目的：研究活化的蛋白C抵抗（activated protein C resistance,APC-R)在正常妊娠中的发生情况，探讨狼疮样抗凝物质（lupus-like anticoagulant,LA)对妊娠性APC-R的影响及二者与凝血酶生成、继发性纤溶的关系。方法：采用APTT-APC法检测...目的：研究活化的蛋白C抵抗（activated protein C resistance,APC-R)在正常妊娠中的发生情况，探讨狼疮样抗凝物质（lupus-like anticoagulant,LA)对妊娠性APC-R的影响及二者与凝血酶生成、继发性纤溶的关系。方法：采用APTT-APC法检测APC-R，dRVTT法测定LA水平，并用ELISA法测定了凝血酶原片段F1+2、栓溶二聚体（D-dimer,D-D)的含量。结果：共检测30例正常妇女对照（NC）和50例正常妊娠妇女（均为孕28-32周，NP），结果显示，NC组APC比率为2.88±0.37，NP组为2.04±0.31(APC-R阳性率为42%）；NC组LA阳性率为0,NP组为(0.63±0.11)mg/L，经统计学处理，NP组的APC比率、F1+2和D-D的测定结果均较NC复发性纤溶的发生，提示妊娠妇女可能发生轻微的血管内凝血；这些变化可能是妊娠高凝状态的重要促进因素。展开更多
Objective To investigate the mechanism of anticoagulation protein defect in the pathogenesis of unexplained recurrent miscarriage. Methods Fifty-seven patients with a history of unexplained abortion were enrolled as t...Objective To investigate the mechanism of anticoagulation protein defect in the pathogenesis of unexplained recurrent miscarriage. Methods Fifty-seven patients with a history of unexplained abortion were enrolled as the investigation group for tests of protein C, protein S, antithrombinⅢ(AT-Ⅲ), as well as activated protein C resistance (APC-R). The control group con-sisted of fifty healthy women with a history of normal pregnancy and delivery. Blood samples were obtained for measuring serum activity of protein C, protein S, AT-Ⅲ, and APC-R. Patients with positive APC-R were tested for factorⅤ(FⅤ) Lei-den gene mutation by PCR-RFLP method. Results Of the 57 patients, 12 (21.1%), 1 (1.8%), and 5 (8.8%) cases were found with protein S, protein C, and AT-Ⅲdeficiency respectively, and 13 (22.8%) cases with positive results of APC-R. Of the control group, no protein C or AT-Ⅲdeficiency was ever found, whereas 2 (4.0%) volunteers were presented with protein S deficiency and 3 (6.0%) with positive results of APC-R. No FⅤLeiden gene mutation was identified in all the patients with positive APC-R results. Late spontan-eous abortion cases had higher incidence of anticoagulation protein defect than the early cases. Conclusion Anticoagulation protein defect may play a role in the pathogenesis of fetal loss, especially for those occurr-ing in late stage of pregnancy.展开更多
文摘目的：研究活化的蛋白C抵抗（activated protein C resistance,APC-R)在正常妊娠中的发生情况，探讨狼疮样抗凝物质（lupus-like anticoagulant,LA)对妊娠性APC-R的影响及二者与凝血酶生成、继发性纤溶的关系。方法：采用APTT-APC法检测APC-R，dRVTT法测定LA水平，并用ELISA法测定了凝血酶原片段F1+2、栓溶二聚体（D-dimer,D-D)的含量。结果：共检测30例正常妇女对照（NC）和50例正常妊娠妇女（均为孕28-32周，NP），结果显示，NC组APC比率为2.88±0.37，NP组为2.04±0.31(APC-R阳性率为42%）；NC组LA阳性率为0,NP组为(0.63±0.11)mg/L，经统计学处理，NP组的APC比率、F1+2和D-D的测定结果均较NC复发性纤溶的发生，提示妊娠妇女可能发生轻微的血管内凝血；这些变化可能是妊娠高凝状态的重要促进因素。
文摘Objective To investigate the mechanism of anticoagulation protein defect in the pathogenesis of unexplained recurrent miscarriage. Methods Fifty-seven patients with a history of unexplained abortion were enrolled as the investigation group for tests of protein C, protein S, antithrombinⅢ(AT-Ⅲ), as well as activated protein C resistance (APC-R). The control group con-sisted of fifty healthy women with a history of normal pregnancy and delivery. Blood samples were obtained for measuring serum activity of protein C, protein S, AT-Ⅲ, and APC-R. Patients with positive APC-R were tested for factorⅤ(FⅤ) Lei-den gene mutation by PCR-RFLP method. Results Of the 57 patients, 12 (21.1%), 1 (1.8%), and 5 (8.8%) cases were found with protein S, protein C, and AT-Ⅲdeficiency respectively, and 13 (22.8%) cases with positive results of APC-R. Of the control group, no protein C or AT-Ⅲdeficiency was ever found, whereas 2 (4.0%) volunteers were presented with protein S deficiency and 3 (6.0%) with positive results of APC-R. No FⅤLeiden gene mutation was identified in all the patients with positive APC-R results. Late spontan-eous abortion cases had higher incidence of anticoagulation protein defect than the early cases. Conclusion Anticoagulation protein defect may play a role in the pathogenesis of fetal loss, especially for those occurr-ing in late stage of pregnancy.
