Hofmann M, Casper F, Prellwitz W, Brockerhoff P
Universitätsfrauenklinik Mainz.
Z Geburtshilfe Neonatol. 1996 May-Jun;200(3):104-8.
Pregnancy is accompanied by a physiological activation of intravascular coagulation; however without disorder. Normal markers of coagulation are unchanged despite activation. Special coagulation parameter--such as Thrombin-Antithrombin-III-complex (TAT) or D-Dimer are increased also in normal pregnant women. Pregnancy induced hypertension (SIH) and preeklampsia may be associated with a disorder of coagulation that precedes the well known clinical manifestation of hypertension. Therefore it was the aim of the study to distinguish both the pregnancy induced hypertension (15 patients) and preeklampsia (10 patients) as far as it is possible by coagulation parameters such as thrombin generation (by TAT), fibrinolysis (by D-Dimer), AT-III, platelets and others comparing them with 25 normotensive pregnancies. In preeklampsia, the results showed that clinical signs were associated with simultaneous coagulation abnormalities. TAT and D-Dimere are significant increased whereas a decrease of AT-III and platelets was observed. There are no significant differences between SIH and normal pregnancies. Three days after delivery there was an increase of D-Dimer, AT-III and platelets and a decrease of TAT-complex in all groups. For risk pregnancy, the parameters TAT and D-Dimer may be useful as screening test. They although may support confirming the diagnosis of preeklampsia.
妊娠伴随着血管内凝血的生理性激活,但无紊乱。尽管有激活,但正常凝血指标未发生变化。正常孕妇的特殊凝血参数,如凝血酶 - 抗凝血酶 - III复合物(TAT)或D - 二聚体也会升高。妊娠高血压综合征(SIH)和先兆子痫可能与凝血紊乱有关,这种紊乱先于高血压的著名临床表现出现。因此,本研究的目的是通过凝血参数,如凝血酶生成(通过TAT)、纤维蛋白溶解(通过D - 二聚体)、抗凝血酶III(AT - III)、血小板等,尽可能区分妊娠高血压综合征(15例患者)和先兆子痫(10例患者),并将它们与25例血压正常的妊娠进行比较。在先兆子痫中,结果表明临床症状与同时出现的凝血异常有关。TAT和D - 二聚体显著升高,而观察到AT - III和血小板减少。SIH与正常妊娠之间无显著差异。分娩后三天,所有组的D - 二聚体、AT - III和血小板均升高,TAT复合物降低。对于高危妊娠,TAT和D - 二聚体参数可能作为筛查试验有用。它们虽然可能有助于先兆子痫诊断的确立。