复发性流产患者易栓症指标筛检的意义

目的探讨易栓症相关指标与不明原因复发性流产(URSA)的相关性,为URSA患者的病因排查和治疗提供参考。方法选取2016年11月—2018年3月上海交通大学医学院附属国际和平妇幼保健院104例流产次数≥2次的URSA患者作为URSA组,以45例健康经产妇作为对照组,检测所有研究对象血浆狼疮抗凝物(LA)阳性率、抗心磷脂抗体(ACA)阳性率、蛋白C(PC)活性、蛋白S(PS)活性、抗凝血酶(AT)活性、凝血因子Ⅻ(FⅫ)活性和D-二聚体(DD)水平。结果URSA组LA阳性率、PC活性、PS活性、AT活性、FⅫ活性、DD水平与对照组比较差异均有显著统计学意义(P<0.05)。结论LA阳性、PS缺陷、FⅫ缺陷和DD增高与URSA密切相关。LA、PS、FⅫ、DD是URSA患者体内高凝状态较好的筛查指标,联合检测AT、PC,对预测URSA血栓形成有临床指导意义。

Role of thrombophilia related marker screening in patients with unexplained recurrent spontaneous abortion

Objective To investigate the correlations of thrombophilia related markers and unexplained recurrent spontaneous abortion(URSA),and to provide a reference for etiological investigation and treatment.Methods The URSA group enrolled 104 patients diagnosed with URSA(abortion≥2 times)from November 2016 to March 2018 in the International Peace Maternity and Child Health Hospital.Totally,45 healthy women who had given birth were enrolled as control group.The lupus anticoagulant(LA)positive rate,anticardioliolipin antibody(ACA)positive rate,protein C(PC)activity,protein S(PS)activity,antithrombin(AT)activity,coagulation factorⅫ(FⅫ)activity and D-dimer(DD)level were determined.Results There was statistical significance in LA positive rate,PC activity,PS activity,AT activity,FⅫactivity and DD level between URSA and control groups(P<0.05).Conclusions LA positive,PS deficiency and FⅫdeficiency are related to URSA.LA,PS,FⅫand DD are good screening indicators for determining hypercoagulability in URSA patients,supplemented by AT and PC as reference indicators,which can predict the risk of thrombosis events in URSA.