复发性流产患者凝血-纤溶系统相关因子检测的临床意义  

Clinical significance of detection of coagulation and fibrinolysis factors in patients with recurrent spontaneous abortion

作　　者：倪素娜 刘静 焦思宁 NI Suna;LIU Jing;JIAO Sining(Shijiazhuang Maternity&Child Healthcare Hospital,Hebei,Shijiazhuang 050006,China)

机构地区：[1]河北省石家庄市妇幼保健院,050006

出　　处：《河北医药》2023年第10期1536-1539,共4页Hebei Medical Journal

摘　　要：目的研究复发性流产(recurrent spontaneous abortion,RSA)患者凝血-纤溶系统相关因子检测的临床意义。方法将2019年1月至2020年1月就诊的RSA患者30例设为观察1组,选取同期自愿行人工流产终止妊娠且具有2次人工流产史的女性30例设为观察2组,同时选取来院孕检的正常孕妇30例设为观察3组;采集3组患者晨起空腹肘静脉血,使用全自动血凝分析仪检测血小板(platelet blood test,PLT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶原时间(prothrombin time,PT)、D-D二聚体(D-dimer,D-D),抗凝血酶-Ⅲ(antithrombin-Ⅲ,AT-Ⅲ)水平及蛋白S(protein S,PS)、蛋白C(protein S,PC)水平;采用双抗体一步夹心法检测血浆可溶性血栓调节蛋白(soluble thrombomodulin,sTM)、可溶性内皮细胞蛋白C受体(soluble endothelial protein C receptor,sEPCR)、凝血酶活化的纤溶抑制剂(thrombin-activatable fibrinolysis inhibitor,TAFI)水平。并对比血栓弹力图(thrombelastograph,TEG)在不同组间趋势变化。结果3组外周血中D-D水平比较差异有统计学意义(P<0.05);观察1组外周血D-D水平明显高于观察2、3组,组间两两比较差异均有统计学意义(P<0.05);观察2、3组间外周血D-D水平比较差异无统计学意义(P>0.05);观察1、2组患者PS、PC水平低于观察3组(P<0.05),观察1组PS、PC水平低于观察2组(P<0.05);3组间血浆中sTM、sEPCR水平比较差异有统计学意义(P<0.05),血浆TAFI水平比较差异无统计学意义(P>0.05);观察1组血浆中sTM、sEPCR水平均高于观察2、3组,组间两两比较差异均有统计学意义(P<0.05),观察2、3组间血浆中sTM、sEPCR水平比较差异无统计学意义(P>0.05);3组间R、K、α角及CI值对比无明显差异(P>0.05);观察1组MA值明显高于观察2、3组(P<0.05);观察2组MA值高于观察3组(P<0.05)。结论外周血D-D水平及血浆中sTM、sEPCR水平检测可做为筛查RSA患者血栓前状态(prethrombotic state,PTS)的可靠指标;RObjective To observe the effect of detection of coagulation and fibrinolysis factors in patients with recurrent spontaneous abortion(RSA).Methods Thirty patients with RSA who were admitted in our hospital were included in the study and served as the observation 1 group,30 female who twice voluntarily chose the induced abortion for termination of pregnancy were served as the observation 2 group,30 normal pregnant women who came for pregnancy check were served as the observation 3 group.The fasting venous blood was all collected.The Full-Automatic Coagulation Analyzer was performed to detect the levels of platelet(PLT),activated partial thromboplastin time(APTT),prothrombin time(PT),D-dimer(D-D),and Antithrombin-Ⅲ(AT-Ⅲ),as well as protein S(PS)and protein C(PC).The double-antibody sandwich one-step process was ued to determine the levels of soluble thrombomodulin(sTM),soluble endothelial protein C receptor(sEPCR),and thrombin-activatable fibrinolysis inhibitor(TAFI).The trend changes of thrombelastograph(TEG)between different groups were compared.Results D-D level in the observation 1 group was significantly higher than that other groups(P<0.05),and difference was not statistically significant in D-D level between the observation 2 and 3 groups(P>0.05).The comparison of plasma sTM and sEPCR levels among the three groups was statistically significant(P<0.05),but the comparison of TAFI level was not statistically significant(P>0.05).The plasma sTM and sEPCR levels in the observation 1 group were significantly higher than those in the observation 2 and 3 groups(P<0.05),while the comparison of sTM and sEPCR levels between the observation 2 and 3 groups was not statistically significant(P>0.05).There was no significant difference in R,K,alpha-angle and coagulation index(CI)among the three groups(P>0.05).The MA value of observation group 1 was significantly higher than that in other groups(P<0.05),followed by the observation group 2 and the observation group 3(P<0.05).Conclusion Due to the reliance of detection of th

关 键 词：RSA 凝血因子 纤溶因子 

分 类 号：R714.21[医药卫生—妇产科学]