妊娠高血压综合征患者分娩前、后血浆肝素辅助因子Ⅱ的动态变化及定位研究

Dynamic changes and localization of plasma heparin cofactor Ⅱ before and after delivery in hypertensive pregnancy

目的 揭示肝素辅助因子Ⅱ（ Ｈ ＣⅡ） 体内抗凝的生理意义，探讨妊娠高血压综合征（ 妊高征） 并发血栓形成时的部分发病机制。方法 ①采用发色底物法测定１８ 名正常人，１８ 名正常妊娠妇女及２９ 例妊高征患者分娩前、后血浆 Ｈ ＣⅡ活性；②用 Ｗｅｓｔｅｒｎ 印迹法检测２９ 例妊高征患者分娩前、后血浆 Ｈ ＣⅡ抗原；③免疫荧光定位检测 Ｈ ＣⅡ在胎盘组织上的分布。结果 妊高征患者产前血浆 Ｈ ＣⅡ活性及抗原含量显著降低，其降低程度与妊高征分期相关，产后恢复接近正常；在正常及病理妊娠胎盘未检测到 Ｈ ＣⅡ。结论 ① Ｈ ＣⅡ参与妊高征患者妊娠期高凝状态下凝血酶的灭活过程；②胎盘并非 Ｈ ＣⅡ蛋白的锚定部位；③血浆 Ｈ ＣⅡ可作为反映妊高征病情严重度或预后判定的指标之一。

Objective To explore the physiological significance of the anticoagulation effect of heparin cofactor Ⅱ(HCⅡ) in vivo and investigate the pathogenesis of the development of thrombosis in hypertensive pregnancy. Methods ①Plasma level of HCⅡ activity was measured by chromogenic assay in 18 healthy adults, 18 normal pregnant women and 29 hypertensive pregnant women before and after delivery . ②Plasma level of HCⅡ antigen was measured by Western blot in 29 hypertensive pregnant women before and after delivery.③The distribution of HCⅡin the placenta was determined by immunofluorescent method. Results The plasma HCⅡ activity and antigen content in hypertensive pregnancy decreased significantly before delivery. They correlated with the severity of hypertensive pregnancy, and restored to normal after delivery. No HCⅡ was found in normal and pathological placenta. Conclusion ① Plasma HCⅡ activity decreased during pregnancy in hypertensive pregnancy. ②The placenta is not the target of HCⅡ. ③Dynamic determination of plasma HCⅡ level can reflect the severity of hypertensive pregnancy and be used as one of prognostic indices.