Blood coagulation parameters and platelet indices: changes in normal and preeclamptic pregnancies and predictive values for preeclampsia.
Blood coagulation parameters and platelet indices: changes in normal and preeclamptic pregnancies and predictive values for preeclampsia.
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DOI：
10.1371/journal.pone.0114488
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Li L
中科院分区：
文献类型：
--
作者：
Han L;Liu X;Li H;Zou J;Yang Z;Han J;Huang W;Yu L;Zheng Y;Li L
先兆子痫（PE）是一种发病率和死亡率高但没有明确病因的产科疾病。凝血-纤溶系统功能障碍是PE的显著特征，其严重程度不同，需要不同的治疗方法。因此，有必要寻找合适的预测PE发病和严重程度的指标。我们的目的是评估凝血参数和血小板指数作为PE发病和严重程度的潜在预测指标。采集正常孕妇（79例）、轻度子痫前期（53例）和重度子痫前期（42例）妊娠早期和晚期的血液样本。测定各组患者凝血参数和血小板指数水平，并进行比较。生成这些指标的受试者工作特征（ROC）曲线，并计算曲线下面积（AUC）。对所选电位参数的预测值进行二元回归分析。正常妊娠组妊娠后期活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）、凝血酶时间（TT）及血小板计数均较妊娠早期降低，纤维蛋白原水平及平均血小板体积（MPV）较妊娠早期升高（p<0.05）。然而，PE患者在妊娠晚期出现APTT、TT、MPV和d -二聚体（DD）升高。在有无PE受试者的分析中，TT的AUC最大（0.743），具有较高的预测价值。在不同严重程度的PE患者中，MPV的AUC最大（0.671），预测效果较理想。正常妊娠导致妊娠后期产妇出现生理性高凝状态。PE可能引发内源性凝血途径的复杂紊乱，消耗血小板和FIB，随后激活血小板生成和纤维蛋白溶解。凝血酶时间和MPV可分别作为PE发病和严重程度的早期监测指标。
Preeclampsia (PE) is an obstetric disorder with high morbidity and mortality rates but without clear pathogeny. The dysfunction of the blood coagulation-fibrinolysis system is a salient characteristic of PE that varies in severity, and necessitates different treatments. Therefore, it is necessary to find suitable predictors for the onset and severity of PE. We aimed to evaluate blood coagulation parameters and platelet indices as potential predictors for the onset and severity of PE. Blood samples from 3 groups of subjects, normal pregnant women (n = 79), mild preeclampsia (mPE) (n = 53) and severe preeclampsia (sPE) (n = 42), were collected during early and late pregnancy. The levels of coagulative parameters and platelet indices were measured and compared among the groups. The receiver-operating characteristic (ROC) curves of these indices were generated, and the area under the curve (AUC) was calculated. The predictive values of the selected potential parameters were examined in binary regression analysis. During late pregnancy in the normal pregnancy group, the activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and platelet count decreased, while the fibrinogen level and mean platelet volume (MPV) increased compared to early pregnancy (p<0.05). However, the PE patients presented with increased APTT, TT, MPV and D-dimer (DD) during the third trimester. In the analysis of subjects with and without PE, TT showed the largest AUC (0.743) and high predictive value. In PE patients with different severities, MPV showed the largest AUC (0.671) and ideal predictive efficiency. Normal pregnancy causes a maternal physiological hypercoagulable state in late pregnancy. PE may trigger complex disorders in the endogenous coagulative pathways and consume platelets and FIB, subsequently activating thrombopoiesis and fibrinolysis. Thrombin time and MPV may serve as early monitoring markers for the onset and severity of PE, respectively.
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DOI：
10.4021/jocmr1682w
发表时间：
2014-02
期刊：
Journal of clinical medicine research
影响因子：
--
作者：
Al-Jameil N;Aziz Khan F;Fareed Khan M;Tabassum H
通讯作者：
Tabassum H
DOI：
10.1111/j.1749-6632.2010.05674.x
发表时间：
2010-01-01
期刊：
WOMEN'S HEALTH AND DISEASE
影响因子：
--
作者：
Benedetto, Chiara;Marozio, Luca;Di Giampaolo, Francesca
通讯作者：
Di Giampaolo, Francesca
影响因子：
3
作者：
Dundar, Ozgur;Yoruk, Pinar;Mungen, Ercument
通讯作者：
Mungen, Ercument
影响因子：
4.3
作者：
De Vivo, Antonio;Baviera, Giovanni;D'Anna, Rosario
通讯作者：
D'Anna, Rosario
影响因子：
2.9
作者：
Tanjung, MT;Siddik, HD;Koh, SCL
通讯作者：
Koh, SCL