反复早期自然流产妇女血浆蛋白Z检测的意义  

Clinical Significance of Plasma Protein Z in Patients with Recurrent Early Spontaneous Abortion

作　　者：郝艳华[1] 江丽丽[1] 秦惠琳[1] 刘香萍[1] 姚吉龙[2] 

机构地区：[1]南方医科大学附属深圳宝安医院,深圳518101 [2]深圳市妇幼保健院,深圳518001

出　　处：《热带医学杂志》2010年第7期827-829,共3页Journal of Tropical Medicine

基　　金：深圳市科技和信息局资助项目(No.200703004)

摘　　要：目的探讨反复早期自然流产妇女血浆蛋白Z(PZ)检测的意义。方法分别测定26例反复早期自然流产患者和30例相同孕周的正常妊娠妇女血浆PZ和纤维蛋白原(Fg)水平以及凝血酶原时间(PT)和活化的部分凝血活酶时间(APTT),采用单因素方差分析和非参数检验比较两组之间各项指标水平的差异。结果反复早期自然流产组PT、APTT、Fg水平与正常妊娠组相比差异无统计学意义(P>0.05),但反复早期自然流产组血浆PZ平均水平显著低于正常妊娠组[(1.55±0.63)mg/Lvs(1.90±0.60)mg/L,F=4.57,P=0.037],且其血浆PZ中位水平(1.45mg/L,范围:0.62～3.25mg/L)也显著性低于正常妊娠组(1.74mg/L,范围:0.78～3.36mg/L)(χ2=5.485,P=0.019);以PZ<0.90mg/L作为PZ缺乏的标准,反复早期自然流产组有4例(15.4%)、正常妊娠组有1例(3.3%)血浆PZ缺乏,但二者差异无统计学意义(χ2=2.49,P=0.115)。结论反复早期自然流产患者常规凝血指标和PZ缺乏率与正常对照组无差异,但其血浆中抑制因子Ⅹa活性的PZ水平较低,表明其发病可能与低PZ水平有一定的关系。Objective To explore the clinical significance of plasma protein Z（PZ）in patients with recurrent early spontaneous abortion.Methods The levels of plasma PZ and fibrinogen（Fg）,prothrombin time（PT）and activated partial thromboplastin time（APTT）from 30 normal pregnant women（NP）and 26 patients with recurrent early spontaneous were measured.Patients with maternal plasma concentration of ≤0.90 mg /L was defined as PZ deficiency.One-way analysis of variance method（ANOVA）and non-parametric statistics were used for analysis.Results Significant difference was not found in the levels of Fg,PT and APTT between the RESA and NP group（P〉0.05）.Patients with RESA had a lower level of plasma PZ than NP [（1.55±0.63）mg /L vs.（1.90±0.60）mg /L,F=4.57,P=0.037],and the median PZ level in RESA was also lower than that in NP（RESA：median 1.45 mg /L,range 0.62～3.25 mg /L;NP：median 1.74 mg /L,range 0.78～3.36 mg /L;χ^2=5.485,P=0.019）.One woman with NP had a lower PZ level（3.3%）,compared with the 4 patients with RESA（15.4%）,the frequency of decreased PZ was not significantly difference between the two groups（χ^=22.49,P=0.115）.Conclusion The levels of routine blood coagulation tests and the rate of decreased PZ were not significantly difference between patients with RESA and NP.Patients with RESA had a significantly lower level of plasma PZ,which serves as a cofactor for the inactivation of factor Xa.Low level of PZ may be associated with the pathogenesis etiology of RESA.

关 键 词：反复早期自然流产 蛋白Z 凝血 

分 类 号：R714.21[医药卫生—妇产科学]