Tei A, Mutoh S, Yaoi Y, Saito M
Department of Obstetrics and Gynecology, Faculty of Medicine, Tokyo Medical and Dental University.
Bull Tokyo Med Dent Univ. 1989 Jun;36(2):19-26.
Plasma levels of fibrinopeptide A (FPA), fibrinopeptide B beta 15-42 (FPB beta 15-42), high molecular weight kininogen (HMW-kg), kinin, prekallikrein and kallikrein inhibitor during pregnancy, labor, cesarean section and puerperium were studied in 170 cases of full term normal delivery and 20 cases of cesarean section delivery with 30 non-pregnant women taken as control. Significant increases of FPA, FPB beta 15-42 and kinin during normal delivery and puerperium were found. There was also a significant increase of FPA in the uterine venous blood during cesarean section. Significant decrease of HMW-kg during normal labor and also significant decrease of prekallikrein and kallikrein inhibitor after cesarean section were also seen. Our findings suggested that the hypercoagulable state during pregnancy is due to the increase of thrombin and plasmin activity, and the kallikrein-kinin system may be related to the onset of labor and post-delivery uterine contraction. Increase of the FPA in the uterine blood promoted localised coagulation activity during cesarean section.
对170例足月顺产和20例剖宫产分娩的产妇以及30例未孕女性作为对照，研究了妊娠、分娩、剖宫产及产褥期血浆中纤维蛋白肽A（FPA）、纤维蛋白肽Bβ15 - 42（FPBβ15 - 42）、高分子量激肽原（HMW - kg）、激肽、前激肽释放酶和激肽释放酶抑制剂的水平。发现顺产和产褥期FPA、FPBβ15 - 42和激肽显著增加。剖宫产时子宫静脉血中FPA也显著增加。正常分娩时HMW - kg显著降低，剖宫产术后前激肽释放酶和激肽释放酶抑制剂也显著降低。我们的研究结果表明，孕期的高凝状态是由于凝血酶和纤溶酶活性增加所致，激肽释放酶 - 激肽系统可能与分娩发动及产后子宫收缩有关。剖宫产时子宫血中FPA增加促进了局部凝血活性。
