国际检验医学杂志
國際檢驗醫學雜誌
국제검험의학잡지
INTERNATIONAL JOURNAL OF LABORATORY MEDICINE
2010年
3期
209-211
,共3页
妊娠并发症%高血压%P选择素%血小板%血液凝固%流式细胞术
妊娠併髮癥%高血壓%P選擇素%血小闆%血液凝固%流式細胞術
임신병발증%고혈압%P선택소%혈소판%혈액응고%류식세포술
pregnancy complications%hypertension%P selectin%blood platelets%blood coagulation%flow cytometry
目的 探讨妊娠高血压综合征(妊高征)患者、正常妊娠早期、中期、晚期妇女血小板活化状态、血小板指标、凝血功能指标的变化,探讨其对妊高征患者血栓前状态的临床预测及诊治价值.方法 随机选取22例妊高征患者(妊高征组)、71例正常妊娠妇女(妊娠早期组24例、妊娠中期组23例、妊娠晚期组24例)和22例正常体检妇女(健康对照组)作为研究对象,运用流式细胞仪、血细胞分析仪、血凝仪观察各组血小板上CD62P、CD63的表达及血小板(PLT)、血小板压积(PCT)、血小板体积(MPV)、血小板宽度(PDW)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fbg)等含量.结果 妊高征组CD62P含量明显上调,与妊娠早期组、妊娠中期组和妊娠晚期组比较,差异具有统计学意义(分别P<0.01、P<0.01、P<0.05),妊高征组CD63表达量也高于妊娠早期组、妊娠中期组及妊娠晚期组,但差异无统计学意义(P>0.05).妊娠晚期组CD62P表达量明显高于妊娠早期组及妊娠中期组,差异具有统计学意义(P<0.01).妊娠晚期组的PLT含量显著高于妊娠早期和妊娠中期组的孕妇(分别P<0.01、P<0.05).妊高征组PLT含量减少,与妊娠早期组、妊娠中期组及妊娠晚期组相比差异无统计学意义(P>0.05).PLT与CD62P呈负相关(r=-0.256,P<0.05);PLT与CD63呈负相关(r=-0.336,P<0.01).CD62P与CD63呈正相关(r=0.303,P<0.01).CD62P、CD63、PLT、MPV、PCT、PDW、PT、Fbg指标在妊娠晚期组、妊高征组和健康对照组之间差异有统计学意义(P<0.01).妊娠晚期组MPV、PDW、PT、Fbg与健康对照组相比明显上调,差异具有统计学意义(P<0.01);TT与健康对照组相比明显下调,差异具有统计学意义(P<0.01).妊高征组CD62P、CD63、PDW、Fbg与健康对照组相比明显上调,差异具有统计学意义(P<0.01);PLT、PCT与健康对照组相比明显下调,差异具有统计学意义(P<0.01).妊高征组CD62P与妊娠晚期组相比明显上调,差异具有统计学意义(P<0.05);MPV、PCT、PT、Fbg指标与妊娠晚期组相比明显下调,差异具有统计学意义(P<0.05).联合检测CD62P和CD63诊断妊高征敏感性为77.3%,特异性为67.6%,假阳性率为32.4%,假阴性率为22.7%,阳性预测值为42.5%,阴性预测值为90.6%.结论 流式细胞术检测CD62P、CD63比血小板和凝血功能指标更能反映血栓形成倾向,对妊高征的防治具有重要价值.
