TheSimpson Centre for Reproductive Health, The Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK.
Thromb Haemost. 2010 Feb;103(2):372-8. doi: 10.1160/TH08-12-0780. Epub 2010 Jan 13.
Platelet activation has a key role in mediating thrombotic and inflammatory events. This study aimed to determine the influence of the menstrual cycle, pregnancy and pre-eclampsia on in vivo platelet activation. Twelve healthy nulliparous, non-smoking women with regular menses were studied over a single menstrual cycle. Twenty-one healthy primigravida pregnant women were studied longitudinally at 16, 24, 32 and 37 weeks gestation and seven weeks post-partum. Sixteen primigravida women with pre-eclampsia were studied at time of diagnosis and at seven weeks post-partum. Platelet-monocyte aggregates and platelet-surface P-selectin expression were assessed by flow-cytometry. Soluble P-selectin and CD40 ligand (CD40L) were measured by ELISA. Markers of platelet activation did not vary over the menstrual cycle. Platelet-monocyte aggregates were greater in the third trimester of pregnancy compared to non-pregnant women (p=0.003). Platelet surface and plasma soluble P-selectin concentrations increased with gestation (p<0.0001) and were raised by 24 weeks of pregnancy compared to non-pregnant women (p< or =0.02 for both) and together with platelet monocyte aggregates, decreased post-partum (p< or =0.02). Soluble CD40L concentrations fell in pregnancy, reaching a nadir at mid-gestation (p=0.002). There were no differences in markers of platelet activation between normal and pre-eclamptic pregnancies. In conclusion, platelet activation is increased in pregnancy and increases with gestation but is unaffected by pre-eclampsia. This suggests that systemic platelet activation is a feature of pregnancy but this is not affected by established pre-eclampsia.
血小板活化在介导血栓形成和炎症反应中起着关键作用。本研究旨在确定月经周期、妊娠和子痫前期对体内血小板活化的影响。研究了 12 名健康、初产、非吸烟、月经规律的女性，在单个月经周期内进行研究。21 名健康初产妇在妊娠 16、24、32 和 37 周及产后 7 周进行纵向研究。16 名患有子痫前期的初产妇在确诊时和产后 7 周进行研究。通过流式细胞术评估血小板-单核细胞聚集和血小板表面 P-选择素表达。通过 ELISA 测量可溶性 P-选择素和 CD40 配体（CD40L）。血小板活化标志物在月经周期内没有变化。与非妊娠妇女相比，妊娠晚期的血小板-单核细胞聚集更多（p=0.003）。血小板表面和血浆可溶性 P-选择素浓度随妊娠而增加（p<0.0001），与非妊娠妇女相比，在妊娠 24 周时升高（p<或=0.02），与血小板-单核细胞聚集一起，产后降低（p<或=0.02）。可溶性 CD40L 浓度在妊娠期间下降，在中期达到最低点（p=0.002）。正常妊娠和子痫前期妊娠之间的血小板活化标志物无差异。结论：妊娠期间血小板活化增加，并随妊娠而增加，但不受子痫前期影响。这表明全身血小板活化是妊娠的特征，但不受已建立的子痫前期影响。
