Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.
Clin Appl Thromb Hemost. 2023 Jan-Dec;29:10760296231204604. doi: 10.1177/10760296231204604.
Preeclampsia (PE) is associated with endothelial injury and hemostatic abnormalities. However, the diagnostic role of coagulation parameters and natural anticoagulants in predicting PE has not been explored in Ghana. This study assessed plasma levels of these factors as surrogate markers of PE and its subtypes. This case-control study included 90 women with PE (cases) and 90 normotensive pregnant women (controls). Blood samples were drawn for the estimation of complete blood count and coagulation tests. The prothrombin time (PT), activated partial thromboplastin time (APTT), and the calculation of the international normalized ratio (INR) were determined by an ACL elite coagulometer while the levels of protein C (PC), protein S (PS), antithrombin III (ATIII), and D-dimers were also measured using the solid-phase sandwich enzyme-linked immunosorbent assay (ELISA) method. All statistical analyses were performed using the R Language for Statistical Computing. Results showed significantly (< .05) shortened APTT (28.25 s) and higher D-dimer levels (1219.00 ng/mL) among PE women, as well as low levels of PC (1.02 µg/mL), PS (6.58 µg/mL), and ATIII (3.99 ng/mL). No significant difference was found in terms of PT and INR. From the receiver operating characteristic analysis, PC, PS, and ATIII could significantly predict PE and its subtypes at certain cutoffs with high accuracies (area under the curve [AUC] ≥0.70). Most women with PE are in a hypercoagulable state with lower natural anticoagulants. PC, PS, and ATIII are good predictive and diagnostic markers of PE and its subtypes (early-onset PE [EO-PE] and late-onset PE [LO-PE]) and should be explored in future studies.
子痫前期（PE）与血管内皮损伤和止血异常有关。然而，在加纳，尚未探讨凝血参数和天然抗凝剂在预测 PE 中的诊断作用。本研究评估了这些因子作为 PE 及其亚型的替代标志物的血浆水平。这项病例对照研究纳入了 90 例 PE 妇女（病例）和 90 例正常血压孕妇（对照）。采集血液样本以评估全血细胞计数和凝血试验。通过 ACL elite 凝血仪测定凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）和国际标准化比值（INR）的计算，同时使用固相夹心酶联免疫吸附测定（ELISA）法测定蛋白 C（PC）、蛋白 S（PS）、抗凝血酶 III（ATIII）和 D-二聚体的水平。所有统计分析均使用 R 语言进行。结果表明，PE 妇女的 APTT（28.25 s）明显缩短（<0.05），D-二聚体水平升高（1219.00 ng/mL），PC（1.02 μg/mL）、PS（6.58 μg/mL）和 ATIII（3.99 ng/mL）水平较低。PT 和 INR 无显著差异。来自接受者操作特征分析，PC、PS 和 ATIII 可以在某些截断值下以高准确度（曲线下面积[AUC]≥0.70）显著预测 PE 和其亚型。大多数 PE 妇女处于高凝状态，天然抗凝剂水平较低。PC、PS 和 ATIII 是 PE 和其亚型（早发型 PE [EO-PE] 和晚发型 PE [LO-PE]）的良好预测和诊断标志物，应在未来的研究中进一步探讨。
