Nakamura N, Tanaka Y, Hirooka S, Hayashida M, Nasu T, Tsubakio T, Doi Y, Yoshihara W, Hirai T, Hosono T
Department of Gynecology and Obstetrics, Suita Municipal Hospital.
Rinsho Ketsueki. 1993 May;34(5):649-55.
A 26-year-old pregnant woman was diagnosed as having both lupus anticoagulant (LA) and anticardiolipin antibody (ACA). Her previous pregnancy ended in intrauterine fetal death at 27 weeks' gestation. During the present pregnancy she was treated with aspirin, dipiridamole, predonisolone, and heparin. At 24 weeks, fetal growth became retarded, accompanied by markedly decreased activities of AT-III, protein C, plasminogen and alpha 2-plasmin inhibitor. Supplement of human AT-III led both to prolongation of the gestational period and improvement of fetal growth. The pregnancy ended in cesarean section because of signs of fetal distress at 30 weeks. The infant was a 1025-g male with Apgar scores of 5 and 9 at one and five minutes, respectively, and is healthy. The mother developed DIC after surgery, but recovered after therapy. In this case, TAT, alpha 2PI-plasmin complex, FDP Ddimer, FPB beta 15-42, L-FDP showed little correlation with the clinical course.
一名26岁的孕妇被诊断同时患有狼疮抗凝物（LA）和抗心磷脂抗体（ACA）。她前次妊娠在孕27周时以宫内胎儿死亡告终。在本次妊娠期间，她接受了阿司匹林、双嘧达莫、泼尼松龙和肝素治疗。孕24周时，胎儿生长迟缓，同时伴有抗凝血酶III（AT-III）、蛋白C、纤溶酶原和α2-纤溶酶抑制剂活性显著降低。补充人AT-III既延长了妊娠期，又改善了胎儿生长。由于孕30周时出现胎儿窘迫征象，此次妊娠以剖宫产结束。婴儿为一名体重1025克的男婴，1分钟和5分钟时的阿氏评分分别为5分和9分，且健康。母亲术后发生了弥散性血管内凝血（DIC），但经治疗后康复。在该病例中，凝血酶-抗凝血酶复合物（TAT）、α2-纤溶酶抑制物-纤溶酶复合物、纤维蛋白降解产物D-二聚体、纤维蛋白肽Bβ15-42、低分子纤维蛋白降解产物（L-FDP）与临床病程几乎没有相关性。
