不明原因复发性流产孕妇易栓症标志物凝血酶原-Ⅲ、蛋白C、蛋白S的表达及预后研究

Research on Expressions of Thrombophilia Markers Antithrombin-Ⅲ,Protein C,Protein S and Prognosis in Pregnant Women with Unexplained Recurrent Abortion

目的:分析早期复发性流产的病因,探讨易栓症标志物抗凝血酶-Ⅲ、蛋白C及蛋白S与不明原因复发性流产的关系。方法:回顾性分析2020年10月-2022年10月广东省珠海市中西医结合医院收治的160例复发性流产患者的临床资料,将筛查出的60例不明原因复发性流产患者纳入观察组,另选取60例行健康体检妇女作为对照组。分析两组易栓症标志物抗凝血酶-Ⅲ、蛋白C及蛋白S水平及缺陷率。结果:160例复发性流产患者中,单病因患者92例,占比57.50%,自身免疫异常共41例(25.62%),夫妻染色体异常31例(19.37%),多病因患者8例(5.00%);不明原因患者60例(37.50%)。两组抗凝血酶-Ⅲ水平比较,差异无统计学意义(P>0.05);观察组蛋白C、蛋白S水平低于对照组,差异有统计学意义(P<0.05)。观察组抗凝血酶-Ⅲ、蛋白S及蛋白C缺陷发生率均高于对照组,差异有统计学意义(P<0.05)。结论:早期复发性流产发生的原因较多,部分患者存在多因素致病的情况,不少患者致病因素不明。不明原因复发性流产的发生与抗凝血酶-Ⅲ、蛋白S及蛋白C缺陷存在密切关联。

Objective:To analyze the etiology of early recurrent abortion and explore the relationship between thrombophilia markers antithrombin-Ⅲ,protein C,protein S and unexplained recurrent abortion.Methods:The clinical data of 160 patients with recurrent abortion in Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine Hospital from October 2020 to October 2022 were analyzed retrospectively.Sixty patients with unexplained recurrent abortion screened were included in the observation group,and 60 women who underwent health examination were selected as the control group.The levels of thrombophilia markers antithrombin-Ⅲ,protein C and protein S and the incidence of defects in two groups were analyzed.Results:Among 160 patients with recurrent abortion,92 patients had single cause,accounting for 57.50%;Among them,autoimmune abnormalities 41 cases(25.62%),chromosomal abnormalities in couples,31 cases(19.37%);8 patients had multiple causes(5.00%);60 patients had unknown causes(37.50%).The level of antithrombin-Ⅲbetween the two groups was not significantly different(P>0.05).The levels of protein C and protein S in the observation group were lower than those in the control group,with statistically significant difference(P<0.05).The incidence of antithrombin-Ⅲ,protein S and protein C defects in the observation group was higher than that in the control group,and the differences were statistically significant(P<0.05).Conclusion:There are many causes of early recurrent abortion.Some patients have multifactorial disease,and many patients have unknown pathogenic factors.The occurrence of unexplained recurrent abortion is closely related to antithrombin-Ⅲ,protein S and protein C defects.