妊娠期静脉血栓患者血清同型半胱氨酸和雌孕激素的测定及意义

Measurement and Significance of Serum Homocysteine,Estradiol and Progesterone in Patients with Venous Thrombosis during Pregnancy

目的研究妊娠期静脉血栓形成与血清同型半胱氨酸(Hcy)、雌孕激素水平变化的关系。方法分别留取24例正常妊娠和24例妊娠期静脉血栓患者血清,采用荧光偏振免疫法(FPIA)测定Hcy,釆用化学发光免疫检测法检测雌二醇(E_2)和孕酮(P)浓度。结果妊娠期静脉血栓患者血清Hcy、P和P/E_2明显高于正常妊娠妇女[(12.43±1.85)vs.(10.22±1.34)μmol/L]、[(119.18±6.18)vs.(104.04±7.49ng/ml)]、[(10.00±1.36)vs.(7.35±0.76)],E_2水平明显低于正常妊娠妇女[(12.13±1.698)vs.(14.24±1.36)ng/ml],差异显著(P均<0.01)。正常妊娠和妊娠期静脉血栓患者,E_2与Hcy浓度呈正相关(r=0.502,P=0.012;r=0.804,P=0.000),P/E_2与Hcy浓度呈负相关(r=-0.585,P=0.003;r=-0.646,P=0.001);而正常妊娠妇女P与Hcy浓度无相关性(r=-0.364,P=0.081),妊娠期静脉血栓妇女P浓度与Hcy浓度呈正相关(r=0.542,P=0.006)。结论妊娠期静脉血栓患者血清中Hcy和P水平高于正常孕妇,而E_2水平低于正常孕妇;妊娠期静脉血栓患者E_2与Hcy呈正相关,P与Hcy呈负相关。血清高Hcy、低E_2水平。

Objective To study the relationships between the changes of serum homocysteine, estrogen and progesterone levels and venous thrombosis during pregnancy. Methods The serum specimens from 24 cases of normal pregnant women and 24 cases of pregnan patients with venous thrombosis were respectively collected. The serum homocysteine （Hey） concentration was measured by fluorescence polarization immunoassay （FPIA） , while serum estradiol （E2） and progesterone （P） concentrations were detected by chemical luminescence immunoassay. Results The levels of serum Hcy, P and P/E2 of pregnant patients with venous thrombosis were significandy higher than those of normal pregnant women [ （ 12.43±1.85 ）vs. （10.22±1.34） p, mol/L], [ （119.18±6.18） vs. （104.04±7.49ng/ml） ] ,and[ （10.00±1.36） vs. （7.35±0.76） respectively ~, while their level of serum E2 was significantly lower than that of normal pregnant women （ 12.13±1. 698） vs. （14.24±1.36） ng/ml] ,P〈0.01. For both types of women, E2 was positively correlated with Hey （ r = 0. 502, P = 0. 012 ; r = 0. 804, P = 0. 000 ）, but P/E2 was negatively correlated with Hcy （ r = -0. 585, P = 0. 003 ; r = -0. 646, P = 0. 001 ）. In normal pregnant women, P had no correlation with Hey （r= -0. 364,P=0.081 ） ,but in pregnant women with venous thrombosis, E2 was positively correlated with Hcy （r=0. 542 ,P= 0.006）. Conclusion In pregnant women with venous thrombosis, Hcy and P levels are higher and E2 level is lower than in normal pregnant women. The levels of E2 and Hcy are positively correlated while those of P and Hcy are negatively correlated. The high levels of Hcy and P and a low level of estrogen in serum may be associated with the formation of venous thrombosis during preg- nancy.