照组的R值、K值、α角、CI比较，差异无统计学意义（P>0.05）。Spearman秩相关分析结果显示，RSA患者PCOS病史与TEG参数中的MA值呈正相关（r=0.235,P<0.05），与R值、K值、α角、CI无关（P>0.05）。结论 具有PCOS病史的RSA患者早孕期的TEG参数表现出明显的高凝状态，其中MA值受到PCOS病史的显著影响。PCOS病史可能是RSA患者血栓形成风险的一个重要因素。更多还原

【Abstract】 Objective To explore the difference of thromboelastography(TEG) in the first trimester of recurrent spontaneous abortion(RSA) patients with polycystic ovary syndrome(PCOS) history. Methods A total of 60 RSA pregnant women with a history of PCOS who were treated in Jiangxi Maternal and Child Health Hospital from January to December 2021 were selected as the research objects, and they were set as the observation group. At the same time, 60 RSA pregnant women without a history of PCOS were selected as the control group, and the observation group and the control group were included in the RSA group. A total of 60 healthy pregnant women who established childbirth records in Jiangxi Maternal and Child Health Hospital during the same period were selected as the healthy control group. Five parameters of TEG(K value, R value, MA value, α angle, coagulation index [CI]) in each group were observed. ROC curve was drawn to analyze the value of TEG parameters in the evaluation of RSA. Spearman rank correlation analysis was used to explore the relationship between the history of PCOS and TEG parameters in RSA patients. Results The R value and K value of the RSA group were shorter than those of the healthy control group, and the αangle, MA value and CI were higher than those of the healthy control group, and the differences were statistically significant(P<0.05). The results of ROC curve showed that the AUC of R value, K value, α angle, MA value and CI were 0.999, 0.945, 0.791, 0.798 and 0.941, respectively, which had certain value. The R value and K value of the observation group and the control group were shorter than those of the healthy control group, and the α angle, MA value and CI were higher than those of the healthy control group, and the differences were statistically significant(P<0.05). The MA value of the observation group was higher than that of the control group, and the difference was statistically significant(P<0.05).There were no statistically significant differences in R value, K value, α angle and CI between the observation group and the control group(P>0.05). Spearman rank correlation analysis showed that the history of PCOS in RSA patients was positively related to MA value in TEG parameters(r=0.235, P<0.05), but not related to R value, K value, α angle and CI(P>0.05).Conclusion TEG parameters of RSA patients with PCOS history show obvious hypercoagulable state in the first trimester,and the MA value is significantly affected by PCOS history. History of PCOS may be an important factor in the risk of thrombosis in RSA patients.更多还原