Procházka M, Krcová V, Hrachovec P, Kudela M, Slavík L
Porodnicko-gynekologická klinika FN a LF UP Olomouc.
Ceska Gynekol. 2002 Sep;67(5):251-4.
The aim of the study was to detect the incidence of resistance to activated protein C in pregnant or puerperal women with confirmed diagnosis of deep venous thrombosis or pulmonary embolism.
Case-control study.
Dept. of Obstetrics and Gynaecology, Dept. of Haemato-oncology, Medical Faculty, Palacky University, Olomouc.
The group of 33 women with confirmed deep venous thrombosis were examined for resistance to activated C protein. The levels of C and S proteins, antithrombin III., prothrombin, heparin II cofactor and plasminogen were measured. Patient with APC ratio below 1.86, were tested by PCR analysis for the detection of the FV:Q506 allele. The control group had 51 pregnant women, chosen randomly. The statistical evaluation was performed by STATISTICA program. For the analyzing of the continuous variables the Students' T-test was used. For the categorical variables the chi 2 test was used (for comparison of 2 relative values). Values below P < 0.01 were considered to be statistically significant.
Women who have shown to suffer from deep venous thrombosis (DVT) came to the mean age of 31 +/- 3.1 years, weight 75.3 +/- 7.9 kg and BMI 28.7 +/- 4.3. All of the results above were rendered to be statistically significant. 54.5% of thrombosis occurred in the 3rd trimester, 61% were localised to the left iliofemoral vein. APC resistance appeared in 17 (51%) women with DVT, in comparison to 5 (9.8%) women in the control group (i.e. statistically significant). Factor V appeared in II (33.3%) women, in comparison to 3 (5.9%) women in the control group.
APC resistance and factor V. Leiden represent as important factors in the aetiology of deep venous thrombosis in pregnancy.
本研究旨在检测确诊为深静脉血栓形成或肺栓塞的孕妇或产褥期妇女中对活化蛋白C产生抵抗的发生率。
病例对照研究。
奥洛穆茨帕拉茨基大学医学院妇产科、血液肿瘤学系。
对33例确诊为深静脉血栓形成的女性进行活化C蛋白抵抗检测。检测C蛋白、S蛋白、抗凝血酶III、凝血酶原、肝素II辅因子和纤溶酶原的水平。APC比值低于1.86的患者通过PCR分析检测FV:Q506等位基因。对照组为51名随机选择的孕妇。采用STATISTICA程序进行统计评估。对于连续变量的分析，使用学生t检验。对于分类变量，使用卡方检验（用于比较两个相对值）。P值小于0.01被认为具有统计学意义。
出现深静脉血栓形成（DVT）的女性平均年龄为31±3.1岁，体重75.3±7.9kg，BMI为28.7±4.3。上述所有结果均具有统计学意义。54.5%的血栓形成发生在孕晚期，61%位于左髂股静脉。17例（51%）DVT女性出现APC抵抗，而对照组为5例（9.8%）女性（即具有统计学意义）。FV Leiden出现在2例（33.3%）女性中，而对照组为3例（5.9%）女性。
APC抵抗和FV Leiden是妊娠深静脉血栓形成病因中的重要因素。
