同型半胱氨酸水平对晚期孕妇血栓前状态标志物的影响

目的 分析同型半胱氨酸(HCY)水平对晚期孕妇血栓前状态(PTS)标志物的影响.方法 收集2015年1月至2016年7月在巴南区人民医院产科就诊的289例晚期孕妇,按照HCY水平分为高HCY水平组(HHCY组:HCY≥15μmol/L,n=69)和低HCY水平组(LHCY组:HCY<15μmol/L,n=220).检测两组晚期孕妇血栓前状态标志物指标,分析HCY水平与血栓前状态标志物的相关性.结果 与LHCY组比较,HHCY组晚期孕妇的抗凝血酶Ⅲ(AT-Ⅲ)含量明显降低[(68.45±12.37)mg/L vs(91.23±9.29)mg/L];血栓调节蛋白(TM)、血小板α颗粒膜蛋白140(GMP-140)含量明显升高[TM:(5.38±1.17)ng/mL vs(3.58±1.09)ng/mL;GMP-140:(20.12±6.32)ng/mL vs(15.28±5.15)ng/mL],差异均有统计学意义(P<0.05).两组晚期孕妇间的D-二聚体(D-dimer)、纤维蛋白原(Fib)、红细胞压积(Hct)比较差异均无统计学意义(P>0.05).相关性分析结果显示,血浆HCY水平与AT-Ⅲ呈负相关(r=-0.213,P=0.018),与TM呈正相关(r=0.278,P=0.021).结论 HCY可能通过改变晚期孕妇PTS介导对机体产生损伤作用.

Effect of homocysteine level on prethrombotic state markers in late-pregnant women

Objective To study the effect of different homocysteine levels on prethrombotic state markers in women in late pregnancy. Methods From Jan. 2015 to Jul. 2016, 289 women in late pregnancy in Chongqing Ba'nan District People's Hospital were selected and divided, according to homocysteine (HCY) level, into high HCY group (HH-CY group, HCY≥15μmol/L, n=69) and low HCY group (LHCY group, HCY<15μmol/L, n=220). Prethrombotic state markers were detected, and Pearson correlation test was used to analyze the correlation between homocysteine and the laboratory parameters of prethrombotic state. Results Compared with LHCY group, the Antithrombin Ⅲ (AT-Ⅲ),thrombomodulin (TM), Granule membrane protein 140 (GMP-140) in HHCY group were (68.45 ± 12.37) mg/L, (5.38 ± 1.17) ng/mL, (20.12±6.32) ng/mL, as compared with (91.23±9.29) mg/L, (3.58±1.09) ng/mL, (15.28±5.15) ng/mL in the LHCY group (P<0.05). There were no significant differences in D-dimer, Fib, Hct between the two groups (P>0.05). Pearson correlation analysis showed that the level of plasma homocysteine was negatively correlated with AT-Ⅲ(r=-0.213, P=0.018) and was positively correlated with TM (r=0.278, P=0.021). Conclusion Homocysteine damage ef-fect may be mediated through changing the prethrombotic state of women in late pregnancy.