【摘要】 目的探讨妊娠期妇女血浆中活化蛋白C抵抗(APCR)现象发生的原因及其与凝血因子V(FV)基因多态性、狼疮抗凝物(LA)、抗心磷脂抗体IgG(ACAIgG)的关系。方法对50例健康非孕妇女、50例健康妊娠妇女、30例妊娠高血压综合征(下称妊高征)患者及20例习惯性流产患者应用多聚酶链反应-限制性内切酶长度多态性分析法对FV基因多态性进行分析,同时用APTT-APC法、简化的单管稀释蝰蛇毒时间测定法(DVVT)以及酶联免疫吸附双抗体夹心法检测APCR敏感性比值、LA水平及ACAIgG含量。结果健康非孕妇女正常化APCR敏感指数的比值(n-APCR-SR)为0.95±0.16,以n-APCR-SR<0.63为APCR阳性标准,则对照组、妊娠组、妊高征组及习惯性流产组APCR阳性率分别为4.0%、44.0%、40.0%、35.0%。各组研究对象均未检测到FV基因突变。发现LA及ACAIgG阳性率与APCR阳性率在妊娠各组有较好的一致性。结论本研究发现APCR是妊娠期高凝状态的一个危险因素,但并非由FV基因点突变引起;LA和ACAIgG可能是获得性APCR的一个重要原因。更多还原

【Abstract】 Objective To investigate the activated protein C resistance (APCR) and its relationship to factor V (FV) gene polymorphism, lupus anticoagulant(LA)and anticardiolipin antibody(ACA IgG)in pregnant women.Methods 50 cases of non-pregnant healthy women, 50 cases of healthy pregnant women, 30 cases of pregnant patients with pregnancy-induced hypertension syndrome (PIH) and 20 patients with recurrent abortion were enrolled in the study. Restriction fragment length polymorphism(PCR-RFLP)assay was applied to detecting FV gene polymorphism. Activated partial thrombplastin time (APTT) -APC assay, simplified single-tube diluted viper venom time assay (DVVT) and double antibody sandwiched ELISA were applied to measuring APCR sensibility ratio (APCR-SR), LA level and ACA IgA content.Results Normalized APCR-SR (n-APCR-SR) in healthy non-pregnant women was 0.95±0.16. The value of 0.63 was regared as cutoff of n-APCR-SR. The positive (n-APCR-SR<0.63) rate was 4.0%, 44.0%, 40.0% and 35.0% in control group, pregnancy group, PIH group and recurrent abortion group respectively. No FV Leiden mutation was found in all cases. We also found that plasma levels of LA and ACA were coincident with the positive rate of APCR in pregnency groups.Conclusion Our results indicated that APCR might be a risk factor for hypercoagulation of pregnancy women, but it isn’t related to FV Leiden mutation. LA and ACA might be one of main reasons for acquired APCR.更多还原