论文部分内容阅读
目的:了解抗活化的蛋白C(APC)在习惯性流产(RSA)患者中的发生情况,并进一步探讨APCR引起胎盘血管微小血栓形成并进而引起RSA的发生机制。方法:采用APC-KPTT法,ELISA法和PTT-LA法分别对16例RSA及20例正常对照(NC)进行APCR、抗心磷脂抗体(ACA)和狼疮抗凝物(LA)检测,采用一期法检恻FVⅦ:C,胶乳凝集法检测D-Dimer。结果:16例RSA患者共8例抗磷脂抗体(APA)阳性,其中4例LA阳性,2例ACA阳性,2例LA、ACA同时阳性,阳性率(50%)明显高于NC组(0/20)(P<0.005),APCR阳性率为50％,明显高于NC组(5%)(P<0.005)。APA阳性组APCR阳性率(87.5%)明显高于NC组(5%)(P<0.005)FVⅡ:C及D-Dimer阳性率均明显高于NC组(P<0.001及P<0.05)。APA阴性组APCR阳性率(12.5%)与NC组无显著性差异(P>0.05)FVⅡ:C明显高于NC组(P0.05),相关分析显示,APA阳性组APCR发生率(87.5％)明显高于地APA阴性组(12.5%)(P<0.005)。结论:习惯性流产患者胎盘血管发生血栓一方面由于患者体内处于高凝状态,另一方面由于APCR在习惯性流产患者中有较高的发生率且与APA有明显相关性,APCR可能是引起胎盘微血栓形成并引起习惯性流产的主要原因之一。
OBJECTIVE: To investigate the occurrence of anti-activated protein C (APC) in patients with habitual abortion (RSA) and to further explore the mechanism by which APCR causes placental microvascular thrombosis and then RSA. Methods: APCR, anticardiolipin antibody (ACA) and lupus anticoagulant (LA) were detected in 16 patients with RSA and 20 patients with normal controls by ELISA and PTT-LA method. Period method test 恻 FVⅦ: C, latex agglutination test D-Dimer. Results: A total of 8 patients with RSA were positive for antiphospholipid antibody (APA), 4 were LA, 2 were ACA, 2 were LA and ACA were positive at the same time. The positive rate was 50% 20) (P <0.005). The positive rate of APCR was 50%, which was significantly higher than that of NC group (5%) (P <0.005). The positive rate of APCR in APA positive group (87.5%) was significantly higher than that in NC group (5%) (P <0.005). The positive rates of FVII: C and D-Dimer were significantly higher than those in NC group (P <0.001 and P <0.05). The positive rate of APCR in APA negative group (12.5%) was not significantly different from that in NC group (P> 0.05), while the FVII: C was significantly higher in NC group than in NC group (P <0.01) P> 0.05). Correlation analysis showed that the incidence of APCR in APA positive group (87.5%) was significantly higher than that in negative APA group (12.5%) (P <0.005). Conclusions: Placental thrombosis in patients with habitual abortion is due to hypercoagulability in the patient on the one hand, and APCR may be the cause of placenta accretion due to the high incidence of APCR in patients with habitual abortion and significant correlation with APA One of the main causes of microthrombus formation and habitual abortion.