Harlow Françoise H, Brown Mark A, Brighton Timothy A, Smith Susan L, Trickett Annette E, Kwan Y-L, Davis Gregory K
Department of Obstetrics and Gynaecology, St George Hospital and University of New South Wales, Australia.
Am J Obstet Gynecol. 2002 Sep;187(3):688-95. doi: 10.1067/mob.2002.125766.
The purpose of this study was to determine whether platelet activation occurs only in preeclampsia or also in normal pregnancy.
Thirty women with preeclampsia, 30 women with gestational hypertension, 20 women with essential hypertension, 30 pregnant women with normotension, and 30 nonpregnant women were recruited at St George Hospital, Sydney, Australia. Platelet activation was determined by flow cytometry on whole blood samples.
Platelet activation was similar in all groups, except the group with preeclampsia. Compared with normal pregnant women, women with preeclampsia had significantly greater CD62 expression (1.35% vs 0.61%; P =.002), CD63 expression (1.73% vs 0.95%; P <.0001) and annexin V binding (1.03% vs 0.66%;P =.03) and significantly fewer circulating platelet microparticles (33 vs 49 x10(9)/L; P =.001). This was unrelated to other parameters that included platelet counts. Women with gestational hypertension in whom preeclampsia developed did not have enhanced platelet activation profiles.
Platelet activation is increased in preeclampsia but not in other hypertensive disorders or in normal pregnancy. This may be part of the pathophysiologic factors of preeclampsia complications but is not predictable by the platelet count and is not apparent in all women with preeclampsia.
本研究旨在确定血小板活化是否仅发生在子痫前期，还是也发生在正常妊娠中。
在澳大利亚悉尼的圣乔治医院招募了30名单纯性子痫前期患者、30名妊娠高血压患者、20名原发性高血压患者、30名血压正常的孕妇以及30名非孕妇。采用流式细胞术对全血样本进行血小板活化检测。
除子痫前期组外，其他各组的血小板活化情况相似。与正常孕妇相比，子痫前期患者的CD62表达显著更高（1.35% 对0.61%；P = 0.002）、CD63表达显著更高（1.73% 对0.95%；P < 0.0001）、膜联蛋白V结合显著更高（1.03% 对0.66%；P = 0.03），而循环血小板微粒显著更少（33对49×10⁹/L；P = 0.001）。这与包括血小板计数在内的其他参数无关。发生子痫前期的妊娠高血压患者的血小板活化情况并未增强。
子痫前期患者的血小板活化增加，而其他高血压疾病或正常妊娠中则无此现象。这可能是子痫前期并发症病理生理因素的一部分，但无法通过血小板计数预测，且并非在所有子痫前期患者中都明显。
