抗凝血酶Ⅲ活性与妊娠期急性脂肪肝的关系探讨

The Association of Antithrombin-Ⅲ Activity and Acute Fatty Liver of Pregnancy

目的:研究孕期抗凝血Ⅲ(AT-Ⅲ)活性的变化及其与妊娠期急性脂肪肝(AFLP)的关系。方法:以2008年7月至2014年7月我科住院分娩的AFLP孕妇24例为研究组,同期住院分娩的正常孕妇30例为对照组,比较两组间及组内早孕期(12-14周)、中孕期(26-28周)、晚孕期(34-36周)AT-Ⅲ活性的变化。结果:随着孕周的发展,AT-Ⅲ活性逐渐降低(P<0.05);两组早孕期AT-Ⅲ活性无明显差异(P>0.05),研究组中、晚孕期AT-Ⅲ活性较对照组明显降低[(94.40±11.09)%vs(103.98±12.34)%,(70.61±13.80)%vs(89.05±10.30)%,P<0.05)];中、晚孕期AT-Ⅲ活性诊断AFLP的界值分别是86.20%及96.10%。结论:中、晚孕期AFLP患者血浆AT-Ⅲ活性明显降低,AT-Ⅲ活性分别低于86.20%及96.10%时可预测AFLP的发生。

Objective ： To explore the changes of antithrombin-Ⅲ（AT-Ⅲ） activityin pregnancy and the association with acute fatty liver of pregnancy（AFLP）. Methods ： 24 patients with AFLP were classified as research group from Jul 2008 to Jul 2014, while 30 women with normal pregnancy were classified as control group. The activity of AT-Ⅲ were compared in early term（12-14 weeks）,middle term（26-28 weeks） and later term（34-36weeks） between the two groups. Results ： With the development of gestational age, AT-Ⅲ activity decreased significantly（P〉0.05）.At early term, AT-Ⅲ activity had no significant differences between the two group（P〈0.05）,at middle and later term, the AT-Ⅲ activity in the research group were significantly lower than those in the control group [（94.40±11.09）% vs（103.98±12.34）%,（70.61±13.80）% vs（89.05±10.30）%,P〈0.05） ].The diagnostic cut-offs were 96.10% and 86.20% at the second and the third term respectively. Conclusions ： The AT-Ⅲ activity of patients with AFLP are significantly decreased at middle and later term of pregnancy,and it may indicate the occurrence of AFLP if the AT-Ⅲ activity is lower than 86.20% and 96.10% respectively.