妊娠高血压综合征患者血栓前状态功能指标的检测及其意义

Changes of relative variables about prethrombosis state and its clinical significance in patients with pregnancy induced hypertension

目的 探讨妊娠高血压综合征 (妊高征 )患者的血小板活化状态、血管内皮损伤、止血及凝血系统部分功能指标的变化 ,对妊高征患者血栓前状态 (PTS)的诊断意义。方法 检测正常非孕妇女 3 0例 (正常非孕组 )、正常晚孕妇女 3 0例 (正常晚孕组 )和妊高征患者 5 0例 (妊高征组 )的血管性血友病因子 (vWF)、血小板α 颗粒膜蛋白 (GMP 140 )、蛋白C依赖的活化部分凝血酶原时间 (PCAT)、抗凝血酶 Ⅲ (AT Ⅲ )、纤维蛋白原 (Fbg)、纤溶酶原 (PLG)、组织纤溶酶原激活物 (t PA)及其抑制物 (PAI)、D 二聚体 (D Dimer)含量。结果 妊高征组GMP 140、vWF含量 [( 2 3 9± 3 6) μg/L ,( 15 6± 2 3 ) % ]与正常非孕组 [( 8 7± 2 5 ) μg/L ,( 82± 11) % ]及正常晚孕组 [( 11 9± 4 1) μg/L ,( 12 3± 2 7) % ]比较 ,均显著增高 (P <0 0 1) ,并随病情加重而呈增高趋势 ;而AT Ⅲ、蛋白C活性均显著下降 (P <0 0 1) ,且病情越重下降越明显 ;妊高征组与正常非孕组比较 ,Fbg、PLG、D Dimer、PAI含量均显著增高 (P <0 0 5 ) ,中、重度患者增高尤其明显 ,而t PA含量无显著性改变 (P >0 0 5 )。结论 正常晚期妊娠妇女存在PTS ,而妊高征患者存在明显的PTS。

Objective To explore the changes of the hemorrheology coagulation and fibrinolytic system in patients with pregnancy induced hypertension(PIH). Methods To examine the platelet alphagranule membrane protein (GMP-140), Von-Willebrand factor (vWF),antithrombin Ⅲ activity(AT-Ⅲ),plasminogen activity(PLG),theactivity of tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI) in 30 non-pregnancy women ,30 normal late pregnancy women and 50 pregnancy induced hypertension women. Results In PIH group vWF[(156±23)%],GMP-140[(23.9±3.6)μg/L], Fbg[(15.5±0.8) g/L], PLG, D-Dimer[(1.42±0.32) mg/L],PAI [(9.2±0.8) kU/L]were obviously higher than those of control group. AT-Ⅲ,ProC in PIH group were lower than that of the control group (P<0.01). t-PA has no significant differences (P>0.05). Conclusions Prethrombotic state was shown in normal late pregnancy women. Obvious prethrombotic state was shown in patients with pregnancy induced hypertension women.