胎儿凝血因子活性及凝血功能初探  

Study on the coagulation factor activity of fetuses

作　　者：林琳华[1] 霍梅[1] 袁红[1] 姚秋璇[1] 曾彩兰[1] 任景慧[1] 

机构地区：[1]暨南大学医学院第二附属医院,518020

出　　处：《中国妇幼保健》2004年第3期47-48,共2页Maternal and Child Health Care of China

基　　金：深圳市科技局立项课题 (课题号 2 0 0 2 0 4 0 2 8)

摘　　要：目的 :初步探讨胎儿血液凝血因子 、 、 (F 、F 、F )的活性及活化部分凝血活酶时间 (APTT) ,评估上述指标作为血友病患儿产前诊断指标的可行性。方法 :检测 12 9例无血友病家族史的胎儿脐带血 F 、F 、F 的活性 ,其中 60例同时测定 APTT,分析胎儿 3种凝血因子活性及其与胎龄的相关关系。结果 :1妊娠中晚期胎儿的凝血因子活性为 F 45.83 %± 13 .2 8% (95% CI43 .42 %～ 48.2 4% )、 F 10 .51%± 6.0 2 % (95% CI9.42 %～ 11.61% )、 F 2 0 .82 %± 13 .82 % (95%CI18.3 1%～ 2 3 .3 3 % )。 2 F 、 F 、 F 的活性均与胎龄呈正相关关系 ,r分别为 0 .3 2 0、 0 .458、 0 .3 54,P值均为 0 .0 0 0。 3妊娠中晚期胎儿的 APTT为 57.77s± 19.65s (95% CI52 .69s～ 62 .84s)。结论 :妊娠中晚期的正常胎儿 F 活性已达 3 0 %以上 ,取脐带血测定 F 的活性是产前筛查血友病甲的可行性手段 ;正常胎儿 APTT比正常成人延长 2 0 s以上 ,F 和 F 的活性仅达正常成人的 10 %和 2 0 % ,脐带血 F 、 F 的活性及Objective: To determine the coagulation factor Ⅷ,Ⅸ,Ⅺ (FⅧ, FⅨ, FⅪ) activity and activated partial thromboplastin time (APTT) of healthy fetus and study the value of these parameters screening hemophilia Methods: The umbilical cord blood of 129 fetuses between 21 and 35 weeks of gestat ional age was collected by cordocentesis The coagulation FⅧ, FⅨ and FⅪ act ivity were determined APTT of 60 fetuses were analyzed The relationship betw een the c oagulation factor activity and fetal age was studied Results: ① The activities of FⅧ , FⅨ and FⅪ were 45 83%±13 28%(95% confidence intervals (CI) 4 3 42%~48 24%), 10 51%±6 02%(95% CI 9 42%~11 61%)and 20 82%±13 82%(95 %CI 18 31%~23 33%)respectively ② There was positive correlation between the ac tivit y of FⅧ, FⅨ, FⅪ and the fetal ages The correlation coefficient values were 0 320, 0 458 and 0 354 respectively (P = 0 000) ③ The APTT was 57 77±1 9 65 seconds(95%CI 52 69 ~ 62 84 seconds) Conclusion: The 95% confi dence interval lower bound of FⅧ of normal fetuses at the second and third tri mester of gestation was higher than 30% Determination of FⅧ activity of umbi l ical cord blood could help screen hemophilia A The APTT of normal fetuses wa s 20 seconds longer than that of normal adults The activity of FⅨ and FⅪ we re 10% an d 20% of normal adults respectively Further study of significance of FⅨ, FⅪ and APTT in diagnosing hemophilia was needed

关 键 词：凝血因子 胎儿 凝血功能 

分 类 号：R714[医药卫生—妇产科学]