Clinical Analysis Of TEG And Platelet-related Functions In Preeclampsia In Late Pregnancy

Objective:To discuss Thrombelastography(TEG),Platelet Aggregation(PAgT)and Circulating Platelets Activation(CPA)in patients with preeclampsia and gestational thrombocytopenia,and assess blood coagulation function;To compare the similarity and difference of these indexes,finding the influencing factors.Materials and methods:This study adopts the method of case-control study.The experimental cases were patients who were hospitalized and gave birth in our hospital from January 2019 to November 2019.Study groups: 45 pregnant women with preeclampsia in the third trimester(group A),25 pregnant women with gestational thrombocytopenia in the third trimester(10 cases in group B1 and 15 cases in group B2),and 28 pregnant women with severe preeclampsia with thrombocytopenia in the third trimester(11 cases in group C1 and 17 cases in group C2).Control group: randomly selected 33 pregnant women with normal pregnancy during the same period(group D).Collecting the study groups’ general clinical data at the time of admission,and performed four tests including thromboelastography,platelet aggregation function,and circulating activated platelet indicators.(1)To compare general clinical data of study group and control group,including age,gestational week,systolic blood pressure,diastolic blood pressure,BMI ratio and platelet count.(2)To compare the differences of TEG parameters R,K,α angle,MA,LY30 and EPL between the study group and the control group.(3)To compare the platelet aggregation function induced by ADP,epinephrine,collagen and AA(Arachidonic acid)between the study group and the control group.(4)To compare the difference of circulating activated platelet rate in each group.(5)Analyzing the related factors that affect the changes of various parameters in general clinical data.Results:(1)Analysis of TEG parameters between groups: no significant difference was found between the indicators in group A and group D,P> 0.05;compared with group D,group B had an increase in K value,α angle,MA value,and CI decreased,P <0.05;compared with group D,group C had higher K value and CI,lower α angle and MA.Comparing group A with group B,the K value in group A decreased,α angle,MA,and CI increased,P <0.05;compared with group C,K value of group A decreased,and α angle,MA,and CI increased,P <0.05;compared with the C1 group,the B1 group had a higher K value,lower α angle,MA,and CI values,P <0.05;compared with the C2 group,the B2 group had lower LY30 and EPL,P <0.05.(2)Analysis of four items of platelet aggregation function between each group: No significant difference was found between the indexes in group A and group D,group B and group C,P> 0.05;compared with group D,the four values of platelet aggregation function in group B decreased,P <0.05;compared with group D,four platelet aggregation of group C reduced.Compared with group A and group B,the four items of platelet aggregation function in group A increased;compared with group C,group A had lower platelet aggregation function values,P <0.05;compared with the C1 group,collagen-induced platelet aggregation value decreased,and AA-induced platelet aggregation value increased,P <0.05;compared with C2,epinephrine-induced platelet aggregation value of grouop B2 increased.AA-induced platelet aggregation decreased,P <0.05.(3)Measurement of circulating activated platelets between groups: There was no significant difference between group A and group D,group B and group D,P> 0.05;compared with group C and group D,the circulating activated platelet value of group C decreased;Compared with group B,no significant difference was found,P> 0.05;compared with group B1,the value of circulating activated platelets increased,P <0.05;compared with group C2,the value of circulating activated platelets of group B2 increased,P <0.05;Compared with group C,the value of circulating activated platelets increased in group A,P <0.05.(4)In each index,K angle was negatively correlated with platelet count,and α angle,MA,and platelet aggregation function were positively correlated with platelet count.Alpha angle,MA,platelet aggregation function(ADP,epinephrine,collagen induction)and circulating activated platelets were positively correlated with BMI.Conclusion:(1)In patients with preeclampsia,the coagulation status is different due to the gestational stage of the patient.The results of this study indicate that if the number of platelets does not decrease in preeclampsia patients,the indexes are still within the normal range,and there may be no significant difference in coagulation function compared with normal pregnant patients;however,when the number of platelets decreases during the progression of the disease,it resulting in low overall coagulation function(CI value)of the body.Compared with the control group,the K value increased and the α angle,MA value,CI,and EPL decreased in the patients with thrombocytopenia during pregnancy.(2)Comparing the coagulation function of patients with preeclampsia and GT,the function of coagulation factors and fibrinogen in the coagulation state of patients with preeclampsia is stronger,and the four values of platelet aggregation function are higher.(3)Comparison of patients with thrombocytopenia during pregnancy and preeclampsia with thrombocytopenia shows that when the degree of thrombocytopenia is mild,there is no significant difference in the body’s coagulation status,but patients with preeclampsia with thrombocytopenia have stronger fibrinolysis than GT and thrombocytopenia.When the degree is severe,the patient’s blood is hypocoagulated,but the coagulation function of the GT patient is more severe.Patients with GT affect platelet aggregation,while preeclampsia-associated thrombocytopenia also affects platelet activation.(4)The K was negatively correlated with platelet count,and the α angle,MA,and four terms of platelet aggregation function were positively correlated with platelet count.Alpha angle,MA,platelet aggregation(ADP,adrenaline,collagen)and circulating activated platelets were positively correlated with BMI.