外周血凝血相关因子水平与不明原因反复自然流产的关系

The relationship between peripheral blood coagulation factor and unexplained recurrent spontaneous abortion

目的对比观察78例不明原因反复自然流产患者外周血抗凝血因子（AT-Ⅲ、TAT）及凝血相关因子（F1＋2、PAI-1）水平情况。方法选取排除遗传、感染、性激素、解剖因素的反复自然流产患者78例作为反复自然流产组,选取同期门诊行无痛人流的妊娠40～45d早孕患者50例为非正常妊娠组,另选取同期门诊行宫内节育器放置术1～2次正常生育史非孕期正常妇女50例为正常未孕组,抽取所有研究对象外周血,采用ELISA检查患者外周血F1＋2、TAT、PAI-1水平,采用发色底物法测定AT-Ⅲ水平,观察比较3组间及反复自然流产组不同流产次数患者检查结果的差异。结果反复自然流产组AT-Ⅲ水平低于非正常妊娠组及正常未孕组,TAT水平高于非正常妊娠组及正常未孕组,差异均有统计学意义（P〈0.05）。反复自然流产组F1＋2、PAI-1水平高于非正常妊娠组及正常未孕组,差异有统计学意义（P〈0.05）。反复自然流产组患者随着流产次数增加,AT-Ⅲ水平下降,TAT、F1＋2、PAI-1水平上升,差异有统计学意义（P〈0.05）。结论反复自然流产组患者随着流产次数增加,反复自然流产妇女血清AT-Ⅲ水平下降而TAT、F1＋2和PAI-1水平升高。不明原因反复自然流产患者外周血凝血相关因子水平有明显异常,患者血液处于高凝状态,妊娠后胎盘微血管易发生血栓,对反复自然流产患者外周血凝血相关因子进行检测能够为针对性抗凝治疗,恢复患者生育功能提供相关依据。

Objective To observed the effect of 78 patients with unexplained recurrent spontaneous abortion patients peripheral blood anti coagulation factor（AT-Ⅲ,TAT）and coagulation factors（F1＋2,PAI-1）level.Methods A total of exclusion genetic,infection,sex hormone,anatomical factors in patients with recurrent spontaneous abortion 78 cases as recurrent spontaneous abortion group,selected the same period outpatient painless abortion of pregnancy 40-45 dpregnancy patients 50 cases as unnormal pregnancy group,selected patient over the same period the palace IUD placement of 1-2times the normal reproductive history non normal pregnancy women 50 cases as normal non pregnant group,peripheral blood was drawn,enzyme linked immunosorbent assay method were used to examine the patients week blood F1＋2,tat,PAI-1levels,chromogenic substrate method was used for the determination of AT-Ⅲlevels,the results were compared among the three groups and recurrent spontaneous abortion group.ResultsThe repeated levels of AT-Ⅲin recurrent spontaneous abortion group was lower than unnormal pregnancy group and normal non pregnant group,TAT levels were significantly higher than those of unnormal pregnancy group and normal non pregnant group,the difference was statistically significant（P〈0.05）.The F1＋2,PAI-1levels in recurrent spontaneous abortion group were higher than that of unnormal pregnancy group and normal non pregnant group,the difference was statistically significant（P〈0.05）.Recurrent spontaneous abortion group with the increase in the number of abortions,AT-Ⅲlevels declined,TAT and F1＋2,PAI-1level increased,the difference was statistically significant（P〈0.05）.Conclusion Recurrent spontaneous abortion serum levels decline in AT-Ⅲ women,increased TAT,F1＋2and PAI-1levels,with the increase in the number of abortions showed the same changes.Unexplained recurrent spontaneous abortion patients peripheral blood coagulation related factors have obvious abnormality,blood in hypercoagulable state,after pregnancy placental microvascular prone to thrombosis,peripheral blood coagulation of patients with recurrent spontaneous abortion related factors were tested for the therapy of anti coagulation and restore reproductive function in patients and to provide evidence.