Significance Of Detection Of Platelet Glycoprotein Ⅰbα And Platelet In Patients With Pre-eclampsia Or Eclampsia

Objective :In this study, we have detected the CD42b levels , the variation of PLT count and relative parameters and relative indexes of blood coagulation(PT,APTT) of patients with pre-eclampsia and eclampsia in Hypertensive disorders complicating pregnancy,and detected expression of GPIbα(CD42b) in the placenta.Then we discussed the function of platelet glycoprotein GPIbα(CD42b) in the development of pre-eclampsia or eclampsia, furthermore we discussed the damage of vascular endothelial cell and the actived state of platelet and the prothrombotic state in capillary vessel. In the end, We look forward to providing reliable indexes for estimating the progress of eclampsism or eclampsia, and providing clinical envidence for the development of relative drug.Stuff and methods: The venous blood of 48 pre-eclampsia or eclampsia women , 22 normal pregnancy women and 20 normal non pregnany women were collected before operation and 72 hours after the operation.in our obstetric department from Mar 2006 to Feb 2008 . The groups were divided according to the diagnosis standards of hypertensive disorders complicating pregnancy in the sixed edition ?Obstetric & Gynecology? edited by Jieyue.The CD42b levels were detected by flow cytometey (FCM) ,the platelet count and relative parameters were detected by the auto blood analyzing instrument ,and detected the blood clotting relative indexes—PT,APTT. The expression of CD42b and location in the placenta of 20 normal pregnancy women ,15 mild pre-eclampsia and 22 severe pre-eclampsia and eclampsia patients and 4 HELLP patients were detected by S-P immunohistochemistry.The methods of statistics:the results were analyzed by ANOVA,rank sum test and spearman rank correlation and processed by SPSS 11.5. Results:1.The CD 42b levels of the four groups : The CD42b levels of the normal late pregnancy group were lower than the control group .There was no significance between mild pre-eclampsia group,the normal late pregnancy group and the control group( P>0.05) .CD42b levels of the severe pre-eclampsia and eclampsia were much lower than all above.(P<0.01)。2. The CD42b levels ,the change of PLT count and relative parameters and the correlation: the platelet count of severe pre-eclampsia and eclampsia was much lower than that of normal late pregnancy group and control group (P<0.01);There was no significance of PLT count between mild pre-eclampsia group and normal late pregnancy group (P>0.05).;The levels of MPV and PDW in severe eclampsism and eclampsia were much higher than normal late pregnancy group(P<0.01); There was no significance between the PLT levels of severe eclampsism and mild eclampsia (P>0.05),but the levels of MPV and PDW in severe eclampsism were much higher than mild eclampsia (p<0.01).There was significant correlation between the CD42b and PLT count .3. The PLT count and CD42b levels of preoperative and postoperative patients: in normal pregnancy group , there was no significance between the PLT count and CD42b level of preoperative: and postoperative patients(P>0.05); The PLT levels of the postoperative mild pre-eclampsia group were much higher than preoperative group (P<0.01),but there was no significance in the CD42b levels between the two groups. In the severe pre-eclampsia and eclampsia group, PLT and CD42b of postoperative patients were higher than preoperative patients (P<0.05).4. Blood coagulation relative indexes—PT,APTT : PT in patients with pre-eclampsia or eclampsia and normal late pregnancy group were shorter than control group (P<0.01); PT in severe pre-eclampsia and eclampsia group was shorter than normal late pregnancy group(P<0.05); PT of postoperative patients in all group were much shorter than Preoperative patients(P<0.01).APTT in normal late pregnancy group ,severe eclampsism and eclampsia group were obviously shorter than control group (P<0.05);There was no significance between postoperative patients and preoperative patients in APTT of all groups(P>0.05)。5. The positive location of CD42b in placenta tissue in all guoup was the same -- that is the placental villus nutrient cell exterior margin , endothelial cell and margin of villus capillary vessel and villus interstitial vessel .the positive rate of the HELLP group was higher than that in other groupConclusions:1. patients with severe pre-eclampsia and eclampsia have the condition that vascular endothelial cells are damaged all around the body and the platelets are actived , even there is a prothrombotic state in capillary vessel.2. The decrease of CD42b ,PLT count and PCT levels accompany with the increase of MPV and PDW can be the detective indexes show that the vascular endothelial cell is damageed and there is a prothrombotic state in pre-eclampsia and eclampsia patients, and this can be a convenient and reliable forecast index .3.It is valuable to observe the state of the blood coagulation system and the state of the vascular endothelial cell damaged by detect CD42b,PT and APTT allied...