血栓前状态指标与不明原因复发性流产的相关性研究

Association between pre-thrombus status and unexplained recurrent spontaneous abortion

目的检测凝血、纤溶系统、血小板活化指标,探讨血栓前状态指标在不明原因复发性流产(URSA)临床诊断中的意义。方法选取URSA患者108例及健康体检人员100例,采用凝固法检测PT、APTT、纤维蛋白原(Fg);采用免疫比浊法检测D-二聚体(D-D);采用ELISA法检测组织纤溶酶原激活物(t PA)、纤溶酶原激活抑制物-1(PAI-1)、血小板第四因子(PF4)、P选择素,并对检测结果进行统计分析。结果与对照组比较,URSA组Fg、D-D、t PA、PAI-1、PF4和P选择素水平均增高(均P<0.05);流产次数≥3次组Fg、D-D、t PA、PAI-1、PF4和P选择素水平高于流产次数2次组(均P<0.05);早期流产组PF4和P选择素水平高于晚期流产组(均P<0.05)。结论检测不明原因复发性流产患者Fg、D-D、t PA、PAI-1、PF4、P选择素等指标,采取预防治疗措施,对改善妊娠结局具有重要的意义。

Objective To investigate the association between pre-thrombus status and unexplained recurrentspontaneous abortion （URSA）. Methods One hundred and eight patients with URSA admitted from January 2014 to October2016, and 100 healthy women （control group） were enrolled in the study. The prothrombin time （PT）, activated partialthromboplastin time （APTT） and fribrinogen （Fg） were measured with freeze method; the D-dimer （D-D） was assayed withimmunoturbidimetry; tissue polypeptide antigen （tPA）, plasminogen activator inhibitor-1 （PAI-1）, platelet factor 4 （PF4）, andP-selectin were determined with enzyme-linked immune sorbent assay （ELISA）. Results Compared with the control group, Fg,D-D, tPA, PAI-1, PF4 and P-selectin contents in URSA group were significantly increased （P〈0.05）. The Fg, D-D, tPA, PAI-1,PF4 and P-selectin levels in patients with abortion time ≥3 were significantly higher than those in patients with abortion time=2（P〈0.05）. The PF4 and P-selectin levels in early abortion patients were higher than those in late abortion patients （P〈0.05）.Conclusion To monitor the Fg, DD, tPA, PAI-1, PF4 and P-selectin levels and to take appropriate measures would be important inimproving pregnancy outcomes for women of URSA.