妊娠高血压综合征患者血管内皮细胞损伤指标测定的意义

Dection and Clinical Significance of Vascular Endothelial Cell Damages in Patients with Pregnancy Induced Hypertension Syndrome

目的探讨妊娠高血压综合征(妊高征)患者血管内皮细胞的改变及其在妊高征血栓前状态(PTS)中的诊断意义。方法应用 ELISA 法及发色底物法测定妊高征患者血中血管性血友病因子(vWF)、组织型纤溶酶原激活物 (tPA)及纤溶酶原激活物抑制剂-1(PAI-1)活性。结果妊高征患者 vWF、tPA、PAI-1 较正常非孕组明显升高,差异有统计学意义(P＜0.05或 P＜0.01)；与正常晚孕组比较,妊高征及各组患者 vWF、PAI-1 活性显著增高(P＜0.05或 P＜ 0.01),且病情越重增高越明显；而 tPA 则无明显改变。中、重度妊高征组血浆 vWF 与 PAI-1水平呈直线正相关关系(r =0.723,P＜0.5；r=0.765,P＜0.05)。结论妊高征患者由于内皮细胞功能异常,导致了凝血功能及纤溶抑制功能亢进,因此测定血浆中 vWF 和 PAI-1水平,及时发现血管内皮细胞损伤,对于指导临床诊断及治疗具有重要意义。

Objective To explore the changes and clinical significance of plasma yon Willebrand factor （vWF） ,tissue-type plasminogen activator（tPA） and plasminogen activator inhibitor-1 （PAI-1） levels in patients with induced pregnancy hypertension. Methods Plasma vWF, tPA and PAI-1 were determined by ELISA and chromogenic assay respectively in 50 non-pregnancy （control group） ,50 normal pregnancy women （normal pregnancy group） and 85 patients with preganacy induced hypertension （PIH group）. Results In normal late pregnancy group and PIH group vWF,tPA and PAI-1 were significently higher than those of con- trol group;In PIH group vWF and PAI-1 were significently higher than those of normal pregnancy group but tPA did not. There was a positive correlation between the plasma vWF and PAI-1 levels in moderate and severe PIH group （ r = 0. 723, P 〈 0.05 ; r = 0. 765, P 〈 0.05 respectively）. Conclusion There was endothelial damages in patients with induced pregnancy hypertension. The levels of plasma vWF and PAI-1 may be two indices for the surveillance of PIH. It is important for the diagnosis and therapy of PIH to oberserve the changes of their levels.