血浆游离蛋白S、蛋白C及抗凝血酶Ⅲ活性变化与子痫前期相关性研究

Associations between preeclampsia and the activity of free protein S, protein C and AT Ⅲ

目的比较子痫前期(PE)与健康孕妇血浆游离蛋白S(fPS)、蛋白C (PC)、抗凝血酶Ⅲ(ATⅢ)活性的水平,探究孕妇血浆fPS、PC及ATⅢ活性改变是否与子痫前期发病有关。方法采用随机排列表抽取2018年1月至2019年4月郑州大学第一附属医院定期产前检查、临床资料完整的PE患者89例,其中早发型PE组(<34周)53例,晚发型PE组(≥34周)36例。抽取同期本院定期产前检查74例健康孕妇为对照组,其中<34周对照组30例,≥34周对照组44例。采用凝固法检测血浆fPS活性,发色底物法检测血浆PC、ATⅢ活性,比较孕妇血浆fPS、PC、ATⅢ活性。结果①早发型PE组、<34周对照组、晚发型PE组、≥34周对照组孕妇血浆fPS活性分别为(44.10±1.8)%、(49.7±1.8)%、(42.3±3.0)%、(46.7±1.7)%,PC活性分别为(116.0±3.8)%、(111.4±2.7)%、(107.8±3.7)%、(109.4±2.9)%,ATⅢ活性分别为(72.1±1.7)%、(95.0±3.0)%、(75.0±2.4)%、(91.1±2.5)%,早发型PE组较与<34周对照组孕妇血浆fPS、ATⅢ活性均降低,(P均<0.05)。②晚发型PE组孕妇血浆fPS、ATⅢ活性与≥34周对照组均降低(P均<0.05)。③早发型PE组孕妇血浆fPS、PC及ATⅢ活性与晚发型PE组比较,差异均无统计学意义(P均>0.05);结论孕妇血浆fPS、ATⅢ活性降低可能与PE发病有关;早发型、晚发型PE患者体内可能均存在血浆fPS、ATⅢ活性降低引发的易栓状态。

Objective To evaluate the difference of the plasma value of free proteins S(fPS)activity,proteins C(PC)and antithrombinⅢ(ATⅢ)activity between preeclamptic(PE)and normotensive pregnant women and to investigate the association between changes of fPS activity,PC,ATⅢactivity and preeclampsia.Methods A total of 89 PE patients with regular prenatal examinations and complete clinical data were randomly selected from The First Affiliated Hospital of Zhengzhou University from January 2018 to April 2019.Among them,there were 53 patients with early-onset preeclampsia(<34 weeks gestation,WG),and 36 patients with late-onset preeclampsia(≥34 weeks gestation,WG).A total of 74 healthy pregnant women who received regular prenatal examinations in our hospital during the same period were selected as the control group,among whom 30 were in the control group at<34 weeks and 44 were in the control group at≥34 weeks.Plasma fPS activity was determined by coagulation method,PC and ATⅢactivity were determined by chromogenic substrate method.Results①Plasma fPS activity of pregnant women in early-onset preeclampsia group,<34 weeks control group,late-onset preeclampsia group,≥34 weeks control group were(44.10±1.8)%,(49.7±1.8)%,(42.3±3.0)%,(46.7±1.7)%,respectively,PC activity were(116.0±3.8)%,(111.4±2.7)%,(107.8±3.7)%,(109.4±2.9)%,respectively,ATⅢactivity were(72.1±1.7)%,(95.0±3.0)%,(75.0±2.4)%,(91.1±2.5)%respectively,fPS,ATⅢactivity were significantly lower in cases with early-onset preeclampsia compared with<34 weeks control group(P<0.05).②fPS,ATⅢactivity were significantly lower in cases with late-onset preeclampsia compared with≥34 weeks control group(P<0.05).③There were no significant differences in fPS,PC and ATⅢactivity between early-onset preeclampsia and late-onset preeclampsia(P>0.05).Conclusions There may be a correlation between preeclampsia and decreased fPS and ATⅢactivity,thrombophilia induced by decreased fPS and ATⅢactivity may exists both in early-onset and in late-onset preeclampsia.