妊娠期高血压疾病凝血指标和vWF的变化与意义
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摘要
目的探讨凝血指标和血管性血友病因子(vWF)在妊娠期高血压患者和正常妊娠妇女中的表达与意义。方法选择妊娠期高血压疾病患者81例(妊娠期高血压组21例,轻度子痫前期组26例,重度子痫前期组34例)和正常妊娠妇女40例,采用免疫比浊法检测外周血中vWF的水平,并用全自动生化分析仪对凝血酶原时间(PT)、活化部分凝血酶时间(APTT)及凝血酶时间(TT)的表达水平进行检测。结果重度子痫前期组和轻度子痫前期组PT低于正常妊娠组,重度子痫前期组PT低于妊娠高血压组和轻度子痫前期组,差异均有统计学意义(均<0.05)。重度子痫前期组APTT和TT均低于正常妊娠组(均<0.05)。重度子痫前期组、轻度子痫前期组、妊娠高血压组vWF水平均高于正常妊娠组(均<0.05),重度子痫前期组的vWF水平高于妊娠高血压组和轻度子痫(均<0.05)。结论妊娠高血压患者血液呈现异常的高凝状态,同时机体内vWF表达水平显著高于正常妊娠妇女,并随着病情加重而增高。凝血指标和vWF的检测可以作为初步判断病情严重程度的指标,这对HDCP的诊断和防治具有重要的临床价值。
Objective To observe the application value of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT) and von Willebrand factor(v WF) of plasma in normal pregnant women and gestational hypertension. Methods Eighty-one gestational hypertension patients(21 in the hypertensive disorder group, 26 in the mild preeclampsia group, 34 in the severe preeclampsia group) and 40 normal pregnant women were tested for peripheral blood by immunoturbidimetry. The level of v WF was measured and the expression levels of PT, APTT and TT were detected by an automatic biochemical analyzer. Results The PT in the severe preeclampsia group and the mild preeclampsia group was lower than that in the normal pregnancy group(all < 0.05). The PT in the severe pre-eclampsia group was lower than that in the pregnancy-induced hypertension group and the mild pre-eclampsia group(all < 0.05). The APTT and TT in the severe preeclampsia group were lower than those in the normal pregnancy group(all < 0.05). The v WF level in the pre-eclampsia group, the mild pre-eclampsia group, and the pregnancy-induced hypertension group was higher than that in the normal pregnancy group(all < 0.05), and the v WF level in the severe pre-eclampsia group was higher than that in the normal preeclampsia group( < 0.05). Conclusions The blood of pregnant women with gestational hypertension was in abnormal high coagulation state,and the v WF level in the body was significantly higher than that of normal pregnant women, increasing with the severity of the disease. The detection of coagulation index and v WF can be used as indicators to judge the severity of the disease, and they have important clinical value for diagnosis and treatment of gestational hypertension.
Objective To observe the application value of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT) and von Willebrand factor(v WF) of plasma in normal pregnant women and gestational hypertension. Methods Eighty-one gestational hypertension patients(21 in the hypertensive disorder group, 26 in the mild preeclampsia group, 34 in the severe preeclampsia group) and 40 normal pregnant women were tested for peripheral blood by immunoturbidimetry. The level of v WF was measured and the expression levels of PT, APTT and TT were detected by an automatic biochemical analyzer. Results The PT in the severe preeclampsia group and the mild preeclampsia group was lower than that in the normal pregnancy group(all < 0.05). The PT in the severe pre-eclampsia group was lower than that in the pregnancy-induced hypertension group and the mild pre-eclampsia group(all < 0.05). The APTT and TT in the severe preeclampsia group were lower than those in the normal pregnancy group(all < 0.05). The v WF level in the pre-eclampsia group, the mild pre-eclampsia group, and the pregnancy-induced hypertension group was higher than that in the normal pregnancy group(all < 0.05), and the v WF level in the severe pre-eclampsia group was higher than that in the normal preeclampsia group( < 0.05). Conclusions The blood of pregnant women with gestational hypertension was in abnormal high coagulation state,and the v WF level in the body was significantly higher than that of normal pregnant women, increasing with the severity of the disease. The detection of coagulation index and v WF can be used as indicators to judge the severity of the disease, and they have important clinical value for diagnosis and treatment of gestational hypertension.
引文
[1]Szpera-Gozdziewicz A,Majcherek M,Boruczkowski M,et al.Circulating endothelial cells,circulating endothelial progenitor cells,and von Willebrand factor in pregnancies complicated by hypertensive disorders[J].Am J Reprod Immunol,2017,77(3):e12625.
