Changes of new coagulation markers in healthy pregnant women and establishment of reference intervals in Changsha / 中南大学学报(医学版)

OBJECTIVES@#There is a high coagulation state in pregnant women, which is prone to coagulation and fibrinolysis system dysfunction. This study aims to explore the latest coagulation markers-thrombomodulin (TM), thrombin-antithrombin complex (TAT), plasmin-α2 plasmin inhibitor complex (PIC), and tissue plasminogen activator/plasminogen activator inhibitor compound (tPAI-C) in different stages of pregnancy, establish reference intervals (RIs) for healthy pregnant women of Chinese population, and to provide an effective and reliable reference for clinicians.@*METHODS@#A total of 492 healthy pregnant women, who underwent pregnancy examination and delivery in the Department of Obstetrics, Second Xiangya Hospital of Central South University from October 2019 to October 2020, were enrolled for this study. They were assigned into the first trimester group, the second trimester group, the third trimester group, and the puerperium group according to the pregnancy period, and 123 healthy non-pregnant women were selected as the controls. Plasma levels of TM, TAT, PIC and tPAI-C were analyzed by automatic chemiluminescence immunoassay analyzer. The RIs for TM, TAT, PIC, and tPAI-C were defined using non-parametric 95% intervals, determined following Clinical and Laboratory Standards Institute Document C28-A3c (CLSI C28-A3c), and Formulation of Reference Intervals for the Clinical Laboratory Test Items (WS/T402-2012).@*RESULTS@#TM and TAT levels increased gradually in the first, second, and third trimester women and decreased in the puerperium women (P<0.05 or P<0.01). PIC level of healthy non-pregnant women was lower than that of pregnant women (P<0.05 or P<0.01), but PIC level of pregnant and puerperium women did not differ significantly (P>0.05). tPAI-C level in healthy non-pregnant women was lower than that of pregnant women (P<0.05 or P<0.01), and tPAI-C level was significantly decreases in the puerperium women (P<0.01). The RIs for TM were as follows: Healthy non-pregnant women at 3.20-4.60 TU/mL, the first and second trimester at 3.12-7.90 TU/mL, the third trimester at 3.42-8.29 TU/mL, puerperium at 2.70-6.40 TU/mL. The RIs for TAT were as follows: Healthy non-pregnant women at 0.50-1.64 ng/mL, the first and second trimester at 0.52-6.91 ng/mL, the third trimester at 0.96-12.92 ng/mL, puerperium at 0.82-3.75 ng/mL. The RIs for PIC were as follows: Healthy non-pregnant women at 0.160-0.519 ng/mL, pregnant women at 0.162-0.770 μg/mL. The RIs for tPAI-C were as follows: Healthy non-pregnant women at 1.90-4.80 ng/mL, the first and second trimester at 2.03-9.33 ng/mL, the third trimester at 2.80-14.20 ng/mL, puerperium at 1.10-8.40 ng/mL.@*CONCLUSIONS@#The levels of 4 new coagulation markers TM, TAT, PIC, and tPAI-C in pregnant women are increased significantly during pregnancy and gradually return to normal after delivery. The RIs for TM, TAT, PIC, and tPAI-C in pregnant women by trimester are established according to CLSI C28-A3c, thus providing a clinical reference for clinician in judgement of thrombotic risk.

Changes of serum immunoglobulin level in healthy pregnant women and establishment of its reference interval / 中南大学学报(医学版)

OBJECTIVES@#Pregnant women in a special physiological period, the body's blood indicators will change to a certain extent. This study aims to explore the changes of serum immunoglobulin levels in healthy pregnant women and establish its reference interval (RI).@*METHODS@#A total of 369 healthy pregnant women, who underwent pregnancy examination in the Department of Obstetrics, Second Xiangya Hospital of Central South University from August 2019 to October 2019, were enrolled for this study. They were divided into an early pregnancy group, a middle pregnancy group, and a late pregnancy group according to the pregnancy period, and 123 healthy non-pregnant women were selected as the controls. The levels of immunoglobulin G (IgG), immunoglobulin M (IgM), and immunoglobulin A (IgA) were determined by immune transmission turbidities. The level of immunoglobulin E (IgE) was determined by electrochemiluminescence. The differences in immunoglobulin levels between pregnant women and non-pregnant women and among different gestational periods were analyzed, and the RI of serum immunoglobulin level during pregnancy was established.@*RESULTS@#Compared to the non-pregnant women, the levels of serum IgG, IgM, IgA, and IgE in pregnant women were significantly decreased (all @*CONCLUSIONS@#The levels of immunoglobulin in pregnant women are decreased significantly. The establishment of RIs of IgG, IgM, IgA and IgE in healthy pregnant women could provide scientific basis for clinical decision-making.

Determination of serum tryptophan metabolites in patients with systemic lupus erythematosus by high performance liquid chromatography-fluorescence detection / 临床检验杂志

Objective A method was developed for the simultaneous determination of tryptophan(Trp) and its metabolites kynurenine(Kyn) and kynurenic acid(Kyna) by high performance liquid chromatography with fluorescence detection(HPLC-FD),and testing serum levels of Trp metabolites in systemic lupus erythematosus(SLE) patients.Methods Serum samples were deproteinized by equal volume of 0.624 mol/L perchloric acid.The analytical column was Hypersil C18 column,and the mobile phase was 0.20 mol/L zinc acetate,8.3 mmol/L acetic acid,and 2.5% acetonitrile;flow rate was 1.5 ml/min.The excitation and emission wave length of fluorescence detector were 365 nm and 480 nm in 0~11 min,344 nm and 404 nm in 11~15.5 min,254 nm and 404 nm in 15.5~20 min,respectively.Results The linear range of Trp was 0.610~196 ?mol/L,the detection limit was 0.005 ?mol/L,and the average recovery was 103.71%.The linear range of Kyn was 0.049~98 ?mol/L,the detection limit 0.025 ?mol/L,and the average recovery was 97.45%.The linear range of Kyna was 1.050~1047 ?mol/L,the detection limit was 0.050 nmol/L,and the average recovery was 100.60%.Inter-and intra-day precisions were both less than 5%.Phenylalanine,tyrosine,and 5-hydroxytryptamine had no interference.The assay was employed to analyze serum samples of SLE patients.The result showed significant difference in Trp,Kyn,and Kyna content,Kyn/Trp ratio between SLE patients and control group.Conclusions A new method was established for simultaneous determination of Trp,Kyn,and Kyna in serum.The method is simple,fast,sensitive,specific,and suitable for applicability to clinical measurement.