Clark P, Brennand J, Conkie J A, McCall F, Greer I A, Walker I D
Department of Haematology, Royal Infirmary, Glasgow, UK.
Thromb Haemost. 1998 Jun;79(6):1166-70.
A prospective study of activated protein C sensitivity, protein C, protein S, and other coagulation factors in 239 women during normal pregnancy was carried out. Protein C activity appeared unaffected by gestation, although an elevation of protein C activity was observed in the early puerperium. A fall in total and free protein S with increasing gestation was observed. Activated protein C sensitivity ratio (APC:SR) showed a progressive fall through pregnancy. This fall correlated with changes in factor VIIIc, factor Vc and protein S. 38% of subjects, with no evidence of Factor V Leiden or anticardiolipin antibodies, showed a low APC:SR (APC:SR <2.6) in the third trimester of pregnancy. Aside from a significant reduction in birth weight, no difference in pregnancy outcome was observed between these subjects and those with a normal APC:SR. Activated protein C sensitivity ratio, modified by pre-dilution of patient samples with factor V depleted plasma, showed no consistent trend with gestation.
对239名正常孕期女性的活化蛋白C敏感性、蛋白C、蛋白S及其他凝血因子进行了一项前瞻性研究。蛋白C活性似乎不受妊娠影响，尽管在产褥早期观察到蛋白C活性升高。随着孕周增加，总蛋白S和游离蛋白S均下降。活化蛋白C敏感率（APC:SR）在孕期呈逐渐下降趋势。这种下降与因子VIIIc、因子Vc和蛋白S的变化相关。38%无因子V Leiden或抗心磷脂抗体证据的受试者在妊娠晚期显示低APC:SR（APC:SR<2.6）。除出生体重显著降低外，这些受试者与APC:SR正常的受试者在妊娠结局方面未观察到差异。用缺乏因子V的血浆预稀释患者样本后修正的活化蛋白C敏感率与孕周无一致趋势。
