抗心磷脂抗体阳性孕妇的血液动力学特点  

Characteristics of blood dynamic parameters in pregnant women with anticardiolipin antibodies and history of adversely pregnant complications

作　　者：朱付凡[1] 丁虹[2] 谭玲[1] 杨元娟[1] 刘庄云[1] 黄建良[1] 

机构地区：[1]中南大学湘雅二医院妇产科,长沙410011 [2]长沙市妇幼保健院妇产科

出　　处：《中华妇产科杂志》2005年第5期309-311,共3页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的　探讨抗心磷脂抗体(aCL)阳性孕妇的血液动力学特点。方法　选择aCL阳性孕妇272例,其中有不良孕产史(含1次及以上自然流产、死胎史)91例(A组)、无不良孕产史者181例(B组),aCL阴性且无不良孕产史孕妇186例(C组),采用金标免疫斑点法检测3组孕妇血清aCL,无创性妊娠高血压综合征(妊高征)血液动力学监测仪监测3组孕妇血液动力学参数变化。结果血液黏度A组为(4 .7±0 .5)mPa·s、B组(4. 6±0 .7)mPa·s、C组(4 .4±0 .4)mPa·s,B、C两组比较,差异有统计学意义(t=-2 157,P<0 .05);波形系数A组为0 .41±0. 04、B组为0 39±0. 05、C组为0. 39±0 .04,A、B两组比较,差异有统计学意义(P<0 .05);外周阻力A组为( 1 .3±0 .4 )mmHg·s·ml-1、B组为(1 .2±0 .4)mmHg·s·ml-1、C组为(1. 2±0. 4)mmHg·s·ml-1,A、B两组比较,差异有统计学意义(P<0 .05);心脏排血指数A组为( 43±15 )ml/(s·m2 )、B组为( 48±16 )ml/(s·m2 )、C组为(48±14)ml/(s·m2 ),A、B两组比较,差异也有统计学意义(P<0 .05)。结论　aCL阳性有不良孕产史孕妇的血液黏度、波形系数、外周阻力异常增高,心脏排血指数下降,aCL可能与自然流产、死胎等不良妊娠结局相关。Objective To study the characteristics of blood dynamic parameters in pregnant women with anticardiolipin antibody(aCL) and a history of adversely pregnant complications. Methods The study included a prospective cohort of pregnant women with(272 cases) and without(186 cases) aCL. Among the aCL positive pregnant women, 91 cases had the history of adversely pregnant complications including spontaneous abortion, still fetus. Serum antibodies to cardiolipin (CL) were measured by a specific enzyme linked immunosorbent assay. Blood dynamics parameters were measured by non-invasive cardiovascular parameters surveyor(TP-CBS).Results The women were divided into three groups: group A(91 cases)included women with both the history of adversely pregnant complications and positive aCL, group B(181 cases) with positive aCL alone and group C(186 cases) without either of them. In group A maximum blood viscosity(Vmax) was (4.7±0.5) mPa·s and in group B it was (4.6±0.7) mPa·s. Both was higher than normal.In group B the Vmax was higher(P<0.05) than in group C [(4.4±0.4) mPa·s]. The wave form coefficient(K) was different in three groups: group A was 0.41±0.04,group B was 0.39±0.05 and group C was 0.39±0.04.In group A their wave form coefficient was higher than in group B (P<0.05).Their total peripheral resistance (TPR) was higher(P<0.05) in group A [(1.3±0.4) mm Hg· s·ml -1] than in group B[(1.2±0.4) mm Hg·s·ml -1]. The cardiac index(CI) was in group A[(43±15)ml/(s·m 2)],in group B[(48±16) ml/(s·m 2)] and in group C[(48±14) ml/(s·m 2)], lower in group A than in group B(P<0.05) . Conclusions An important change of blood dynamic parameters of pregnant women with aCL is the increase of Vmax. If Vmax, K and TPR were increased and CI was decreased simultaneously in women with aCL, it would result in more chances of adversely pregnant complications. Measuring the blood dynamics parameters will help us discover the sub-clinical hypercoagulable state of patients with aCL and guide us to treat them promptly, so

关 键 词：抗心磷脂抗体阳性 力学特点 妊娠高血压综合征(妊高征) 不良孕产史 金标免疫斑点法 血液动力学 不良妊娠结局 自然流产 血液黏度 外周阻力 aCL 统计学 孕妇血清 参数变化 0.05 异常增高 B组 C组 监测仪 无创性 死胎 波形 

分 类 号：R714.2[医药卫生—妇产科学]