子痫前期及子痫期患者联合检测血小板膜糖蛋白及凝血酶原的临床意义  

Significances of Detecting Platelet GPIbα,GPⅡb Associated with PT,APTT of Patients with Pre-eclampsia or Eclampsia

作　　者：郑明阳[1] 马晓艳[1] 廖琪[1] 

机构地区：[1]吉林大学第二医院妇产科,吉林长春130041

出　　处：《中国微循环》2009年第4期297-299,共3页Journal of Chinese Microcirculation

基　　金：长春市科学技术局资助(2008116)

摘　　要：目的研究子痫前期及子痫期患者血管内皮损伤和血小板活化状态及凝血系统活跃程度。方法采用全血流式细胞术分别检测32例重度子痫前期/子痫患者、16例轻度子痫前期患者、22例孕晚期妇女剖宫产术前及剖宫产术后72h内血小板膜糖蛋白Ibα(GPIbα)、Ⅱb(GPⅡb)水平变化,采用血凝仪同期检测血浆凝血酶原时间(PT)和活化部分凝血活酶时间(APTT)。结果剖宫产术前,与轻度子痫前期组、正常孕晚期组比较,重度子痫前期及子痫组GPIbα和PT明显降低(P<0.01),术后两者72h内恢复至正常孕晚期水平,与术前比较差异显著(P<0.01);各组间剖宫产术前或术后GPⅡb变化无显著性差异(P>0.05);正常孕晚期组、轻度子痫前期组及重度子痫前期子痫组APTT递次延长但无统计学差异(P>0.05);术后上述三组APTT递次降低,但无显著性差异(P>0.05)。GPIbα与PT呈正相关(r=0.371,P<0.01)。结论孕晚期子痫前期及子痫患者存在血管内皮细胞损伤及血小板活化状态,引起外源性凝血系统活跃,而内源性凝血系统由于肝脏产生的凝血因子相对减少而活跃性相对降低。Objective To study the damage of vascular endothelial cell, the actived state of platelet and the state of actived blood coagulation system of patients with pre-eclampsia and eclampsia. Methods detect levels of GPⅠbα and GP Ⅱb by flow cytometey（FCM）, and detect levels of PT and APTT by auto blood coagulation instrument. The venous blood of 32 severe pre-eclampsia or eclampsia women, 16 mild pre-eclampsia women and 22 normal pregnancy women were collected before operation and 72 hours after the operation. Resuits Before the cesarean section, the levels of GPⅠbα and PT of the severe pre-eclampsia and eclampsia group were much lower than normal late pregnancy group and mild pre-eclampsia group（ P 〈 0.01 ）, after cesarean section, GPⅠbα and PT returned to late pregnancy levels and had significant difference with levels before cesarean section（ P 〈 0.01）. There is no significant difference of levels of GP Ⅱ b and APTF between each group（ P 〉 0.05）. Level of GP Ⅰbα is positively correlated with level of PT. Conclusion In patients with severe pre-eelampsia and eclampsia, vascular endothelial cells are damaged and platelets are actived, which cause the activation of extrinsic coagulation system, at the same time, the activity of intrinsic coagulation system is relatively lower due to decrease of blood coagulation factor from liver.

关 键 词：子痫前期 子痫 血小板膜糖蛋白 凝血酶原时间 

分 类 号：R714.245[医药卫生—妇产科学] Q513.2[医药卫生—临床医学]