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

doi:10.3969/j.issn.1673-8640.2021.04.008

Abstract

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

CLC Number:

R446.1

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.

Figures/Tables 1

References 16

[1]	PRITCHARD A M, HENDRIX P W, PAIDAS M J. Hereditary thrombophilia and recurrent pregnancy loss[J]. Clin Obstet Gynecol, 2016,59(3):487-497. URL PMID
[2]	赵永强. 易栓症研究概况[J]. 中国实用内科杂志, 2007,27(1):49-52.
[3]	朱轶楠, 赵永强. 2012版易栓症诊断中国专家共识解读[J]. 临床血液学杂志, 2013,26(3):156-157.
[4]	BROAD A J, LOICHINGER M H, AHN H J, et al. Protective proteins and telomere length in placentas from patients with pre-eclampsia in the last trimester of gestation[J]. Placenta, 2017,50:44-52. DOI URL PMID
[5]	UMEHARA N, TANAKA T. The incidence of various antiphospholipid antibodies,measured by commercial-based laboratory,with recurrent spontaneous abortion and the impact of their profiles on reproductive outcome with active anticoagulant therapy[J]. ISRN Obstet Gynecol, 2012,2012:819356. DOI URL PMID
[6]	RAWAT A, SIKKA M, RUSIA U, et al. Lupus anticoagulants and anticardiolipin antibodies in Indian women with spontaneous,recurrent fetal loss[J]. Indian J Hematol Blood Transfus, 2015,31(2):281-285. URL PMID
[7]	LOCKSHIN M D, KIN M, LASKIN C A, et al. Prediction of adverse pregnancy outcome by the presence of lupus anticoagulant,but not anticardiolipin antibody,in patients with antiphospholipid antibodies[J], Arthritis Rheum, 2012,64(7):2311-2318. DOI URL PMID
[8]	PATIL R, GHOSH K, VORA S. Inherited and acquired thrombophilia in Indian women experiencing unexplained recurrent pregnancy loss[J]. Blood Cells Mol Dis, 2015,55(3):200-205. DOI URL PMID
[9]	刘志兰, 康晓敏, 张晓欣, 等. 复发性自然流产1 101例病因分析[J]. 上海交通大学学报(医学版), 2015,35(3):401.
[10]	VORA S, SHETTY S, SALVI V, et al. Thrombophilia and unexplained pregnancy loss in Indian patients[J]. Natl Med J India, 2008,21(3):116-119. URL PMID
[11]	庞苗苗, 谭雯, 韩华, 等. 早期复发性流产患者血浆D-二聚体、抗凝血酶Ⅲ、蛋白C、蛋白S活性变化及分析[J]. 临床军医杂志, 2017,45(9):908-910.
[12]	时晓华, 徐成伟. 妊娠妇女活化蛋白C抵抗与狼疮抗凝物和抗心磷脂抗体的关系[J]. 检验医学与临床, 2007,4(9):803-805.
[13]	MATSUKAWA Y, ASANO E, TSUDA T, et al. Genotyping analysis of protein S-Tokushima(K196E) and the involvement of protein S antigen and activity in patients with recurrent pregnancy loss[J]. Eur J Obstet Gynecol Reprod Biol, 2017,211:90-97. DOI URL PMID
[14]	HALBMAYER W M, MANNHALTER C, FEICHTINGER C, et al. Factor Ⅻ(hageman factor) deficiency:a risk factor for development of thromboembolism. Incidence of factor Ⅻ deficiency in patients after recurrent venous or arterial thromboembolism and myocardial infarction[J]. Wien Med Wochenschr, 1993,143(2):43-50. URL PMID
[15]	CUSHMAN M, FOLSOM A R, WANG L, et al. Fibrin fragment D-dimer and the risk of future venous thrombosis[J]. Blood, 2003,101(4):1243-1248. DOI URL PMID
[16]	JONES D W, GALLIMORE M J, HARRIS S L, et al. Antibodies to factor Ⅻ associated with lupus anticoagulant[J]. Thromb Haemost, 1999,8(3):387-390.

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