妊娠高血压综合征患者血浆纤维蛋白溶解系统变化的初步观察

PRELIMINARY INVESTIGATION OF CHANGES IN THE FIBRINOLYTIC SYSTEM OF PATIENTS WITH PREGNANCY INDUCED HYPERTENSION

目的：观察妊高征患者血浆纤维蛋白溶解系统的变化。方法：测定20例正常孕妇及15例妊局征患者血浆中D-二聚体（D－D）、纤维蛋白降解产物（FDP）、纤维蛋白原（Fg）含量、组织型纤溶酶原激活物活性（t－PA：A）、α2－纤溶酶抑制物活性（α2－PI：A）。结果：非孕妇与正常孕妇、正常孕妇与好高征患者之间D—D含量有明显差异（P＜0．01，P＜0．001）；好高征患者FDP阳性率（100％）明显高于正常妊娠组（15％）；非孕妇与正常孕妇及好高征患者间Fg含量有明显差异（P＜0.01）；非孕妇与正常孕妇之间t－PA:A无差异，但与妊高征之间有明显差异（P＜0.001），α2－PI：A则无组间差异。结论：正常孕妇处于高凝状态，妊高征者有血栓形成倾向。本文所检测的指标，尤其D－D、t－PA：A和α2－PI：A为纤溶系统分子标志物，可作为监测妊高征纤溶及凝血变化的重要指标。

Aim: To investigate changes in various parameters of the fibrnolytic system of patientswith pregnancy induced hypertension (PIH). Methods: The values of D - dimer (D - D), fibrin degradation products (FDP), fibrinogen (Fg), tissue plasminogen activator (t - PA) and a2 - plasmin inhibitor (a2 - PI) activity were determined in 20 normal pregnant women and 15 patients with PIH. Results: The value of D - D showed significant difference between nonpregnant and normal pregnant women(P < 0 .01) and very significant difference between normal pregnant women and patients with PIH (P <0.001); the 100% appearance of FDP in PIH patients was significantly higher than that of 15% seen innormal pregnant women; the fibrinogen level showed significant diffevence between the above three groupsof women (P <0.01); the t - PA value showed no substantial difference between nonpregnant and normal pregnant women, but significant difference between the latter group and patients with PIH (P<0.001); a2 - PI activity exhibited no significant difference between the three groups. Conclusion: Normal pregnant women are in a hypercoagulable stste and the PIH patients show a tendency to develop thrombosis and predispose to spontaneous intravascular coagulation, moreoverl the parameters D - D and activityof t - PA and of a2 - PI are molecular markers of the fibrinolytic system and can be applied to monitor thechanges in fibriolysis and thrombosis in PIH patients.