血浆抗凝血酶Ⅲ及蛋白C、蛋白S活性与复发性流产的关联性

Correlation between the changes of plasma antithrombin Ⅲ, activity of protein C and protein S of women and their recurrent spontaneous abortion

目的:探究复发性流产(RSA)患者血浆抗凝血酶Ⅲ(AT-Ⅲ)、蛋白C(PC)、蛋白S(PS)活性及预测价值。方法:选取本院2019年1月-2020年12月收治的RSA(流产≥3次)患者100例为RSA组,首次流产且既往无流产史患者100例为流产组,无既往流产史健康早孕妇女100例为对照组,检测并比较3组血浆AT-Ⅲ、PC、PS水平。结果:血浆AT-Ⅲ、PC、PS水平RSA组、流产组、对照组依次升高(P<0.05)。经受试者工作特征曲线分析,预测RSA最佳临界值血浆AT-Ⅲ为92.14%,曲线下面积(AUC)为0.779,灵敏度为83.7%,特异度为64.9%;PC为89.47%,AUC为0.704,灵敏度为72.3%,特异度为77.5%;PS为84.26%,AUC为0.752,灵敏度为79.2%,特异度为70.3%。结论:RSA患者血浆AT-Ⅲ、PC、PS异常降低,提示机体存在血液高凝态倾向,通过检测上述指标对预测RSA有临床指导意义。

Objective: To explore the changes of plasma antithrombin Ⅲ(AT-Ⅲ), activity protein C(PC) and protein S(PS) of women with recurrent spontaneous abortion(RSA), and to study the value of activity changes of plasma AT-Ⅲ, PC, and PS for predicting RSA of the women. Methods: 100 women with RSA(miscarriage >2 times) were selected in group A, 100 women with the first miscarriage were selected in group B, and 100 women with normal pregnancy and without history of miscarriage were selected in group C from January 2019 to March 2020. The levels of plasma AT-Ⅲ, PC, and PS of the women were detected and were compared among the three groups. Results: The levels of plasma AT-Ⅲ, PC, and PS activity of the women in group A, in group B, and in group C had increased gradually(P<0.05). The receiver operator characteristic(ROC) curve analysis showed that the optimal critical value of the plasma AT-Ⅲ level for predicting RSA was 92.1%, the area under curve(AUC) of ROC of which was 0.779, the sensitivity of which was 83.7%, and the specificity of which was 64.9%. The optimal critical value of the plasma PC level for predicting RSA was 89.47%, AUC of ROC of which was 0.704, the sensitivity of which was 72.3%, and the specificity of which was 77.5%. The optimal critical value of the plasma PS level for predicting RSA was 84.3%, AUC of ROC of which was 0.752, the sensitivity of which was 79.2%, and the specificity of which was 70.3%. Conclusion: The activities of plasma AT-Ⅲ, PC, PS of the women with RSA decrease abnormally, which suggests that there is a tendency to hypercoagulability of blood of these women. The detections of the plasma AT-Ⅲ, PC and PS activity have clinical value for predicting RSA of the women.