几种内皮细胞损伤与凝血活化分子标志物在妊高征患者血中的变化

The Level of Endothelium Damage Markers and Prethrombotic Markers in Pregnancy-Induced Hypertension Women

目的:观察几种内皮细胞损伤与凝血活化分子标志物在妊高征患者血中的变化及其与病情的关系。方法:将86例妊高征患者分为轻、中、重度三组,分别用ELISA法测定其血浆中的凝血酶原片段F_(1+2)、凝血酶-抗凝血酶复合物(TAT)、vWF因子和凝血酶调节蛋白(TM)。结果:F_(1+2)、TAT和TM在各组妊高征中的含量均高于正常对照组,其中F_(1+2)和TAT在各妊高征组中含量并无差异,相关性分析显示二者间有显著性相关;TM 随病情加重而升高。各妊高征组中vWF含量与正常对照组相比并无显著性差异,各组之间也无显著性差异;各组F_(1+2)和TAT与vWF和TM含量之间并无相关性。结论:妊高征患者中存在着明显的凝血活化和内皮细胞损害,但现有指标显示凝血活化进程与血管内皮细胞损害进程之间并无相关性;vWF在评价妊高征患者血管内皮细胞功能的价值值得进一步探讨。

Objective: To study the alteration of several kinds of endothelium damage markers and prethrombotic state molecular markers in pregnancy-induced hypertension women. Methods: 86 women with pregnancy-induced hypertension (PIH) were divided into three groups according to their severity. The levels of prothrombin fragment F1+2,thrombin-antithrombin (TAT), vWF and Thrombomodulin (TM) were determinated in plasma of them. Results: In all the three groups, the levels of F1+2, TAT and TM were significantly increased in relation to values observed in the control group, but only the TM levels were significant different among the three PIH groups which showed increased with the severity of patients. A significant correlation only between F1+2 and TAT (r=0.84,P<0. 0001) was found in all PIH groups. There were no significant differences among the three PIH groups, neither between PIH groups and normal control group. Conclusions: PIH is associated with marked activation of coagulation and endothelium damage, but there is no essential relationship between them based on the evidence we found. The value of vWF in evaluation of endothelium damage status need to be extensive studied.