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正常孕妇体内的纤维蛋白单体复合物:一种潜在的妊娠血栓形成标志物。

Fibrin monomer complex in normal pregnant women: a potential thrombotic marker in pregnancy.

作者信息

Onishi Hiroaki, Kaniyu Kimiko, Iwashita Mitsutoshi, Tanaka Asashi, Watanabe Takashi

机构信息

Department of Laboratory Medicine, Kyorin University, Tokyo, Japan.

出版信息

Ann Clin Biochem. 2007 Sep;44(Pt 5):449-54. doi: 10.1258/000456307781646076.

Abstract

BACKGROUND

Pregnancy represents a major risk factor for deep vein thrombosis (DVT). Most coagulation/fibrinolysis markers currently utilized change during pregnancy, and therefore they cannot accurately evaluate thrombotic events in pregnancy because the rate of false positive results is high. Fibrin monomer complex (FMC) has recently become widely available for diagnosing DVT. The present study examined whether FMC is suitable for evaluating thrombotic status in pregnancy.

METHODS

Concentrations of FMC and other haemostatic markers were investigated in 87 pregnant women without major complications at early, mid- or late pregnancy. FMC concentrations were also measured in 127 normal non-pregnant women, and in one woman who developed DVT after delivery.

RESULTS

In normal pregnant women, FMC concentrations were unchanged during early or mid-pregnancy and slightly elevated during late pregnancy. Concentrations were within reference range in most cases, and none exceeded the cut-off value for DVT. In contrast, thrombin-antithrombin complex (TAT) and D-dimer (DD) concentrations were significantly elevated in late pregnancy, and median values exceeded reference ranges. The DVT case displayed significantly elevated FMC concentrations.

CONCLUSIONS

Changes in FMC concentrations during normal pregnancy are minimal compared with other haemostatic markers. Because the rate of false positivity is lower, FMC could be a potential marker of thrombotic status in pregnancy rather than TAT and DD.

摘要

背景

妊娠是深静脉血栓形成(DVT)的主要危险因素。目前使用的大多数凝血/纤溶标志物在孕期会发生变化,因此它们不能准确评估孕期的血栓形成事件,因为假阳性结果的发生率很高。纤维蛋白单体复合物(FMC)最近已广泛用于诊断DVT。本研究探讨了FMC是否适用于评估孕期的血栓形成状态。

方法

对87例妊娠早期、中期或晚期无重大并发症的孕妇的FMC和其他止血标志物浓度进行了研究。还对127例正常非妊娠妇女以及1例产后发生DVT的妇女进行了FMC浓度测定。

结果

在正常孕妇中,FMC浓度在妊娠早期或中期无变化,在妊娠晚期略有升高。大多数情况下浓度在参考范围内,且无超过DVT的临界值。相比之下,凝血酶 - 抗凝血酶复合物(TAT)和D - 二聚体(DD)浓度在妊娠晚期显著升高,中位数超过参考范围。DVT病例的FMC浓度显著升高。

结论

与其他止血标志物相比,正常孕期FMC浓度变化极小。由于假阳性率较低,FMC可能是孕期血栓形成状态的潜在标志物,而非TAT和DD。

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