Valéra Marie-Cécile, Parant Olivier, Cenac Claire, Arnaud Catherine, Gallini Adeline, Hamdi Safouane, Sié Pierre, Arnal Jean-François, Payrastre Bernard
INSERM, U1048, CHU de Toulouse and Université Toulouse 3, Toulouse Cedex 04, France.
Service de Gynécologie Obstétrique, CHU de Toulouse, Toulouse, France.
Am J Reprod Immunol. 2015 Dec;74(6):533-41. doi: 10.1111/aji.12433. Epub 2015 Oct 4.
Platelet reactivity has not been evaluated in integrated functional testing during normal pregnancy. Here, we analysed platelet functions under arterial shear rate in comparison with static conditions.
Thirty pregnant women with uncomplicated pregnancies and 30 healthy non-pregnant women were enrolled in this study. Platelet adhesion to collagen and fibrinogen and subsequent thrombus formation were measured at arterial shear rate in whole blood using a microfluidic and imaging system. Standard light transmission aggregometry, flow cytometry of activation markers in washed platelets and impedance aggregometry in whole blood were also used to assess platelet responsiveness in static conditions.
Compared to non-pregnant controls, thrombus formation on collagen fibres and firm platelet adhesion on fibrinogen under arterial shear rate were significantly reduced in pregnant women. Platelet aggregometry assays in suspension showed a slight increase in platelet reactivity in pregnant women.
While platelet aggregometry and platelet activation markers in static conditions show little changes in platelet reactivity, monitoring of platelet adhesion and thrombus growth on collagen or fibrinogen under flow condition in whole blood indicates a significant decrease in pregnant women compared to controls. This decrease might contribute to counteract a hypercoagulable state and to reduce the risk of arterial thrombosis.
在正常妊娠期间的综合功能测试中，尚未对血小板反应性进行评估。在此，我们分析了与静态条件相比，在动脉剪切速率下的血小板功能。
本研究纳入了30例无并发症妊娠的孕妇和30例健康非孕妇。使用微流控和成像系统在全血的动脉剪切速率下测量血小板对胶原蛋白和纤维蛋白原的黏附以及随后的血栓形成。还使用标准光透射聚集法、洗涤血小板中活化标志物的流式细胞术以及全血中的阻抗聚集法来评估静态条件下的血小板反应性。
与非妊娠对照组相比，孕妇在动脉剪切速率下胶原蛋白纤维上的血栓形成和纤维蛋白原上牢固的血小板黏附显著减少。悬浮液中的血小板聚集试验显示孕妇的血小板反应性略有增加。
虽然静态条件下的血小板聚集试验和血小板活化标志物显示血小板反应性变化不大，但在全血流式条件下监测血小板对胶原蛋白或纤维蛋白原的黏附以及血栓生长表明，与对照组相比，孕妇的血小板反应性显著降低。这种降低可能有助于抵消高凝状态并降低动脉血栓形成的风险。
