Warwick R, Hutton R A, Goff L, Letsky E, Heard M
Department of Haematology, Queen Charlotte's and Chelsea Hospital, London.
J R Soc Med. 1989 Oct;82(10):591-4. doi: 10.1177/014107688908201008.
Two longitudinal studies were undertaken to measure the naturally occurring coagulation inhibitors, protein C and protein S, in females who were either pregnant or who were undergoing hysterectomy. Functional and immunological protein C and free protein S were assayed. During pregnancy, protein C levels remained unchanged except for a small increase in protein C antigen at 28-32 weeks gestation. The free protein S fell significantly and progressively during pregnancy, although only in about one-third of patients did the level fall below the normal range. In the hysterectomy study, a significant fall in protein C occurred on days one and three after surgery but had returned to normal by the time of discharge (days 7-10). A small rise in free protein S was observed at time of discharge, but this factor was otherwise unchanged. We conclude that the changes observed may contribute to the hypercoagulable state which is associated with pregnancy or major surgery.
开展了两项纵向研究,以测量怀孕或接受子宫切除术的女性体内自然存在的凝血抑制剂蛋白C和蛋白S。对功能性和免疫性蛋白C以及游离蛋白S进行了检测。在孕期,蛋白C水平保持不变,只是在妊娠28 - 32周时蛋白C抗原略有增加。孕期游离蛋白S显著且逐渐下降,不过只有约三分之一的患者其水平降至正常范围以下。在子宫切除术研究中,术后第1天和第3天蛋白C显著下降,但到出院时(第7 - 10天)已恢复正常。出院时观察到游离蛋白S略有升高,但该因子在其他方面没有变化。我们得出结论,观察到的这些变化可能导致了与妊娠或大手术相关的高凝状态。