复发性流产患者易栓症指标筛检的意义

doi:10.3969/j.issn.1673-8640.2021.04.008

检验医学 ›› 2021, Vol. 36 ›› Issue (4): 388-391.DOI: 10.3969/j.issn.1673-8640.2021.04.008

复发性流产患者易栓症指标筛检的意义

蔡眉, 沈琼丹, 林亦宇, 何佳亮, 唐振华()

上海交通大学医学院附属国际和平妇幼保健院上海市胚胎源性疾病重点实验室上海市临床重点专科（建设项目）“强主体”妇产科,上海 200041

收稿日期:2019-11-19 出版日期:2021-04-30 发布日期:2021-04-28
通讯作者: 唐振华
作者简介:唐振华,E-mail： labtang910@hotmail.com。
蔡眉,女,1973年生,硕士,副主任技师,主要从事临床血液学检测工作。
基金资助:
中国福利会国际和平妇幼保健院院级课题(GFY5715)

Role of thrombophilia related marker screening in patients with unexplained recurrent spontaneous abortion

CAI Mei, SHEN Qiongdan, LIN Yiyu, HE Jialiang, TANG Zhenhua()

Department of Gynaecology and Obstetrics,the International Peace Maternity and Child Health Hospital of Shanghai Jiao Tong University School of Medicine,Shanghai Key Laboratory of Embryo Original Diseases,Shanghai Municipal Key Clinical Specialty,Shanghai 200041,China

Received:2019-11-19 Online:2021-04-30 Published:2021-04-28
Contact: TANG Zhenhua

摘要/Abstract

摘要：

目的探讨易栓症相关指标与不明原因复发性流产（URSA）的相关性,为URSA患者的病因排查和治疗提供参考。方法选取2016年11月—2018年3月上海交通大学医学院附属国际和平妇幼保健院104例流产次数≥2次的URSA患者作为URSA组,以45例健康经产妇作为对照组,检测所有研究对象血浆狼疮抗凝物（LA）阳性率、抗心磷脂抗体（ACA）阳性率、蛋白C（PC）活性、蛋白S（PS）活性、抗凝血酶（AT）活性、凝血因子Ⅻ（FⅫ）活性和D-二聚体（DD）水平。结果 URSA组LA阳性率、PC活性、PS活性、AT活性、FⅫ活性、DD水平与对照组比较差异均有显著统计学意义（P<0.05）。结论 LA阳性、PS缺陷、FⅫ缺陷和DD增高与URSA密切相关。LA、PS、FⅫ、DD是URSA患者体内高凝状态较好的筛查指标,联合检测AT、PC,对预测URSA血栓形成有临床指导意义。

关键词: 不明原因复发性流产, 易栓症, 高凝状态

Abstract:

Objective To investigate the correlations of thrombophilia related markers and unexplained recurrent spontaneous abortion（URSA）,and to provide a reference for etiological investigation and treatment. Methods The URSA group enrolled 104 patients diagnosed with URSA（abortion ≥ 2 times） from November 2016 to March 2018 in the International Peace Maternity and Child Health Hospital. Totally,45 healthy women who had given birth were enrolled as control group. The lupus anticoagulant（LA） positive rate,anticardioliolipin antibody（ACA） positive rate,protein C（PC） activity,protein S（PS） activity,antithrombin（AT） activity,coagulation factor Ⅻ（FⅫ） activity and D-dimer（DD） level were determined. Results There was statistical significance in LA positive rate,PC activity,PS activity,AT activity,FⅫ activity and DD level between URSA and control groups（P<0.05）. Conclusions LA positive,PS deficiency and FⅫ deficiency are related to URSA. LA,PS,FⅫ and DD are good screening indicators for determining hypercoagulability in URSA patients,supplemented by AT and PC as reference indicators,which can predict the risk of thrombosis events in URSA.

Key words: Unexplained recurrent spontaneous abortion, Thrombophilia, Hypercoagulability

中图分类号:

R446.1

蔡眉, 沈琼丹, 林亦宇, 何佳亮, 唐振华. 复发性流产患者易栓症指标筛检的意义[J]. 检验医学, 2021, 36(4): 388-391.

CAI Mei, SHEN Qiongdan, LIN Yiyu, HE Jialiang, TANG Zhenhua. Role of thrombophilia related marker screening in patients with unexplained recurrent spontaneous abortion[J]. Laboratory Medicine, 2021, 36(4): 388-391.

图/表 1

参考文献 16

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组别	例数	PT/s	APTT/s	TT/s	Fib/（g/L）	LA阳性/例（%）
URSA组	104	12.95±0.74	37.93±3.40	16.96±1.10	2.96±0.51	11（10.58）
对照组	45	13.00±0.54	36.48±3.37	16.78±1.04	2.80±0.42	0（0.00）
统计值		-0.385	2.174	0.887	1.818	0.035
P值		0.701	0.031	0.377	0.071	0.016
组别	ACA阳性/例（%）	PC/%	PS/%	AT/%	FⅫ/%	DD/（μg/mL）
URSA组	1（0.96）	114.49±19.41	64.80±25.69	97.83±8.14	74.44±22.14	0.37±0.29
对照组	0（0.00）	109.62±16.17	115.36±9.34	98.93±10.81	108.00±6.00	0.25±0.14
统计值	1.000	1.475	-12.821	-0.687	-9.992	3.060
P值	0.698	0.142	0.000	0.493	0.000	0.003

组别	例数	PT/s	APTT/s	TT/s	Fib/（g/L）	LA阳性/例（%）
URSA组	104	12.95±0.74	37.93±3.40	16.96±1.10	2.96±0.51	11（10.58）
对照组	45	13.00±0.54	36.48±3.37	16.78±1.04	2.80±0.42	0（0.00）
统计值		-0.385	2.174	0.887	1.818	0.035
P值		0.701	0.031	0.377	0.071	0.016
组别	ACA阳性/例（%）	PC/%	PS/%	AT/%	FⅫ/%	DD/（μg/mL）
URSA组	1（0.96）	114.49±19.41	64.80±25.69	97.83±8.14	74.44±22.14	0.37±0.29
对照组	0（0.00）	109.62±16.17	115.36±9.34	98.93±10.81	108.00±6.00	0.25±0.14
统计值	1.000	1.475	-12.821	-0.687	-9.992	3.060
P值	0.698	0.142	0.000	0.493	0.000	0.003

复发性流产患者易栓症指标筛检的意义

Role of thrombophilia related marker screening in patients with unexplained recurrent spontaneous abortion

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