胎儿生长受限孕妇血栓前状态指标的检测及其临床意义.doc

文档介绍：作者:吴爱华,张兰珍,田耕单位:广州医学院第二附属医院产科,广州510260【摘要】目的观察胎儿生长受限(FGR)孕妇的抗凝及纤溶系统部分指标的变化,探讨其对FGR血栓前状态的诊断意义。方法采用酶联免疫吸附试验(ELISA)法和全自动血栓止血分析仪,检测正常非孕妇女、正常晚孕妇女和FGR患者各30例的抗凝血酶(AT)、蛋白C(PC)、蛋白S(PS)、纤维蛋白原(Fbg)、纤溶酶原(PLG)、组织纤溶酶原激活物(tPA)及其抑制物(PAI1)等指标。结果FGR组与正常晚孕组AT及PC、PS均比正常非孕组低,呈下降趋势,PC、PS的表现有统计学意义(P<),但AT的降低未见统计学意义(P>);而FGR组中PC含量比正常晚孕组显著降低,有统计学意义(P<),同时比较这两组的PS含量无明显区别(P>)。与正常非孕组比较,正常晚孕组和FGR组Fbg、PLG、tPA、PAI1等指标均显著增高(P<)。而与正常晚孕组比较,FGR组Fbg、PLG、PAI1均升高,有统计学意义(P<),tPA则无显著性改变(P>)。结论正常妊娠妇女存在高凝状态,而大部分FGR患者存在明显血栓前状态。产前测定有关凝血和纤溶功能指标,对FGR的防治具有重要价值。【关键词】胎儿生长受限;血栓前状态;凝血;纤溶DetectionofPrethrombosisStateinPatientswithPregnancywith FetalGrowthRestriction. WUAihua,ZHANGLanzhen,TIANGen,LIAOZhiqiong,GAOMeiyang(ObstesticDepartment,,Guangdong,510260,China) Abstract:analyzer,somevariablesweredetectedin30normalnonpregnantwomen,30normallatepregnantwomen,and30FGRpatients,whichincludingantithrombinactivity(AT),proteinC(PC),proteinS(PS),fibrinogen(Fbg),plasminogenactivity(PLG),activityoftissuetypeplasminogenactivator(tPA)andplasminogenactivatorinhibitor(PAI1).ResultsThelevelsofPCandPSdropped(P<),whileactivitiesFbg,PLG,tPAandPAI1wereobviouslyhigherinFGRwomen(P<),comparedwiththenonpregnantandlatepregnantwomen,theactivitiesofAThadnosignificantchanges (P>).Furthermore,thesechangesbecamemoreapparentwiththevariablesofthrombolysissysteminFGRwomenandlatepregnantwomen,somevariables,includingFbg,PLGandPAI1intheFGRwomen,weregreatlyhigherthanthoseofthelatepregnantwomen(P<).While,theactivitiesoftPAandPShadnosignificantchangesbetweenthetwogroups(P>).ConclusionsThenormalpregnantwomenareinthehypercoagulationstate,