Concentrations of plasminogen activators and their inhibitors in blood preconceptionally, during and after pregnancy
Concentrations of plasminogen activators and their inhibitors in blood preconceptionally, during and after pregnancy
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DOI：
10.1016/j.ejogrb.2006.02.004
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发表时间：
2006-09-01
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影响因子：
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通讯作者：
Sweep, Fred C. G. J.
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文献类型：
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作者：
Coolman, Marianne;de Groot, Christianne J. M.;Sweep, Fred C. G. J.
背景：止血是导致凝血和溶解的激活和抑制通路的复杂平衡。目的：为了研究纤溶酶原激活物系统在复杂妊娠止血中的作用，有必要了解该系统在正常妊娠期间的参考值。材料与方法：采用ELISA法检测正常妊娠组(41例)妊娠前、妊娠6周、妊娠10周、妊娠20周、妊娠32周、分娩后6周的血浆组织型纤溶酶原激活物(TPA)、尿激酶型纤溶酶原激活物(UPA)、纤溶酶原抑制物-1(PAI-1)、纤溶酶原抑制物-1(PAI-1)、纤溶酶原激活物-1复合体(tPA-PAI-1、uPA-PAI-1)的含量。结果：TPA和uPA浓度在妊娠前10周下降，随后在妊娠晚期升高。PAI-1浓度在妊娠晚期升高，PAI-2浓度在整个妊娠期间升高(妊娠32周分别为38.73vs102.23 ng/ml和151.06 ng/ml，分别为38.73ngml和0.024 ng/ml)。TPA-PAI-1和uPA-PAI-1复合体浓度在妊娠前三个月呈下降趋势，在妊娠晚期呈上升趋势。所有成分的浓度在分娩后6周恢复到预想值。结论：本研究提供了妊娠期间纤溶酶原激活剂系统的激活和抑制成分的纵向数据。深入了解这些浓度的纵向变化可能有助于了解妊娠并发症(如先兆子痫)的血栓形成趋势。(C)2006爱思唯尔爱尔兰有限公司。保留所有权利。
Background: Haemostasis is a complex balance of activating and inhibitory pathways resulting in coagulation and lysis. Normal pregnancy is associated with hypercoagulation that is even more profound in complicated pregnancies.Objective: To study the role of the plasminogen-activator system in complicated pregnancy with regard to haemostasis, it is essential to have reference values of components of this system during uneventful pregnancy. In this study we investigated the concentrations of six different components of the plasminogen-activator system preconceptionally, during and after uncomplicated pregnancies.Material and methods: Tissue-type and urokinase-type plasminogen activator (tPA and uPA), plasminogen inhibitor type-1 and -2 (PAI-1 and-2), and the complexes between tPA and PAI-1, and between uPA and PAI-1 (tPA-PAI-1, uPA-PAI-1) were measured by ELISAs in blood obtained preconceptionally, at 6, 10, 20, 32 weeks of gestation, and 6 weeks after delivery in uncomplicated pregnancies (n = 41; all six parameters n = 22).Results: tPA and uPA concentrations decreased in the first 10 weeks of pregnancy and subsequently increased in the third trimester. PAI-1 concentrations increased in the third trimester and PAI-2 concentrations increased throughout pregnancy (preconception versus 32 weeks of gestation; 38.73 versus 102.23 ng/ml, and 0.024 versus 151.06 ng/ml, respectively). tPA-PAI-1 and uPA-PAI-1 complex concentrations decreased in the first trimester, followed by an increase in the third trimester. The concentrations of all components returned to the preconception values 6 weeks after delivery.Conclusion: This study provides longitudinal data on activating and inhibitory components of the plasminogen-activator system during pregnancy. Insight in the longitudinal changes in these concentrations may be of help in the understanding of the thrombotic tendency in pregnancy complications such as preeclampsia. (C) 2006 Elsevier Ireland Ltd. All rights reserved.