妊高症患者血栓前状态分子标志物变化的临床意义

目的通过观察妊娠期高血压疾病（简称＂妊高症）＂患者分娩前后血浆中各凝血及纤溶系统分子标志物的变化,探讨其临床意义。方法检测正常非孕组、正常晚孕组、妊娠期高血压组、轻度子痫前期组（各30例）及重度子痫前期或子痫组（18例）妇女分娩前后外周血血浆的AT活性、TAT浓度、ProC活性、LPA水平。结果 1.与正常非孕组或正常晚孕组比较,三组妊高症患者分娩前后血浆的TAT及LPA水平显著升高,AT和ProC活性显著降低（P〈0.01）;2.分娩前,正常晚孕组与正常非孕组比较,血浆的TAT及LPA水平显著升高,AT和ProC活性显著降低（P〈0.01）;3.与分娩前比较,正常晚孕组产后血浆TAT及LPA水平轻微降低,AT和ProC活性轻微上升,差异均无显著统计学意义（P〉0.05）;4.与分娩前比较,三组妊高症患者产后血浆TAT及LPA显著降低,AT和ProC活性显著升高（P〈0.01）。结论 1.正常孕晚期妇女分娩前处于轻度的血栓前状态,分娩后短期内无明显改变;2.妊高症患者分娩前存在明显的血栓前状态,分娩后短期内明显缓解。3.妊高症患者血栓前状态随病情加重而加重,并危及胎儿,适时终止妊娠有利于预防血栓形成及减少并发症。

Clinical significance of the changes of molecular makers in patients with hypertensive disorders in pregnancy in pre-thrombosis state

Objective:To explore the clinical significance,by studying the changes of molecular makers in patients with hypertensive disorders in pregnancy(PIH) in pre-thrombotic state.Methods:The activity of AT and Pro C,the level of TAT and LPA,were examined in 30 non-pregnancy women,30 normal late-pregnancy women,30 patients with gestational hypertension,30 patients with mild-preeclampsia and 18 patients with severe-preeclampsia or eclampsia,before delivery and after delivery.Results:1.The levels of TAT and LPA were obviously higher in the three groups of PIH,but were obviously lower in the activity of AT and Pro C,compared with the non-pregnant women and the normal late-pregnancy women(P<0.01).2.The same as in the normal late-pregnancy women before delivery,compared with the non-pregnant women(P<0.01).3.The levels of TAT and LPA were slightly lower in normal late-pregnancy women after delivery,and were slightly higher in the activity of AT and Pro C,but compared with before delivery,there were no significant differences in two groups(P>0.05).4.The levels of TAT and LPA were lower in the three groups of PIH after delivery,but were higher in the activity of AT and Pro C,compared with before delivery,there were significant differences in two groups(P<0.01).Conclusions:Before delivery,the normal late-pregnant women were in mild pre-thrombotic state,and it has no significant changes in the short term after delivery.However,the serious pre-thrombotic state of the patients with PIH before delivery,relieves after delivery in the short term.With the disease aggravating,the serious pre-thrombotic state of the patients with PIH will getting more serious and endanger to the fetus.Timely terminate pregnancy,it will prevent the women from thrombosis and reduce complications.