tPA和PAI-1活性与自然流产的相关性

The Relativity Among Tissue-type Plasminogen Activator (tPA), Plasminogen Activator Inhibitor Type 1(PAI-1) Activity and Spontaneous Abortion

目的探讨组织型纤溶酶原激活剂(tPA)和纤溶酶原激活剂抑制剂-1(PAI-1)活性与自然流产的相关性。方法选择2003年10月至2004年3月中南大学湘雅二医院门诊有自然流产史患者71例(非孕50例,孕妇21例)和对照组41例(非孕20例,孕妇21例)进行研究,运用发色底物法测定血浆tPA和PAI-1活性。结果非孕有自然流产史的研究组tPA活性比对照组低(t=2.226,P=0.029<0.05),早孕研究组tPA活性比对照组低(t=2.166,P=0.036<0.05),差别均有统计学意义;研究组中,tPA活性早孕高于非孕(t=-2.937,P=0.005),PAI-1活性早孕低于非孕(t=2.428,P=0.018);在对照组中,tPA活性早孕也高于非孕(t=2.597,P=0.013),PAI-1活性早孕也低于非孕者(t=2.653,P=0.012)。差别均有统计学意义。结论妊娠后tPA活性增高和PAI-1活性下降。有自然流产史者在非孕状态时tPA活性明显下降,且妊娠后呈低增长水平。tPA活性下降与引起自然流产的发病机制有关。

[Objective]To study the relativity among the tissue-type plasminogen activator （tPA）, plasminogen activator inhibitor type 1 （PAI-1） activity and spontaneous abortion. [Methods]Candidates came from the Second Xiangya Hospital of Central South University, including the pregnant or non-pregnant women with （71 cases） and without（41 cases） the history of spontaneous abortion, Chromogenic assay was used to detect tPA and PAI-1 activity in plasma, [Results]The plasma tPA activity of women with the history of spontaneous abortion was statistically significantly lower than controls among the non-pregnant （ t = 2. 226, P = 0. 029）and early pregnant women（ t = 2. 166, P ：0. 036）. The t-PA activity of the early pregnant was higher than that of the non-pregnant among the women with（ t =-2. 937, P =0. 005） and without （ t =2. 597, P =0. 013） the history of spontaneous abortion. The PAI-1 activity of early pregnant was lower than that of the non pregnant among the women with （ t =2. 428, P =0. 018） and without （t：2, 653, P ：0. 012） the history of spontaneous abortion, [Conclusion] During pregnancy the t-PA activity increases. PAI-1 activity decreases. The t PA activity decreases during non-pregnant period and increases to lower level after pregnancy among the women with the history of spontaneous abortion. The decreased t-PA activity is associated with pathogenesis of spontaneous abortion.