摘要
【目的】探讨血栓前状态分子标志物:凝血酶原片段F1+2(F1+2)、凝血酶-抗凝血酶Ⅲ复合物(TAT)、抗凝血酶Ⅲ(AT-Ⅲ)、D-二聚体(D-Dimer)与早期复发性流产(RSA)的关系,及各分子标志物对血栓前状态(PTS)引起的RSA的诊断价值。【方法】比较103例RSA已孕者(AEP组)、103例有RSA病史现未孕者(ANP组)及40例正常早孕者(NEP组)及40例健康未孕者(NNP组)血清中F1+2、TAT、AT-Ⅲ、D-Dimer水平;并以ROC曲线方法判断PTS引起的RSA发生时以上各个指标的最佳临界值。【结果】1.ANP组血浆F1+2、D-Dimer水平显著高于NNP组,两者间差异有显著性(P<0.008);而且流产3次者较2次者指标水平高,差别有统计学意义(P<0.0167)。F1+2与D-Dimer判断RSA未孕患者存在血栓前状态的最佳筛查界值分别为55.11nmol/L(AUC=0.767)及233.50μg/L(AUC=0.636)。2.ANP组血浆TAT水平高于NNP组,AT-Ⅲ水平低于NNP组,但其差别无统计学意义(P>0.008)。AEP组血浆F1+2、TAT、D-Dimer水平高于NEP组,AT-Ⅲ水平低于NEP组,但其差别无统计学意义(P>0.008)。【结论】RSA与PTS存在相关性;RSA患者在孕前已经表现为PTS,PTS的标志物F1+2、D-Dimer可用于RSA未孕人群流产原因的筛查,其水平越高,流产可能性越大。
【Objective】 To investigate the relationship between F1＋2,TAT,AT-Ⅲ,D-Dimer and recurrent spontaneous abortion. Then to investigate the diagnostic value of each maker of Thrombophilia to RSA. 【Methods】 To compare the serum concentrations of F1＋2,TAT,AT-Ⅲ and D-Dimer in 103 early pregnant women with RSA （AEP group） and 103 non-pregnant women but had RSA history （ANP group） and 40 normal early pregnant women （NEP group） and 40 normal non-pregnant women （NNP group）. Receiver Operating Characteristic curve was used for the critical value. 【Result】 （1） In ANP group,the levels of F1＋2 and D-Dimer were significantly higher than those in NNP group. There were obvious statistical difference （P〈 0.008）. Meanwhile,the levels of F1＋2 and D-Dimer were higher in 3 times abortion than in 2 times abortion. There were obvious statistical difference （P 〈0.0167）. ROC curve analysis revealed that the optimal critical value of F1＋2 for predicting abortion was 55.11 while D-Dimer was 233.50 μg / L. The area under curve （AUC） were 0.767 and 0.636. （2） The levels of TAT in ANP group were higher than those in NNP group. The levels of AT-Ⅲ in ANP group were lower than those in NNP group. But there were no statistical difference （P 〉0.008）. In AEP group ,the levels of F1＋2,TAT,and D-Dimer were higher than those in NEP group,the levels of AT-Ⅲ were lower than those in NEP group. But there were no statistical difference （P 〉0.008）.【Conclusions】 Thrombophilia is one of the causes of RSA. The marker of Thrombophilia F1＋2,D-Dimer can be used to diagnose RSA. the optimal critical value of F1＋2 for predicting abortion was 55.11;while D-Dimer was 233.50 μg / L.
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2010年第4期476-481,共6页
Journal of Sun Yat-Sen University:Medical Sciences
基金
广东高校优秀青年创新人才培育项目(粤财教[2008]342号)
