Pre-Eclampsia-Eclampsia In Patients With Coagulation Parametes Changes The Contents Of TNF-α And Its Clinical Significance

ObjectiveThe etiology of preeclampsia and pathogenesis were studied by measuring thechanges of maternal plasma coagulation and TNF-α levels;In this paper, by analyzing the correlations of the changes in maternal plasmacoagulation and TNF-α levels in patients with the severity of preeclampsia, and thepotential relationship between the changes in coagulation of maternal plasma and TNF-αlevels in patients. An effective method to monitor the development of preeclampsia-eclampsia was proposed. This method provided a new idea for clinical prevention ofpreeclampsia-eclampsia.Method180pregnant women were divided into three groups, of which60healthy pregnantwomen as control group; mild group (60patients including pregnancy-inducedhypertension and mild pre-eclampsia); severe group (60with severe preeclampsia andepilepsy). Severe group of60patients were divided into groups with complications(including eclampsia, HELLP syndrome, placental abruption, kidney disease, retinaldetachment, etc.)30cases and30patients without complications. Diagnostic criteria wasreferred to "Obstetrics and Gynecology”, sixth edition, edited by Yue Jie. It was publishedby People’s Health Publishing House.Except gestational age, the three groups of data werecomparable.3ml venous blood from forearm was collected before delivery. It was placed intoplastic tubes with1/10volume of0.109mol/L sodium citrate anticoagulant solution (1+9liquid anticoagulant whole blood). The plastic tube was gently inverted to mix theblood and solution together. Then centrifugation of3000rpm was applied for15minutes.The upper fluid was collected to detect the activated partial thromboplastin time (APTT), thrombin time (PT), thrombin time (TT), fibrinogen (FIB), and D-dimer (D-dimer.). TNF-αvalues were measured by radioimmunoassay. Coagulation changes and TNF-α levels wereclosely observed with the development of preeclampsia-eclampsia in patients changes.This observation was also meaningful to find the potential relationship between thecoagulation changes and TNF-α values.Results(1) PT, APTT values in severe preeclampsia and in mild preeclampsia weresignificantly shorter (Pab<0.05; Pb<0.05) than those in normal late pregnancy. but therewere no significant statistical difference (Pa>0.05) in mild preeclampsia and normal latepregnancy.(2) TT values in mild and severe preeclampsia were obviously shorter (Pa<0.05; Pb<0.05), comparing with the values in normal late pregnancy; but there were no significantstatistical difference (Pab>0.05) in mild preeclampsia and severe preeclampsia/eclampsia.(3) plasma FIB concentration in mild and severe preeclampsia were significantlyhigher than that in normal late pregnancy (Pa<0.05; Pb<0.05); and there were no significantstatistical difference (Pab>0.05) in mild preeclampsia and severe preeclampsia. However, Itdecreased in severe preeclampsia with complications.(4) D-dimer value in mild preeclampsia was significantly higher than that in normallate pregnancy (Pa<0.05), and further increased in severe preeclampsia (Pb<0.05; Pab<0.05).(5) Serum TNF-α values in patients with mild preeclampsia were higher than thosewith normal pregnancy(Pa<0.05). It increased even more in severe pre-eclampsia group(Pb<0.05). Serum TNF-α values in patients with severe pre-eclampsia were higher thanthose with mild pre-eclampsia (Pab<0.05).Conclusions(1) The coagulation function in patients of Preeclampsia were hyperthyroidism,dynamic monitoring of coagulation indicators help to judge the severity.(2) Serum TNF-α was increased with increased exacerbations in pre-eclampsia.TNF-α may be closely associated with preeclampsia and it might be the pathogenesis ofthe disease.(3) Joint, dynamic monitoring of coagulation indexes and tumor necrosis factor–αcan help clinical obstetrician in determining timely termination of pregnancy to providetheoretical basis.