复发性流产患者中血栓前状态指标检测的意义  

Clinical Significance of Detection of Prethrombotic State Indicators in Patients with Recurrent Spontaneous Abortion

作　　者：刘丹[1] 伍曼玉 黄新颜[1] 叶淑婷[1] 金晶晶 LIU Dan;WU Manyu;HUANG Xinyan(Department of Women′s Health Care,Affiliated Foshan Maternity&Child Healthcare Hospital,Southern Medical University,Guangdong 528000,China)

机构地区：[1]南方医科大学附属佛山市妇幼保健院妇女保健科,528000

出　　处：《医学研究杂志》2022年第1期107-111,共5页Journal of Medical Research

基　　金：广东省佛山市科技局医学类科技攻关项目(1920001000395)。

摘　　要：目的探讨血栓前状态(prethrombotic state,PTS)指标在复发性流产(recurrent spontaneous abortion,RSA)患者中检测的价值及临床意义。方法随机选取2019年9月~2021年5月在佛山市妇幼保健院门诊就诊的RSA患者100例作为研究组(RSA组),并取同期笔者医院体检中心健康体检者100例作为正常对照组(对照组)。同时对两组研究对象进行目前临床上常用的12个PTS指标AT-Ⅲ、PC、PS、D-D、Fib、FDP、Hcy以及aPLs(LA、anti-β2GPⅠAb IgG/IgM和ACAIgG/IgM)水平的检测,并记录其年龄和自然流产次数。比较两组研究对象之间及不同流产次数的RSA患者之间各指标的差异。结果RSA组和对照组以及流产2次组和流产≥3次组比较,AT-Ⅲ、PC、PS、D-D、Fib、FDP和Hcy差异均无统计学意义(P>0.05);RSA组LA、anti-β2GPⅠAb IgG/IgM、ACA IgG/IgM的阳性率均高于对照组,差异均有统计学意义(P<0.05);流产≥3次组LA、anti-β2GPⅠAb IgG/IgM和ACA IgG的阳性率均高于流产2次组,但其差异均无统计学意义(P>0.05)。结论aPLs阳性与RSA的关系密切,流产2次与流产≥3次者之间比较,差异无统计学意义,对于连续发生流产2次及以上的女性,孕前行aPLs的筛查对RSA具有重要临床指导意义,其余PTS指标用于RSA的预测仍缺乏足够的证据。Objective To investigate the diagnostic value and clinical significance of prethrombotic state(PTS)indicators in patients with recurrent spontaneous abortion(RSA).Methods From September 2019 to May 2021,100 patients diagnosed with RSA in Foshan Maternity&Child Healthcare Hospitalwere randomly selected as the study group(RSA group),and 100 healthy patients undergoing physical examination in the physical examination center of our hospital during the same period were selected as the normal control group(control group).The levels of AT-Ⅲ,PC,PS,D-D,Fib,FDP,Hcy and aPLs(LA,anti-β2GPⅠAb IgG/IgM and ACA IgG/IgM),and the twelve commonly used PTS indicators in the clinical were detected.Information about age and number of spontaneous abortions were collected from medical records.Results There were no significant differences in AT-Ⅲ,PC,PS,D-D,FIB,FDP and Hcy between RSA group and control group,two abortion group and three or more abortion group(P>0.05).The positive percentages of LA,anti-β2GPⅠAb IgG/IgM,ACA IgG/IgM in RSA group were higher than those in control group(P<0.05).The positive percentages of LA,anti-β2GPⅠAb IgG,anti-β2GPⅠAb IgM and ACA IgG in three or more abortion group were higher than those in two abortion group,but there was no statistically significant difference between the two groups(P>0.05).Conclusion There was a close relationship between positive aPLs and RSA,and no difference between different times of abortion.For women with two or more con-secutive spontaneous abortions,screening aPLs before pregnancy had important clinical significance for RSA.There was still insufficient evidence that the remaining PTS indicators were used to predict RSA.

关 键 词：复发性流产 血栓前状态 抗磷脂抗体 

分 类 号：R711.3[医药卫生—妇产科学]