中晚期孕妇血清亮氨酸氨基肽酶水平及其临床意义

Clinical significance of diversity of serum LAP during pregnancy

目的探讨中晚期孕妇血清亮氨酸氨基肽酶(LAP)的变化水平及其临床意义。方法采用速率法分别检测175例中期妊娠(162例为正常妊娠)妇女、302例晚期妊娠(215例为正常妊娠)妇女及100例健康未孕妇女的血清LAP水平。结果正常中期妊娠组血清LAP活性为(140.43±64.39)U/L,正常晚期妊娠组为(234.72±93.53)U/L,对照组为(72.62±15.31)U/L,前两组的LAP活性显著高于对照组(P<0.05)。当妊娠合并肝内胆汁淤积(ICP)时,均较相应正常妊娠组LAP活性显著增高。结论正常妊娠随着孕周的增加,血清LAP活性随之升高,但如合并ICP时升高更为显著。妊娠高血压综合征时LAP轻微升高,早产时略有降低。LAP水平的变化可作为妊娠合并ICP及孕妇和胎儿健康情况动态监测的一项有效指标。

Objective To explain the physiological properties of serum leucine aminopeptidase （LAP） and discuss the different levels and clinical meaning of serum LAP during the second and the third trimester of gestation. Methods Rate turbidimetry was used to assay serum LAP activity of 175 pregnant women in the second trimester of gestation, among whom 162 were normal and 13 were intrahepatic cholestasis of pregnancy （ICP）, and 302 pregnant women in the third trimester of gestation, among whom 215 were normal, 76 were ICP, 6 were pregnancy-induced hypertension syndrome and 5 were premature delivery, and 100 healthy or non-pregnant women. Results Serum LAP activity of pregnant women in the group of the second trimester of gestation was （ 140.43 ± 64.39） U/L, in the group of the third trimester of the gestation was （234.72 ± 93.53 ） U/L, and in control group was （72.62 ± 15.31 ） U/L The serum LAP activities of the two pregnant groups were much higher than that of control group （ P 〈 0.05 ）. The activity of serum LAP in the pregnant women with ICP was much higher than that of group of normal pregnancy. Conclusion Serum LAP activity stepped up gradually with the increase of gestational weeks. When pregnant women got ICP,their serum LAP activity increased obviously, but LAP activity just increased slightly in the women accompanying hypertension syndrome of pregnancy. In the women with premature delivery LAP activity decreased. Consequently, LAP can be regarded as an auxiliary marker for monitoring the condition of mother and fetus dynamically.