自然流产患者血栓前状态的多因子发病趋势分析

Study on Multiple-factor Morbidity Trend of Thrombophilia of Spontaneous Abortion

目的通过对自然流产患者血栓前状态的相关血栓标志物进行筛查,评估其发病规律及高危因子,提供有效的预防及治疗方案。方法将1300例自然流产患者按流产次数分为1次、2次、3次及以上,分别进行血栓标志物的检测,探讨其与流产次数的关系。结果抗凝血酶Ⅲ、纤溶酶原活性、交联纤维蛋白降解产物、纤维蛋白降解产物、纤溶酶原活化物抑制因子、组织型纤溶酶原激活物等对不良妊娠结局的影响差异具有统计学意义(P<0.01),随着流产次数的增加差异具有统计学(P<0.01)。蛋白C活性、蛋白S活性对不良妊娠结局的影响具有显著统计学差异(P<0.01),随着流产次数的增加2次与3次及以上经两两比较不具备统计学差异(P>0.05)。结论蛋白C活性、蛋白S活性可能是自然流产血栓前状态诊断与治疗的特征性指标或者无相关性。抗凝血酶Ⅲ、纤溶酶原活性、交联纤维蛋白降解产物、纤维蛋白降解产物、纤溶酶原活化物抑制因子、组织型纤溶酶原激活物是自然流产的影响因素,随着流产次数的增加特征性明显。

Objective To evaluate the occurrence regularity and high risk factors thrombophilia of spontaneous abortion and to provide effective precautions and treatments.Methods 1300 patients with spontaneous abortion were divided into four groups randomly according the abortion times,one,two,three and more.The thrombosis markers in these patients were detected.Results The thrombosis markers such as antithrombase Ⅲ,plasminogen activity,fibrin breakdown products,plasminogen activator inhibiting factor,tissue plasminogen activator had remarkable statistical difference to the bad pregnancy outcome （P 〈 0.01）,it was also increased with abortion times （P 〈 0.01）.The activity of protein C and protein S had remarkable statistical difference to the bad pregnancy outcome （P 〈 0.01）.Conclusion The activity of protein C and protein S may be the characteristic markers in the diagnosis and treatment to thrombophilia of recurrent spontaneous abortion.The antithrombin Ⅲ,activity of plasminogen,fibrin degradation product,plasminogen activator inhibiting factor are the influence factors for recurrent spontaneous abortion.These markers become more evident along with the abortion times.