摘要
目的分析正常早期妊娠凝血4项与血栓前状态分子标志物,了解妊娠后凝血、血栓形成、抗凝和纤溶状态的改变。方法选取2005年4月至2009年6月于中山大学孙逸仙纪念医院定期产检的105例妊娠10—12周的孕妇为研究组,另选取82例正常未孕者为对照组。测定凝血常规4项(凝血酶时间、活化部分凝血活酶时间、血浆凝血酶原时间及纤维蛋白原)及血栓前状态分子标志物[凝血酶原片段(F1+2)、血栓调节蛋白(TM)、凝血酶一抗凝血酶复合物(TAT)、抗凝血酶Ⅲ(AT-Ⅲ)、血小板颗粒糖蛋白140(GMPl40)、血栓烷B2(TXB2)、D二聚体(D-Ⅱ)、纤溶酶原激活物抑制物(PAI-2)]。结果F只、F1+2、TAT、GMPl40、D-Ⅱ、PAI-2两组比较差异有统计学意义(P〈0.01),前者分别为4.00g/L、0.66nmol/L、179.95μg/L、9.42μg/L、201.51μg/L、0.047μg/L.后者分别为2.52μg/L、0.31nmol/L、39.46μg/L、19.13μg/L、125.02μg/L、0.006g/L。结论正常妊娠早期血液凝血功能明显增高,抗凝水平略升高、纤溶活性及抗纤溶活性亦出现明显亢进,4者在较高水平保持平衡,血小板活化状况保持在低水平。
Objective To assess the changes in coagulation, thrombosis, anti-coagulation and fibrinolysis during early preguaney. Methods A total of 105 gravidas with monocyetic pregnancies between 10 and 12 weeks gestational age at Sun Yat-sen Memorial Hospital, Sun Yat-sen University during April 2005 to June 2009 were recruited for study group and another 82 non-pregnant women as control group. Coagulation parameters, including thrombin time (T'F), activated partial thromboplastin time (APTT), prothrombin (PT) and fibrinogen ( Fg), were measured. We also tested the prothrombotie state parameters, including prothrombin fragment 1 + 2 ( F1 + 2 ) , thrombomodulin (TM) , thrombin-antithrombin complex (TAT), antithrombin ]II( AT-m ) , GMP140, thromboxane B2 ( TXB2 ), plasminogen activator inhibitor ( PAI-2 ; performed by enzyme-linked immunosorbent assay) and D-direct ( D2 ; tested by latex turbidimetrie immunoassay). Results Fg (4.00 vs2.52 g/L), F1 +2 (0.66 vs 0.31 nmol/L), TAT (179.95 vs 39.46 μg/L), GMP140 (9.42 vs 19. 13μg/L), D2 (201.51 vs 125.02 μg/L) and PAI-2 (0.047 vs 0.006 g/L) were statistically different between the study and control groups ( P 〈0.01 ). Conclusions The coagulation, fibrinolysis and anti-fibrinolysis functions of healthy pregnant women become enhanced during early pregnancy while anti-coagulation function slightly increases. These four basic functions are balanced at a higher level so that the activation of platelets stays at a lower level.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第27期2146-2148,共3页
National Medical Journal of China
基金
国家自然科学基金(81270754
81170625,81170625)
国家自然科学基金青年基金(81000259)
广东省自然科学基金博士启动项目(10451008901004246)
教育部博士点新教师基金(20090171120075)
广东省科技计划项目(20108060900034)
广东省医学科学技术研究基金(A2010171)
关键词
妊娠
凝血功能
Pregnancy
Coagulation function