Zhang Dandan, Xiao Juan, Huang Haoliang, Chen Juanjuan, Liu Tao, Yin Zongzhi, Gao Danping, Liu Qiong, Ai Jihui, Chen Suhua
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
J Huazhong Univ Sci Technolog Med Sci. 2010 Dec;30(6):777-80. doi: 10.1007/s11596-010-0657-4. Epub 2010 Dec 22.
The present study examined von Willebrand factor (vWF) levels and ADAMTS13 activity in pregnant and severe preeclamptic women in order to shed light on the prothrombotic state in severe preeclampsia. Thirty healthy women of childbearing age, 22 second trimester pregnant women, 30 third trimester pregnant women and 10 severe preeclamptic patients were recruited in this study. ADAMTS13 activity was determined by the FRETS-vWF73 assay and vWF antigen (vWF:Ag) levels by an enzyme-linked immunosorbent assay. The results showed that there were statistically significant differences in plasma vWF antigen levels between the severe preeclamptic and third trimester pregnant women, between third and second trimester pregnant women (P<0.05). The third trimester pregnant women had significantly lower plasma ADAMTS13 activity than second trimester pregnant women (P<0.05). Nevertheless, no significant differences in plasma ADAMTS13 activity were found between severe preeclamptic patients and the third trimester pregnant women (P>0.05). In conclusion, plasma ADAMTS13 activity is normal in severe preeclampsia despite the increased vWF:Ag levels. Prothrombotic state is involved in the pathogenesis of severe preeclampsia, as a result of endothelial injury.
本研究检测了妊娠妇女和重度子痫前期妇女的血管性血友病因子(vWF)水平及含血小板解聚蛋白样金属蛋白酶13(ADAMTS13)活性,以阐明重度子痫前期的血栓形成前状态。本研究招募了30名健康育龄妇女、22名孕中期妇女、30名孕晚期妇女和10名重度子痫前期患者。采用荧光共振能量转移法(FRETS-vWF73)检测ADAMTS13活性,采用酶联免疫吸附测定法检测vWF抗原(vWF:Ag)水平。结果显示,重度子痫前期患者与孕晚期妇女之间、孕晚期与孕中期妇女之间的血浆vWF抗原水平存在统计学显著差异(P<0.05)。孕晚期妇女的血浆ADAMTS13活性显著低于孕中期妇女(P<0.05)。然而,重度子痫前期患者与孕晚期妇女之间的血浆ADAMTS13活性无显著差异(P>0.05)。总之,尽管vWF:Ag水平升高,但重度子痫前期患者的血浆ADAMTS13活性正常。由于内皮损伤,血栓形成前状态参与了重度子痫前期的发病机制。