Study Between The Defect Of Endothelial Cell, The Disfunction Of Blood Clotting And The Morbidity Of Severe Pre-eclampsia

Objective:To explore the relationship between the change of blood clotting function with the severity degree of eclampsism and the complication of pregnant women after observe the alterations of hemostatic coagulation markers of von Willebrand factor,dimer and antithrombase.Approaching the relation between the damage of vascular endothelial cell and the change of blood clotting function with the morbility of eclampsism,finding the effective,saitivity index to monitoring the change of illness and guiding the clinical therapy.Method:(1) There are 129 pregnant women.Deviding into 3 groups:The control group(normal pregnant women n=27),mild eclampsism group(including gestational hypertension and mild eclampsism n=45) and severe eclampsism group(n=57).The severe group were divided into complications group(n=40) and no complications group(n=17).(2) Gather the ulnar vein blood from antetheca prior to birth,put it into the canal which contain natrium citricum anticoagulation and misce bene,centrifuge 15 minutes in 3000 roll/minutes and recipe supernate.Detect the part activation thrombin time(APTT),thrombin time(TT),fibrinogen(FIB),D-dimer antithrombase activity(antithrombinⅢAT) and yon Wilebrand Factor(vWF) in the CA-7000 active hemagglutination nalytical system from Sysmex company. Gather the empty stomach ulnar vein blood from antetheca 3ml to detect the cholesterin(TC) and triglyceride(TG) in the automatic biochemistry analysator through the method of nephelometry.Results:①The average level of AT,the control group is 67.48±11.764%,the mild group is 64.40±10.657%,the severe eclampsism is 52.62±10.368%.The activity of AT in the severe eclampsism is lower than the mild and the control group.The difference have statistical significance(P＜0.05).No statistically significant between the control and mild group(P＞0.05).②The activity of vWF from peripheral blood,the control group is 235.25±49.861%,the mild eclampsism is 273.51±98.414% and the severe eclampsism is 339.29±87.136%.The activity of vWF in the severe eclampsism group is higher than the mild and the control group,which have statistically significant(P＜0.05).No statistically significant between the control and the mild group(P＞0.05).③The compare of PT,APTT,FIB,D-dimer among the control group,the mild group and the severe group have no statistically significant(P＞0.05).The D-Dimer of tri-interclass have statistically significant,the severe eclampsism is higher than the normal and the mild group,the mild eclampsism is higher than normal pregnant woman,the difference have statistical significance (P＜0.05).④Having complications group and no complications group in the 57 severe eclampsism patient were compared.The activity of AT have significant difference(P＜0.05),thelevel of the complications is lower than no complications.The activity of vWF have significant difference(P＜0.05),the complications is higher than no complications.⑤A significant negative correlation was found between AT and vWF in the eclampsism and normal control group.Conclusion:①The severe eclampsism and eclampsia patients have severe vascular endothelial cell damage and thrombophilia.②The activity of von Willebrand factor(vWF) is higher than the normal and mild eclampsism patients,The vWF of the severe eclampsism patients with complications is higher than no complications.The damage of vascular endothelial cell maybe one of the most significance factor of the pre-eclampsia.③The activity of antithrombase in the severe eclampsism patients is lower than the normal pregnant women and the mild eclampsism group,and increased with the pathogenetic condition to get worse.④.The decreased of AT activity maybe the reason of the acquired thrombophilia of theeclampsism.A significant negative correlation was found between AT and vWF.The change of blood clotting function is the reason or result of the eclampsism still need more study.⑤No significant difference was found in the blood clotting function and the blood-fat,they cannot be used as the index to judge the pathogenetic condition.⑥The level of AT is close to the critical valueof thrombogenesis in the severe eclampsism no matter have complication or no.It illustrate that the severe eclampsism patients are in pro-thrombus state and it is necessary to carry anticoagulation treatment.Using of Low Molecular Heparin and decoagulant according to the AT level can elevate the curative effect.⑦The combination utilize of vWF,D-dimer,PLT,AT in the early eclampsism treatment can make doctors discover the break-over of disease and adopt utility measures in time,it can improve the prognosis of pregnant woman and fetus.