子痫前期产妇与易栓症的相关研究

Study on Thrombophilia in Preeclampsia Women

目的通过对子痫前期妇女、正常妊娠妇女及存在活化蛋白C抵抗(APCR)现象的子痫前期患者血液中凝血、抗凝血指标的测定,观察子痫前期产妇女与易栓症的关系。方法取子痫前期妇女30例作为研究对象(其中轻度子痫前期15例,重度子痫前期15例),正常妊娠妇女40例作为对照,正常非妊娠妇女20例测定活化蛋白C比率(APCr),作为APCR阳性的判定标准。取外周静脉血4ml,其中2ml应用血球计数仪获取红细胞比积(HCT)、血小板(PLT)、纤维蛋白原(Fbg)值;1.8ml应用血凝仪获取活化部分凝血活酶时间(aPTT)、加入活化蛋白C(APC)后的aPTT值,对以上指标进行统计学分析。结果重度子痫前期组外周血HCT、PLT、Fbg水平、aPTT时间分别为35.51±3.56%、178.87±81.66×109/L、3.68±0.98g/L、33.83±4.77s;轻度子痫前期组为33.15±2.64%、179.60±59.85×109/L、3.83±0.70g/L、32.00±3.51s;正常妊娠组为33.65±2.92%、194.98±62.01×109/L、3.91±0.77g/L、31.70±2.56s。HCT及Fbg水平在子痫前期APCR阳性组中分别为36.80±3.25%、4.52±0.74g/L;在APCR阴性组中为33.71±3.38%、3.57±0.77g/L。HCT水平重度子痫前期组较正常妊娠组及轻度子痫前期组高;aPTT在重度子痫前期组较正常妊娠组延长。子痫前期APCR阳性组中,HCT及Fbg值均比APCR阴性组高,差异有统计学意义(P<0.05)。结果子痫前期孕妇血液呈血栓前状态,这种状态以APCR阳性的子痫前期最为明显。

Objective The purpose of this study is to investigate the thrombophilic state by checking the mark of coagulation and anticoagulation in preeclampsia、 normal pregnancy and activated protein C resistance（ APCR） positive preeclampsia women. Methods 30 preeclampsia women served as study group,and 40 normal pregnant women were selected as control group,20 nonpregnancy women check the APC ratio as the standard of APCR. Blood was drawn from the antecubital vein,2 ml blood get the result of HCT,PLT;1.8 ml get the result of aPTT with and without APC and Fbg. Statistical analysed all above data. Results The level of HCT,PLT,Fbg and aPTT in plasma in sever preeclampsia group were 35.51±3.56%,178.87±81.66×109/L,3.68±0.98 g/L,33.83±4.77 s;Mild preeclampsia group were 33.15±2.64%,179.60±59.85×109/L,3.83±0.70 g/L,32.00±3.51 s;normal pregnancy group were 33.65±2.92%,194.98±62.01×109/L,3.91±0.77 g/L,31.70±2.56 s. The level of HCT and Fbg in APCR positive of preeclampsia group were 36.80±3.25%,4.52±0.74 g/L;The level in APCR negative group were 33.71±3.38%,3.57±0.77g/L. The level of HCT in plasma in sever preeclampsia group,was significantly higher than normal pregnancy group. The aPTT time in sever preeclampsia group was significantly longer than in normal pregnancy group. The level of HCT and Fbg in APCR positive group was significantly higher than it in APCR negative group. There was significantly different between two groups（P〈0.05）.Conclusion There is a prethrombotic state in preeclampsia women.This state is evident in APCR positive preeclampsia group.