活化蛋白C抵抗与反复妊娠丢失相关性  

Study on the association of activated protein C resistance and recurrent pregnancy loss

作　　者：周玉琦[1] 任景芳[1] 郝敏[1] 杨林花[1] 屈秦红[1] 

机构地区：[1]山西医科大学第二医院,山西太原030001

出　　处：《中国妇幼保健》2010年第26期3763-3766,共4页Maternal and Child Health Care of China

摘　　要：目的:探讨凝血因子V Leiden(FVL)突变、活化蛋白C抵抗(APCR)和抗磷脂抗体(APL)与不明原因反复妊娠丢失的相关性及反复妊娠丢失的高危因素。方法:选择不明原因的妊娠丢失患者71例,正常健康有生育史者60例作为对照组,除外有血栓病史和口服避孕药者。研究组及对照组均检测FVL突变、APCR和抗磷脂抗体。结果:①反复妊娠丢失患者及正常对照组均未见FVL突变;②妊娠丢失患者中APCR发生率为22.5%,正常对照妇女的发生率是8.3%,P<0.05;③研究组抗磷脂抗体(APL)阳性率21.1%,对照组APL阳性率6.7%,两组比较差异有统计学意义,P<0.05;胎死宫内与对照组比较P<0.001;④获得性APCR使妊娠丢失的风险增加4.2倍,而且抗磷脂抗体阳性患者中APCR发生率明显高于阴性者。结论:非FVL获得性APCR和APL是妊娠丢失的高危因素,而且APL可能是获得性APCR的原因之一。故不明原因的RPL妇女应常规筛查APL和APCR。Objective：To study the association of factor V Leiden （FVL）,antiphospholipid antibodies （APL） and activated protein C resistance （APCR） with recurrent pregnancy loss.Methods：71 cases with the history at least two or more pregnancy loss were taken as study group and 60 fertile parous women without pregnancy loss and thrombosis history were taken as control group..The marker of FVL,APCR and APL were detected in the two groups.Results：The FVL break was not found in both groups. The incidence rate of APCR was respectively 22.5 % and 8.3% in study group and control group,P〈0.05; APL（21.1%） in study group was higher than that in control group（6.7%）,P〈0.05. APL was significantly increased in people with dead fetus in uterus P〈0.0001. Acquired APCR had a 4.2-fold increased risk of pregnancy loss; Moreover,APCR was higher in women with APL than that in women without APL.Conclusion：Antiphospholipids and APCR are the risk factors of recurrent pregnancy loss. Antiphospholipids contribute to acquired APC resistance,which may be an independent risk for unexplained pregnancy loss in China.

关 键 词：FVL APCR 抗磷脂抗体 妊娠丢失 

分 类 号：R711[医药卫生—妇产科学]