[2]徐晓燕,李晓红,郗爱喜,等.凝血功能和D-二聚体与妊娠高血压疾病严重程度的相关[J].河北医学,2017,23(6):997-999.
[3]舒如明,肖玲,郑丹,等.孕妇妊娠期高血压疾病与血小板和凝血功能的相关性研究[J].血栓与止血学,2017,23(3):403-405.
[4]谢幸.妇产科学[M].8版.北京:人民卫生出版社,2013:64-79.
[5]王艳妮,蒲才秀.正常及妊娠高血压综合征孕妇凝血功能检测的意义探讨[J].中国继续医学教育,2017,9(11):63-65.
[6]Vinayagam V,Bobby Z,Habeebullah S,et al.Plasma markers of endothelial dysfunction in patients with hypertensive disorders of pregnancy:a pilot study in a South Indian population[J].J Matern Fetal Neonatal Med,2016,29(13):2077-2082.
[7]谢金航.纤溶、凝血功能指标检测对妊娠期高血压疾病的临床研究价值[J].血栓与止血学,2015,21(5):316-319.
[8]谢华.妊娠高血压患者体内凝血纤溶状态的变化及其临床意义[J].中外医疗.2012,13(40):52-53.
[9]卡米拉·合亚斯丁,郝立君,等.凝血及纤溶功能联合检测在妊娠高血压综合征患者中的临床价值[J].重庆医学,2016,45(1):17-18.
[10]王建荣,綦丽霞,高辉.妊娠期高血压患者与正常妊娠凝血功能及血栓前状态对比观察[J].贵州医药,2014,38(7):597-599.
[11]周三琴.妊娠高血压疾病纤溶及凝血指标的变化及临床意义[J].中国妇幼健康研究,2016,27(8):1009-1011.
[12]魏蔚.妊娠期高血压疾病患者凝血功能及D-二聚体水平检测的临床意义[J].中国实用医药,2017,12(8):41-43.
[13]杨坤,廖有乔.孕妇血浆血管性假血友病因子和血清C反应蛋白检测的临床意义[J].中国妇幼保健,2010,25(1):15-17.
[14]綦丽霞.VWF检测指导低分子肝素治疗子痫前期的临床研究毕书琴[J].河北医学,2015,21(11):1834-1837.
[2]徐晓燕,李晓红,郗爱喜,等.凝血功能和D-二聚体与妊娠高血压疾病严重程度的相关[J].河北医学,2017,23(6):997-999.
[3]舒如明,肖玲,郑丹,等.孕妇妊娠期高血压疾病与血小板和凝血功能的相关性研究[J].血栓与止血学,2017,23(3):403-405.
[4]谢幸.妇产科学[M].8版.北京:人民卫生出版社,2013:64-79.
[5]王艳妮,蒲才秀.正常及妊娠高血压综合征孕妇凝血功能检测的意义探讨[J].中国继续医学教育,2017,9(11):63-65.
[6]Vinayagam V,Bobby Z,Habeebullah S,et al.Plasma markers of endothelial dysfunction in patients with hypertensive disorders of pregnancy:a pilot study in a South Indian population[J].J Matern Fetal Neonatal Med,2016,29(13):2077-2082.
[7]谢金航.纤溶、凝血功能指标检测对妊娠期高血压疾病的临床研究价值[J].血栓与止血学,2015,21(5):316-319.
[8]谢华.妊娠高血压患者体内凝血纤溶状态的变化及其临床意义[J].中外医疗.2012,13(40):52-53.
[9]卡米拉·合亚斯丁,郝立君,等.凝血及纤溶功能联合检测在妊娠高血压综合征患者中的临床价值[J].重庆医学,2016,45(1):17-18.
[10]王建荣,綦丽霞,高辉.妊娠期高血压患者与正常妊娠凝血功能及血栓前状态对比观察[J].贵州医药,2014,38(7):597-599.
[11]周三琴.妊娠高血压疾病纤溶及凝血指标的变化及临床意义[J].中国妇幼健康研究,2016,27(8):1009-1011.
[12]魏蔚.妊娠期高血压疾病患者凝血功能及D-二聚体水平检测的临床意义[J].中国实用医药,2017,12(8):41-43.
[13]杨坤,廖有乔.孕妇血浆血管性假血友病因子和血清C反应蛋白检测的临床意义[J].中国妇幼保健,2010,25(1):15-17.
[14]綦丽霞.VWF检测指导低分子肝素治疗子痫前期的临床研究毕书琴[J].河北医学,2015,21(11):1834-1837.