Significance And Clinical Analysis Of Plasma Fibronectin Determination In Preeclampsia-eclampsia

Hypertensive disorders complicating pregnancy is a special disease in pregnancy, including transient hypertension, preeclampsia, eclampsia, chronic hypertension and chronic hypertension with superimposed preeclampsia. Transient hypertension ,preeclampsia and eclampsia were called gestational hypertension before.The incidence of our country is 9.4%,and 7%～12% in abroad.The basal chang of pathophysiology in preeclampsia-eclampsia is hyperkinesias of small artery.Because of the hyperkinesias of small artery,the high systemic vascular resistance,the endothelial injury and capillary leak,the clinical finding is a triad of edema,hypertension,and proteinuria occurring primarily after the 20th gestational week, companioning dysfunction of other organs.Now, the cause of hypertensive disorders complicating pregnancy is unknown.The relatively new theory of endothelial injury explains many of the clinical findings in preeclampsia-eclampsia.FN is one of the most important composition of extracellular matrix and body fluid.The source of plasma FN is the endothelial cell.When the endothelial cell isinjured,the synthesis of FN is increased.Objective To investigate the changes of plasma fibronectin (FN),the index of liver function,the index of function of kidney,proteinuria and the coagulation function of the hypertensive disorders complicating pregnancy.To analyze the function of FN in the dysfunction of liver and kidney,in order to seek the fuction of FN in the morbidity and development of preeclampsia-eclampsia. Methods FN,ALT,AST,TP,ALB,ALP,TBIL,DBIL,Cr,BUN,proteinuria,PLT,PT,APTT,FIB were examined in 59 patients with hypertensive disorders complicating pregnancy divided into mild pre-eclampsia and severe preeclampsia-eclampsia, comparing with 35 normal late-pregnancy women,22 non- pregnancy women. Results FN:The FN in patients with preeclampsia-eclampsia is higher than non-pregnancy women(P <0.05) and normal late-pregnancy women(P<0.01);FN in mild preeclampsia is higher than normal late-pregnancy women( P<0.05 ); There is no obvious changes between mild preeclampsia and non-pregnancy women(P>0.05); FN in severe preeclampsia-eclampsia is higher than non-pregnancy women andnormal late-pregnancy women(P<0.01),the same to comparing with mild preeclampsia(P<0.05).The function of liver:ALT,AST: preeclampsia-eclampsia is higher than normal late-pregnancy women(P<0.05); severe preeclampsia-eclampsia is higher than non-pregnancy women and normal late-pregnancy women(P<0.01).TP,ALB: normal late-pregnancy women is lower than non-pregnancy women(P<0.01); preeclampsia-eclampsia is lower than non-pregnancy women and normal late-pregnancy women(P<0.01); mild preeclampsia and severe preeclampsia- eclampsia are both lower than non-pregnancy women and normal late-pregnancy women ,the changes have statistical significance. ALP: normal late-pregnancy women,preeclampsia-eclampsia,mild pre-eclampsia,severe preeclampsia-eclampsia are higher than non-pregnancy women; Changes between each group of preeclampsia-eclampsia and normal late-pregnancy women have no statistical significance(P>0.05). TBIL,DBIL:No significant changes can be seen.The ALT and TP in severe preeclampsia- eclampsia has statistical changes comparing with mile preeclampsia(P<0.01),the same to AST(P<0.05).The functionof kidney:Cr: normal late-pregnancy women is lower than non-pregnancy women(P<0.05); preeclampsia-eclampsia is higher than normal late-pregnancy women ( P<0.01 ) ; severe preeclampsia-eclampsia is higher than normal late-pregnancy women ( P<0.01 ) .BUN: preeclampsia-eclampsia and severe preeclampsia-eclampsia are higher than both non-pregnancy women and normal late-pregnancy women;The Cr and BUN in severe preeclampsia-eclampsia have statistical significant changes comparing with mild pre-eclampsia ( P<0.01 ) . the coagulation function:PLT: normal late-pregnancy women is lower than non-pregnancy women(P<0.05); preeclampsia-eclampsia and severe preeclampsia-eclampsia is less than both non-pregnancy women and normal late-pregnancy women.FIB: normal late- pregnancy women and each groups of preeclampsia-eclampsia is higher than non-pregnancy women(P<0.01).PT:Both normal late-pregnancy women and each groups of preeclampsia-eclampsia are lower than non-pregnancy women(P<0.01); preeclampsia- eclampsia and severe preeclampsia-eclampsia are lower than normal late-pregnancy women (P<0.01).APTT:No significantchanges can be seen.The PLT in severe preeclampsia-eclampsia has significant changes comparing with mild preeclampsia(P<0.01),the same to FIB(P<0.05) There is positive correlation between FN and mean arterial blood pressure,Cr,BUN,ALT and AST . There is negative correlation between FN and TP and PLT. Conclusion FN had a relationship with changes of coagulation function,dysfunction of liver and kidney in patients of preeclampsia and eclampsia;The clinical detection of plasma FN values appear to be useful in diagnosis and progression of preeclampsia and eclampsia.