D-Dimer、AT-Ⅲ、t-PA和PAI-1水平对复发性流产患者血栓前状态的诊断价值

Diagnostic value of D-Dimer,AT-Ⅲ,t-PA and PAI-1 level for prethrombotic state of patients with recurrent spontaneous abortion

目的探讨D-二聚体(D-Dimer)、抗凝血酶Ⅲ(AT-Ⅲ)、组织型纤溶酶原激活物(t-PA)、纤溶酶原激活抑制剂-1(PAI-1)水平对复发性流产(RSA)患者血栓前状态(PTS)的诊断价值。方法选择90例有RSA病史已孕者作为观察组,另选择50例健康已孕者作为对照组,同时根据不同流产次数将观察组分为两个亚组,流产次数≤3次视为观察组A(n=48),流产次数>3次视为观察组B(n=42);对比观察组、对照组以及观察组不同亚组之间的D-Dimer、AT-Ⅲ、t-PA、PAI-1水平差异。结果观察组的D-Dimer、t-PA、PAI-1均明显高于对照组(P均<0.05),而AT-Ⅲ低于对照组(P<0.05);观察组B的D-Dimer、t-PA、PAI-1均明显高于观察组A(P均<0.05),而AT-Ⅲ低于观察组A(P<0.05)。结论 PTS与RSA密切相关;D-Dimer、AT-Ⅲ、t-PA、PAI-1作为PTS的重要检测指标,该4项指标的检查有利于RSA的患者PTS筛查,为RSA未孕人群流产原因研判提供参考,具有较高的诊断价值。

Objective To evaluate the diagnostic value of D - Dimer, AT - III, t - PA and PAI- 1 level for prethrombotic state of patients with recurrent spontaneous abortion. Methods 90 pregnant women with RSA were selected as the observation group, and 50 healthy pregnant women were selected as the control group. And the observation group was divided into two subgroups according to the abortion times, the pregnant women with the abortion times less than 3 times were the A observation group （ n = 48 ）, and those more than 3 times were the B observation group （ n = 42 ）. The D - Dimer, AT - HI, t - PA and PAI- 1 level of the observation group, the control group and the subgroups of the observation group was compared. Results The D - Dimer,t - PA and PAI- 1 of the observation group were evidently higher than those of the control group （ P 〈 0.05 ）, and AT -III of the observation group was lower than that of the control group （ P 〈 0.05 ）. The D - Dimer, t - PA and PAI - 1 of B observation group was evidently higher than those of A observation group （ P 〈 0.05 ）, and AT - III was lower than that of A observation group （ P 〈 0.05）. Conclusion PST has close relationship with RSA. As the important detection indicators of PTS, examining D - Dimer, AT - III, t - PA and PAI- 1 is good for screening PST of patients with RSA, which not only can provide reference for judging the abortion reasons of the women without pregnant, but also has great diagnostic value.