【摘要】 目的:通过对临床资料的前瞻性分析,探讨ADAMTS13活性与妊娠期高血压之间的关系,以及由妊娠期高血压引起的凝血障碍、血栓形成之间的关系。方法:分别收集慢性高血压、子痫前期/子痫、慢性高血压并发子痫前期/子痫患者以及健康孕妇的血浆,采用剩余胶原结合法检测ADAMTS13活性;分别选取健康的正常对照组孕妇和该院诊断的慢性高血压、子痫前期/子痫、慢性高血压并发子痫前期/子痫患者,应用彩色多普勒血流显像仪检测胎盘床动脉血流参数;应用全自动血凝分析仪检测凝血系统各项指标,观察体外血栓的形成情况。结果:60例正常对照组中妊娠妇女血浆中的ADAMTS13活性随着怀孕天数的增加而下降,差异有统计学意义(P<0.05)。随着妊娠期高血压严重程度的增加,ADAMTS13活性也呈现下降趋势(P<0.05)。各类型妊娠期高血压患者的收缩期最大速度与舒张末期速度之比(S/D)、搏动指数(PI)、阻力指数(RI)与正常对照组相比均升高,时间平均流速(TAV)均降低。与正常对照组相比,各个程度妊娠期高血压患者凝血酶原时间(PT)、活化部分凝血酶时间(APTT)均缩短,人纤维蛋白原(FIB)含量均增加,血栓形成增加。结论:ADAMTS13活性在妊娠期高血压患者中明显下降,且随着妊娠期高血压程度的严重,凝血系统功能增强。提示妊娠期高血压所致的ADAMTS13活性降低可能是导致孕妇凝血障碍的重要因素之一。更多还原

【Abstract】 Objective: To explore the relationship between ADAMTS13 activity and hypertensive disorder complicating pregnancy( HDCP) and blood coagulation disorder,thrombogenesis resulted from HDCP by prospectively analyzing clinical data. Methods: The plasma samples of pregnant women with chronic hypertension,preeclampsia /eclampsia,chronic hypertension complicated by preeclampsia /eclampsia and healthy pregnant women were collected respectively,residual collagen binding assay was used to detect ADAMTS13 activity; US was used to detect blood flow parameters of spiral arteries of uteroplacental bed; full- automatic coagulation analyzer was used to detect indexes of coagulation system to observe the formulation of thrombosis in vitro. Results: Plasma ADAMTS13 activity of 60 healthy pregnant women in control group decreased during pregnancy,there was statistically significant difference( P < 0. 05). ADAMTS13 activity showed a decreasing trend with aggravation of severity of HDCP( P < 0. 05). Compared with healthy pregnant women,S /D ratio,PI and RI in patients with chronic hypertension,preeclampsia /eclampsia,chronic hypertension complicated by preeclampsia /eclampsia increased,TAV decreased,PT and APTT shortened,FIB content and thrombogenesis increased. Conclusion: ADAMTS13 activity decreases significantly in patients with HDCP. Blood coagulation system heighten with aggravation of severity of HDCP,which indicates that the decrease of ADAMTS13 activity may be a key factor causing blood coagulation disorder of pregnant women.更多还原