Gris Jean-Christophe, Quéré Isabelle, Dechaud Hervé, Mercier Eric, Pinçon Caroline, Hoffet Médéric, Vasse Marc, Marès Pierre
Laboratoires d'Hématologie, U.F.R. des sciences pharmaceutiques et biologiques de Montpellier, Centres Hospitaliers Universitaires de Nîmes et de Rouen, 5 rue Hoche, F-30 029 Nimes cedex 9, France.
Blood. 2002 Apr 1;99(7):2606-8. doi: 10.1182/blood.v99.7.2606.
The protein Z-protein Z-dependent inhibitor complex is a factor Xa inhibitor. Protein Z deficiencies have recently been described in patients with ischemic stroke. As placenta infarction leads to poor pregnancy outcome, we studied protein Z plasma concentrations in nonthrombotic, nonthrombophilic consecutive patients with unexplained pregnancy wastage. A significant amount of protein Z deficiencies was only found in the early fetal loss group (< 1 mg/L; 44 of 200, P < 10(-4)) and mainly in the case of fetal demise between the beginning of the 10th and the end of the 15th week of gestation (odds ratio, 6.7 [3.1-14.8], P < 10(-3)). These deficiencies were not due to partial vitamin K1 deficiency, and at least some of them were constitutional ones. In women, protein Z deficiency may induce an enhanced risk of severe placental insufficiency soon after the connection of maternal and fetal circulations.
蛋白Z-蛋白Z依赖性抑制剂复合物是一种凝血因子Xa抑制剂。最近在缺血性中风患者中发现了蛋白Z缺乏症。由于胎盘梗死会导致不良妊娠结局，我们研究了连续的非血栓形成、非血栓形成倾向且原因不明的妊娠丢失患者的血浆蛋白Z浓度。仅在早期胎儿丢失组（<1mg/L；200例中有44例，P<10⁻⁴）中发现大量蛋白Z缺乏症，且主要发生在妊娠第10周开始至第15周末胎儿死亡的情况下（优势比为6.7[3.1-14.8]，P<10⁻³）。这些缺乏症并非由于部分维生素K1缺乏引起，其中至少一些是先天性的。在女性中，蛋白Z缺乏可能会在母胎循环连通后不久增加严重胎盘功能不全的风险。
