复发性自然流产患者血浆D-二聚体、抗凝血酶Ⅲ和蛋白C检测的临床意义

Detection and Analysis of D-Dimer,Antithrombin Ⅲ and Protein C in Patients with Recurrent Spontaneous Abortion

目的探讨复发性自然流产(RSA)患者孕早期的D-二聚体(D-Dimer)、抗凝血酶Ⅲ(AT-Ⅲ)和蛋白C(PC)变化的临床意义。方法选取150例有RSA病史且早孕的患者作为RSA组,其中根据流产的次数分为RSAⅠ组94例(流产次数2~3次)和RSAⅡ组56例(流产次数≥4次),另外选择100例健康且无流产史的早孕孕妇作为正常早孕组。对上述各组患者进行D-Dimer,AT-Ⅲ和PC的检测和对比分析。结果 RSA组和正常早孕组的D-Dimer,AT-Ⅲ和PC的结果分别为1.67±0.35mg/L vs 0.37±0.29 mg/L,(84.57±10.88)%vs(99.28±9.01)%和(82.63±11.32)%vs(100.26±10.61)%,差异均有统计学意义(t=8.21,7.87,7.97,均P<0.01);RSAⅡ组和RSAⅠ组上述各参数比较结果分别为(1.84±0.31)mg/L vs(1.53±0.37)mg/L,(80.48±9.87)%vs(88.62±11.23)%和(79.89±11.64)%vs(86.77±12.78)%,差异均有统计学意义(t=3.86,4.31,4.50,均P<0.05)。结论 RSA患者在孕早期血栓形成的风险比正常孕妇高,且与既往的流产次数有一定的相关,D-Dimer,AT-Ⅲ和PC的检测对RSA患者血栓状态的筛查和改善妊娠结局有重要的临床意义。

Objective To investigate the changes of D-Dimer（D-Dimer）,antithrombin III（AT-III）and protein C（PC）in the early pregnancy of recurrent spontaneous abortion（RSA）.Methods A total of 100patients with a history of RSA and early pregnancy patients as RSA group,according to the number of miscarriages were divided into RSA groupⅠ64cases（abortion 2~3times）and RSAⅡGroup 36cases（abortion more than 4times）,another 100healthy pregnant and no history of abortion as a normal pregnancy group.Detection and analysis of D-Dimer,AT-Ⅲand PC in all the above groups were done.Results The results of D-Dimer,AT-Ⅲand PC in group RSA and normal pregnancy group were（1.67＋0.35）mg/L vs（0.37＋0.29）mg/L,（84.57＋10.88）%vs（99.28＋9.01）%and（82.63＋11.32）%vs（100.26＋10.61）%respectively,and the difference was statistically significant（t=8.21,7.87,7.97,all P〈0.01）.The results of the above parameters in group RSAⅡand RSAⅠwere（1.84＋0.31）mg/L vs（1.53＋0.37）mg/L,（80.48＋9.87）%vs（88.62＋11.23）%and（79.89＋11.64）%vs（86.77＋12.78）%respectively,and the differences were statistically significant（t=3.86,4.31,4.50,all P〈0.05）.Conclusion The risk of thrombosis in RSA patients was higher than that of normal pregnant women in early pregnancy,and had a certain correlation with the number of previous abortions.The detection of D-Dimer,AT-Ⅲand PC has important parturient value for screening RSA patients and improving pregnancy outcomes.