高地住民妊婦の凝固線溶動態と胎盤内凝固との関連性

Abstract

The serial pathologic studies of placenta examined in Nepal of high mountain country since 1977 were compared with those of Japanese placentas. As the most characteristic findings of Nepalese placentas, massive subchorionic fibrin deposits were observed. In this paper, in order to find a cause of such a high incidence of intraplacental coagulation, coagulation and fibrinolytic states of 160 Nepalese pregnant women from 20 to 40 weeks of gestation were investigated and compared with those of Japanese pregnant women.Results: 1) Levels of fibrinolytic inhibitors of α1-AT, α2-MG, α2-PI and C1-INA in Nepalese group were higher than those of Japanese group, while AT-III levels were lower than those of Japanese women group. 2) No significant differences of PTT as well as concentrations of fibrinogen, plasminogen and FDP were found in both groups, but FVIII value showed significantly high in Nepalese group. 3) Prekallikrein and kallikrein levels in Nepalese group were much higher than those of Japanese group. 4) Protein C levels in Nepalese pregnant women were less than those of Japanese group, while levels of PIVKA-II over 1μg/ml in Nepalese group amounted to 45%.In conclusion, in general, Nepalese pregnant women at high land have a tendency of hypercoagulable state which might lead to intraplacental hypercoagulation.