Yao Huizhen, Ji Yimei, Zhou Yanru
Huizhen Yao, Department of Obstetrics, Quzhou People's Hospital, Quzhou 324000, Zhejiang Province, P.R. China.
Yimei Ji, Department of Obstetrics, Quzhou People's Hospital, Quzhou 324000, Zhejiang Province, P.R. China.
Pak J Med Sci. 2022 Sep-Oct;38(7):2005-2010. doi: 10.12669/pjms.38.7.6284.
Changes in coagulation indexes, thromboelastogram(TEG) and autoantibodies in patients with recurrent pregnancy loss (RPL) with different number of abortions were analyzed.
Medical records of 48 patients with recurrent abortion, treated in Quzhou people's Hospital from November 2019 to October 2020, were collected as the observation group. Based on the number of abortions, patients were divided into Group-A (Two abortions, n=21), Group-B (Three abortions, n=16) and group C (Abortion ≥ four times, n=11). Records of 50 healthy pregnant women in our hospital in the same period were selected as the control group. Coagulation indexes [prothrombin time (PT), activated partial prothrombin time (APTT), fibrinogen (FIB), D-Dimer (DD)], thromboelastogram (TEG) parameters [reaction time (R), coagulation time(K), maximum thrombus amplitude (MA), coagulation angle (α)], changes in the levels of autoantibodies [anticardiolipin antibody (ACA), anti-endometrial antibody (EmAb), anti-thyroid antibody(ATA)] were compared between the groups.
There were significant differences in the levels of ATPP, Pt, FIB and DD among the groups. Higher number of abortions correlated with lower the levels of ATPP and Pt, and higher levels of FIB and DD (0.05). Compared to the control group, R and K in Group-A,B and C decreased, while α and MA increased (<0.05). There were significant differences in α and MA indexes. The positive rates of ACA, EmAb and ATA in Group-A were higher than those in the control group, but the difference was not statistically significant (>0.05), while the above indexes in groups B and C were significantly higher than those in the control group (<0.05). The positive rates of ACA and ATA in group C were significantly higher than those in Group-A (<0.05), but there was no significant difference in the positive rate of EmAb (>0.05).
RPL was related to the decrease of APTT, PT, and the increase of FIB and DD levels. TEG indicated that the increase of α and MA values indicated that the risk of multiple abortion was increased. The positive rates of ACA, EmAb and ATA were closely related to multiple abortions, especially the positive rates of ACA and ATA.
分析不同流产次数的复发性流产(RPL)患者凝血指标、血栓弹力图(TEG)及自身抗体的变化。
收集2019年11月至2020年10月在衢州市人民医院治疗的48例复发性流产患者的病历作为观察组。根据流产次数,将患者分为A组(流产2次,n = 21)、B组(流产3次,n = 16)和C组(流产≥4次,n = 11)。选取同期本院50例健康孕妇的病历作为对照组。比较各组凝血指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D - 二聚体(DD)]、血栓弹力图(TEG)参数[反应时间(R)、凝固时间(K)、最大血栓振幅(MA)、凝血角(α)]以及自身抗体[抗心磷脂抗体(ACA)、抗子宫内膜抗体(EmAb)、抗甲状腺抗体(ATA)]水平的变化。
各组间APTT、Pt、FIB和DD水平存在显著差异。流产次数越多,APTT和Pt水平越低,FIB和DD水平越高(P < 0.05)。与对照组相比,A组、B组和C组的R和K降低,而α和MA升高(P < 0.05)。α和MA指标存在显著差异。A组中ACA、EmAb和ATA的阳性率高于对照组,但差异无统计学意义(P > 0.05),而B组和C组的上述指标显著高于对照组(P < 0.05)。C组中ACA和ATA的阳性率显著高于A组(P < 0.05),但EmAb的阳性率差异无统计学意义(P > 0.05)。
RPL与APTT、PT降低以及FIB和DD水平升高有关。TEG显示α和MA值升高表明多次流产风险增加。ACA、EmAb和ATA的阳性率与多次流产密切相关,尤其是ACA和ATA的阳性率。