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妊娠毒血症中临床体征与高凝状态的关系。

The relationship between clinical signs and hypercoagulable state in toxemia of pregnancy.

作者信息

Terao T, Maki M, Ikenoue T, Gotoh K, Murata M, Iwasaki H, Shibata J, Nakabayashi M, Muraoka M, Takeda Y

机构信息

Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Japan.

出版信息

Gynecol Obstet Invest. 1991;31(2):74-85. doi: 10.1159/000293106.

Abstract

The hypercoagulable state in patients with toxemia of pregnancy was investigated in comparison with normal pregnant women using new coagulation parameters, mainly thrombin-antithrombin III (TAT) complexes, alpha 2-antiplasmin-plasmin complexes (PIP), and D-dimer FDP. When the patients were categorized by the classification of the WHO Study Group (1985), significant increases of TAT complexes and alpha 2-PIP complexes with decreases of the ATIII level were observed in the groups with preeclampsia and severe gestational hypertensive disease as compared to normal pregnant women. A significant increase of D-dimer FDP was observed in a group with severe gestational hypertensive disease. Additionally, the relationship between clinical signs and the hypercoagulable state in the patients was analyzed using canonical correlation analysis as a multivariate analysis. The clinical signs and coagulation parameters had a significantly high correlation of lambda 1 = 0.7219, p less than 0.01. The results showed that clinical signs were associated with simultaneous coagulation abnormalities. The indices obtained from the results of canonical correlation analysis, which were called the clinical index and the coagulation index, should be useful in evaluating the efficacy of anticoagulation therapy.

摘要

采用新的凝血参数,主要是凝血酶 - 抗凝血酶III(TAT)复合物、α2 - 抗纤溶酶 - 纤溶酶复合物(PIP)和D - 二聚体FDP,对妊娠毒血症患者的高凝状态与正常孕妇进行了比较研究。按照世界卫生组织研究小组(1985年)的分类对患者进行分组后,发现与正常孕妇相比,先兆子痫组和重度妊娠高血压疾病组的TAT复合物和α2 - PIP复合物显著增加,而抗凝血酶III(ATIII)水平降低。在重度妊娠高血压疾病组中观察到D - 二聚体FDP显著增加。此外,使用典型相关分析作为多变量分析方法,分析了患者临床体征与高凝状态之间的关系。临床体征与凝血参数的典型相关系数λ1 = 0.7219,具有显著高度相关性,p < 0.01。结果表明临床体征与同时存在的凝血异常有关。从典型相关分析结果中获得的指标,即临床指标和凝血指标,应有助于评估抗凝治疗的疗效。

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