妊娠高血压综合征患者血浆血管性血友病因子及其裂解酶的测定及临床意义

Changes and Clinical Significance of Plasma Von WiUebrand Factor and Von Willebrand Factor-Cleaving Protease in Pregnancy Induced Hypertension

目的检测正常孕妇及妊娠高血压综合征(PIH)患者血浆血管性血友病因子(vWF:Ag)水平及vWF裂解酶(vWF-CP)活性,探讨vWF及vWF-CP在PIH中的临床意义。方法采用残余胶原结合实验法及ELISA法分别对35例正常孕妇及52例PIH患者血浆vWF-CP活性及vWF:Ag水平进行检测。结果正常妊娠妇女血浆vWF:Ag(103．4±68．4)％显著高于正常非孕妇(78．4±51．6)％(P＜0．01),而血浆vWF-CP活性(76．3±1 8．4)％显著低于正常非孕妇(84．7±2．1)％(P＜0．05)。轻度妊高征妇女血浆vWF:Ag(98．8±48．5)％及vWF-CP活性(70．4±2 1．8)％与正常妊娠妇女无显著性差别(P＞0．05),而中、重度妊高征妇女血浆vWF:Ag(148．4±75．6)％显著高于正常妊娠妇女(P＜0．01),血浆vWF-CP活性(60．8±19．8)％显著低于正常妊娠妇女(P＜0．05)。结论妊高征患者血浆vWF升高,vWF-CP活性低下,参与妊高征的发生、发展,内皮损伤可能是致妊高征患者血浆vWF升高,vWF-CP活性低下的原因。

Objective To evaluate the clinical significance of plasma von Willebrand factor（vWF） and von Willebrand factor-cleaving protease（vWF-CP） activity in pregnancy induced hypertension（PIH）.Methods vWF antigen（vWF：Ag） and vWF-CP activity were respectively evaluated by using ELISA and residual-collagen binding assay （R-CBA） in 52 patients with PIH and 35 normal pregnant women respectively.Results The level of the vWF： Ag in normal pregnancy women（103.4 ± 68.4）% was significantly higher than that in no pregnancy women（78.4 ± 51.6）%（P〈0.01）, while the level of plasma vWF-CP activity in normal pregnancy（76.3 ± 18.4）% was significantly lower than that in the controls（84.7 ± 2. l）%（P〈0.05）.In mild PIH patients the levels of vWF：Ag and vWF- CP activity having no changes compared with those in normal pregnant women, but in moderate or in severe PIH group the level ofvWF：Ag significantly increased compared with the normal pregnant women, while the level of vWF-CP activity in moderate or in severe PIH patients were significantly lower than those in normal pregnant women.Conclusions The injury of endothelial cells was the factor that resulted in lower vWF-CP activity in PIH patients and this lowered activity may influence the progress of PIH.