目的：研究孕期抗凝血Ⅲ（AT－Ⅲ）活性的变化及其与妊娠期急性脂肪肝（AFLP）的关系。方法：以2008年7月至2014年7月我科住院分娩的AFLP孕妇24例为研究组，同期住院分娩的正常孕妇30例为对照组，比较两组间及组内早孕期（12－14周）、中孕期（26－28周）、晚孕期（34－36周）AT－Ⅲ活性的变化。结果：随着孕周的发展，AT－Ⅲ活性逐渐降低（P ＜0．05）；两组早孕期 AT－Ⅲ活性无明显差异（P ＞0．05），研究组中、晚孕期AT－Ⅲ活性较对照组明显降低[（94．40±11．09）％ vs （103．98±12．34）％，（70．61±13．80）％ vs （89．05±10．30）％，P ＜0．05）]；中、晚孕期 AT－Ⅲ活性诊断 AFLP 的界值分别是86．20％及96．10％。结论：中、晚孕期 AFLP 患者血浆AT－Ⅲ活性明显降低，AT－Ⅲ活性分别低于86．20％及96．10％时可预测AFLP的发生。%Objective: To explore the changes of antithrombin-Ⅲ (AT-Ⅲ) activityin pregnancy and the association with acute fatty liver of pregnancy (AFLP). Methods: 24 patients with AFLP were classified as research group from Jul 2008 to Jul 2014, while 30 women with normal pregnancy were classified as control group. The activity of AT-Ⅲ were compared in early term (12-14 weeks),middle term (26-28 weeks) and later term (34-36 weeks) between the two groups. Results: With the development of gestational age, AT-Ⅲ activity decreased significantly(P<0.05).At early term, AT-Ⅲ activity had no significant differences between the two group(P > 0.05), at middle and later term , the AT-Ⅲ activity in the research group were significantly lower than those in the control group [(94.40±11.09)% vs (103.98±12.34)%,(70.61±13.80)% vs (89.05±10.30)%,P < 0.05)].The diagnostic cut-offs were 96.10% and 86.20% at the second and the third term respectively. Conclusions: The AT-Ⅲ activity of patients with AFLP are significantly decreased at middle and later term of pregnancy,and it may indicate the occurrence of AFLP if the AT-Ⅲ activity is lower than 86.20% and 96.10% respectively.
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