妊高征患者血栓前状态指标的检测及其临床意义  

Detection of Prethrombosis State in Patients with Pregnancy Induced Hypertension and Its Clinical Significances

作　　者：郑磊[1] 王前[1] 孙德华[1] 刘宝瑛[1] 钟梅[1] 余艳红[1] 

机构地区：[1]解放军第一军医大学南方医院,广东广州510515

出　　处：《实用妇产科杂志》2003年第6期356-358,共3页Journal of Practical Obstetrics and Gynecology

基　　金：广东省重大社会问题攻关项目 (2KB0 4 70 1S)

摘　　要：目的 :观察妊娠高血压综合征 (简称妊高征 )患者的血管内皮损伤、血小板活化状态、抗凝及纤溶系统部分指标的变化 ,探讨其对妊高征血栓前状态 (PTS)的诊断意义。方法 :采用酶联免疫吸附试验 (ELISA)法和全自动血凝仪分析 ,检测了正常非妊娠妇女、正常晚期妊娠妇女各 2 0例和 5 0例妊高征患者的血管性血友病因子 (vWF)、血小板α 颗粒膜蛋白 (GMP 14 0 )、抗凝血酶 (AT)、蛋白C系统筛选试验 (ProCGlobal)、纤维蛋白原 (Fbg)、纤溶酶原 (PLG)、组织纤溶酶原激活物 (t PA)及其抑制物 (PAI)、D 二聚体 (D Dimer)等指标。结果 :与正常非妊娠组及正常晚期妊娠组比较 ,妊高征组vWF、GMP 14 0水平均显著增高 (P <0 0 1) ,并随病情加重而呈增高趋势 ,而AT、ProCGlobal活性均显著下降 (P <0 0 1) ,病情越重下降越明显。纤溶系统各项指标在妊高征组、正常晚期妊娠组均显著高于非妊娠组 (P <0 0 1) ;而与正常晚期妊娠组比较 ,中、重度妊高征组Fbg、PLG、D Dimer、PAI均显著增高 (P <0 0 1) ,而t PA无显著性改变 (P >0 0 5 )。结论 :正常妊娠妇女存在高凝状态 ,而妊高征患者存在明显血栓前状态。产前测定有关凝血和纤溶功能指标 ,对妊高征的防治具有重要价值。Objective: To study the changes and the diagnostic value of some functional varibles of vascular endothelial cells, platelet activation,antithrombosis and thrombolysis system in patients with pregnancy induced hypertention(PIH). Methods: Using ELISA methods and thrombosis auto-analyzer, some variables were detected in 20 normal non-pregnant women,20 normal late-pregnant women,and 50 PIH patients,which including von Willebrand factor(vWF),platelet alpha-granule membrane protein(GMP-140),antithrombin activity(AT),fibrinogen(Fbg),plasminogen activity(PLG),activity of tissue-type plasminogen activator(t-PA) and plasminogen activator inhibitor(PAI) and D-Dimer. Results: The levels of vWF and GMP-140 were obviously higher(P<0.01),while activities of AT and ProC Gobal dropped in PIH women(P<0.01),compared with the non-pregnant and late-pregnant women. Further more,these changes became more apparent with the disease progression. The variables of thrombolysis system in PIH women and late-pregnant women were significantly higher than that of non-pregnant women. Some variables,including Fbg,PLG,D-Dimer, and PAI in the PIH women, were greatly higher than those of the late-pregnant women(P<0.01). While,the activities of t-PA had no significant changes between the two groups(P>0.05). Conclusions: The normal pregnant women are in the hypercoagulation state,while the PIH women appear in the prethrombotic state. Regular antenatal examination of coagulation function and thrombolysis potentially play an important role in the prevention and treatment of PIH.

关 键 词：妊高征 血栓前状态指标 检测 血管内皮细胞 

分 类 号：R714.24[医药卫生—妇产科学]