Yuasa S, Ishizawa M, Yuki Y, Minoura T, Fujita N, Takahashi H, Yoshimura M, Yamamoto T, Okada H
Section of Clinical Laboratory, University Hospital, Kyoto Prefectural University of Medicine.
Rinsho Byori. 1992 Dec;40(12):1287-91.
We studied on coagulation and fibrinolysis systems during pregnancy by measuring plasma levels of thrombin-antithrombin III complex (TAT), plasmin-alpha 2 plasmin inhibitor complex (PIC), fibrinogen/fibrin degradation products (FDP), plasminogen (PLG) and antithrombin III (AT-III). Ninety seven pregnant, 5 post-delivery and 32 nonpregnant women aged from 20 to 52 years old were included in this study. Plasma concentrations of TAT and PIC in nonpregnant women were 3.38 +/- 1.02 micrograms/l and 0.65 +/- 0.24 micrograms/ml, respectively. TAT gradually increased with the progression of pregnancy and rapidly decreased after the delivery. Whereas PIC and AT-III concentrations did not change significantly during pregnancy. Fibrinogen, PLG and FDP concentrations changed similarly as TAT. Eight pregnants whose plasma PIC concentrations elevated more than 1.0 micrograms/l were further examined. In 6 women out of them (71.5%), FDP concentrations were elevated. In this particular group of subjects, however, they delivered normally without complications such as toxemia. These observations suggest that, at least, a hypercoagulative state progresses with pregnancy, being normalized after the delivery. Although we could not find the relationship between the hypercoagulation and clinical complications such as thrombosis and toxemia of pregnancy, present findings suggest that special caution should be paid on the pregnants whose TAT and FDP levels are elevated.
我们通过检测血浆中凝血酶 - 抗凝血酶III复合物(TAT)、纤溶酶 - α2纤溶酶抑制物复合物(PIC)、纤维蛋白原/纤维蛋白降解产物(FDP)、纤溶酶原(PLG)和抗凝血酶III(AT - III)的水平,对孕期的凝血和纤溶系统进行了研究。本研究纳入了97名年龄在20至52岁之间的孕妇、5名产后女性和32名非孕妇。非孕妇血浆中TAT和PIC的浓度分别为3.38±1.02微克/升和0.65±0.24微克/毫升。TAT随着孕期进展逐渐升高,产后迅速下降。而PIC和AT - III浓度在孕期无显著变化。纤维蛋白原、PLG和FDP浓度的变化与TAT相似。对8名血浆PIC浓度升高超过1.0微克/升的孕妇进行了进一步检查。其中6名女性(71.5%)FDP浓度升高。然而,在这一特定组的受试者中,她们正常分娩,未出现如子痫前期等并发症。这些观察结果表明,至少在孕期会出现高凝状态,产后恢复正常。尽管我们未发现高凝状态与诸如血栓形成和妊娠子痫前期等临床并发症之间的关系,但目前的研究结果表明,对于TAT和FDP水平升高的孕妇应格外谨慎。