正常足月产妇羊水组织因子水平与妊娠高凝状态、羊水栓塞的关系研究

目的探讨正常足月产妇羊水中的组织因子(TF)水平与妊娠高凝状态及羊水栓塞的关系。方法选取2013年1月至2014年12月该院待产的正常足月妊娠产妇158例,检测产妇血浆、羊水、羊水上清液及羊水沉渣中的TF和组织因子途径抑制物(TFPI)水平。结果羊水沉渣TF水平为(1 409.36±120.34)ng/L,明显高于血浆、羊水及羊水上清液水平,差异有统计学意义(P0.05);血浆TF水平为(30.17±6.49)ng/L,明显低于羊水各标本水平,差异有统计学意义(P0.05);羊水沉渣TFPI水平为(9.46±1.77)g/L,明显低于血浆、羊水及羊水上清液水平,差异有统计学意义(P0.05);血浆TFPI水平为(22.19±5.16)g/L,明显高于羊水各标本(P0.05);羊水及羊水上清液TF和TFPI水平差异无统计学意义(P0.05);羊水、羊水上清液、羊水沉渣中TF与TFPI呈负相关关系(P0.05),其中羊水沉渣相关性最强(r=-0.903,P0.05),血浆标本TF与TFPI无相关性(P0.05)。结论正常足月产妇羊水TF含量较高,而TFPI较低,可能在羊水栓塞的发生机制中起一定的临床作用。

To study the relation between normal full-term parturient amniotic fluid TF level detection and hypercoagulable state,amniotic fluid embolism

Objective To investigate in normal full term parturient amniotic fluid and its relationship with hy‐percoagulability and amniotic fluid embolism .Methods 158 cases of normal full‐term pregnant was choosed in our hospital from 2013 January to 2014 December ,detected their maternal plasma ,amniotic fluid ,amniotic fluid superna‐tant ,amniotic fluid sediment TF and tissue factor pathway inhibitor (TFPI) levels .Results Normal full‐term partu‐rient amniotic fluid sediment TF level (1 409 .36 ± 120 .34) ng /L ,was higher than that in plasma ,amniotic fluid ,am‐niotic fluid supernatant samples (P< 0 .05) ;Plasma TF level was (30 .17 ± 6 .49)ng/L ,significantly lower than the various samples of amniotic fluid (P< 0 .05) ;Normal full‐term parturient amniotic fluid sediment TFPI level (9 .46 ± 1 .77) g/L ,was lower than that in plasma ,amniotic fluid ,amniotic fluid supernatant samples (P< 0 .05) ;Plasma TF level was (30 .17 ± 6 .49)g/L ,significantly higher than the various samples of amniotic fluid (P < 0 .05) ;Amniotic fluid and amniotic fluid supernatant TF and TFPI levels difference were no statistically significant (P > 0 .05) ;TF levels and TFPI level had a negative correlation in amniotic fluid ,amniotic fluid supernatant and amniotic fluid sedi‐ment (P< 0 .05) ,in which amniotic fluids ediment ,the strongest correlation (r = - 0 .903 ,P < 0 .05) ,while the TF level and TFPI level in plasma samples had no significant correlation (P> 0 .05) .Conclusion There was a high lever of TF and a low relatively lever of TFPI in normal full‐term parturient amniotic fluid ,which may play a role in the pathogenesis mechanism of amniotic fluid embolism .