目的 探討妊娠高血壓綜閤徵(妊高徵)患者、正常妊娠早期、中期、晚期婦女血小闆活化狀態、血小闆指標、凝血功能指標的變化,探討其對妊高徵患者血栓前狀態的臨床預測及診治價值.方法 隨機選取22例妊高徵患者(妊高徵組)、71例正常妊娠婦女(妊娠早期組24例、妊娠中期組23例、妊娠晚期組24例)和22例正常體檢婦女(健康對照組)作為研究對象,運用流式細胞儀、血細胞分析儀、血凝儀觀察各組血小闆上CD62P、CD63的錶達及血小闆(PLT)、血小闆壓積(PCT)、血小闆體積(MPV)、血小闆寬度(PDW)、凝血酶原時間(PT)、活化部分凝血活酶時間(APTT)、凝血酶時間(TT)、纖維蛋白原(Fbg)等含量.結果 妊高徵組CD62P含量明顯上調,與妊娠早期組、妊娠中期組和妊娠晚期組比較,差異具有統計學意義(分彆P<0.01、P<0.01、P<0.05),妊高徵組CD63錶達量也高于妊娠早期組、妊娠中期組及妊娠晚期組,但差異無統計學意義(P>0.05).妊娠晚期組CD62P錶達量明顯高于妊娠早期組及妊娠中期組,差異具有統計學意義(P<0.01).妊娠晚期組的PLT含量顯著高于妊娠早期和妊娠中期組的孕婦(分彆P<0.01、P<0.05).妊高徵組PLT含量減少,與妊娠早期組、妊娠中期組及妊娠晚期組相比差異無統計學意義(P>0.05).PLT與CD62P呈負相關(r=-0.256,P<0.05);PLT與CD63呈負相關(r=-0.336,P<0.01).CD62P與CD63呈正相關(r=0.303,P<0.01).CD62P、CD63、PLT、MPV、PCT、PDW、PT、Fbg指標在妊娠晚期組、妊高徵組和健康對照組之間差異有統計學意義(P<0.01).妊娠晚期組MPV、PDW、PT、Fbg與健康對照組相比明顯上調,差異具有統計學意義(P<0.01);TT與健康對照組相比明顯下調,差異具有統計學意義(P<0.01).妊高徵組CD62P、CD63、PDW、Fbg與健康對照組相比明顯上調,差異具有統計學意義(P<0.01);PLT、PCT與健康對照組相比明顯下調,差異具有統計學意義(P<0.01).妊高徵組CD62P與妊娠晚期組相比明顯上調,差異具有統計學意義(P<0.05);MPV、PCT、PT、Fbg指標與妊娠晚期組相比明顯下調,差異具有統計學意義(P<0.05).聯閤檢測CD62P和CD63診斷妊高徵敏感性為77.3%,特異性為67.6%,假暘性率為32.4%,假陰性率為22.7%,暘性預測值為42.5%,陰性預測值為90.6%.結論 流式細胞術檢測CD62P、CD63比血小闆和凝血功能指標更能反映血栓形成傾嚮,對妊高徵的防治具有重要價值.
목적 탐토임신고혈압종합정(임고정)환자、정상임신조기、중기、만기부녀혈소판활화상태、혈소판지표、응혈공능지표적변화,탐토기대임고정환자혈전전상태적림상예측급진치개치.방법 수궤선취22례임고정환자(임고정조)、71례정상임신부녀(임신조기조24례、임신중기조23례、임신만기조24례)화22례정상체검부녀(건강대조조)작위연구대상,운용류식세포의、혈세포분석의、혈응의관찰각조혈소판상CD62P、CD63적표체급혈소판(PLT)、혈소판압적(PCT)、혈소판체적(MPV)、혈소판관도(PDW)、응혈매원시간(PT)、활화부분응혈활매시간(APTT)、응혈매시간(TT)、섬유단백원(Fbg)등함량.결과 임고정조CD62P함량명현상조,여임신조기조、임신중기조화임신만기조비교,차이구유통계학의의(분별P<0.01、P<0.01、P<0.05),임고정조CD63표체량야고우임신조기조、임신중기조급임신만기조,단차이무통계학의의(P>0.05).임신만기조CD62P표체량명현고우임신조기조급임신중기조,차이구유통계학의의(P<0.01).임신만기조적PLT함량현저고우임신조기화임신중기조적잉부(분별P<0.01、P<0.05).임고정조PLT함량감소,여임신조기조、임신중기조급임신만기조상비차이무통계학의의(P>0.05).PLT여CD62P정부상관(r=-0.256,P<0.05);PLT여CD63정부상관(r=-0.336,P<0.01).CD62P여CD63정정상관(r=0.303,P<0.01).CD62P、CD63、PLT、MPV、PCT、PDW、PT、Fbg지표재임신만기조、임고정조화건강대조조지간차이유통계학의의(P<0.01).임신만기조MPV、PDW、PT、Fbg여건강대조조상비명현상조,차이구유통계학의의(P<0.01);TT여건강대조조상비명현하조,차이구유통계학의의(P<0.01).임고정조CD62P、CD63、PDW、Fbg여건강대조조상비명현상조,차이구유통계학의의(P<0.01);PLT、PCT여건강대조조상비명현하조,차이구유통계학의의(P<0.01).임고정조CD62P여임신만기조상비명현상조,차이구유통계학의의(P<0.05);MPV、PCT、PT、Fbg지표여임신만기조상비명현하조,차이구유통계학의의(P<0.05).연합검측CD62P화CD63진단임고정민감성위77.3%,특이성위67.6%,가양성솔위32.4%,가음성솔위22.7%,양성예측치위42.5%,음성예측치위90.6%.결론 류식세포술검측CD62P、CD63비혈소판화응혈공능지표경능반영혈전형성경향,대임고정적방치구유중요개치.
Objective To study the predictive and diagnostic value for pre - thrombus status according to the changes of platelet activation, platelet count and parameters, coagulation function parameters in patients with pregnancy induced hypertension (PIH),early-pregnant women,middle-pregnant women and late-pregnant women. Methods Twenty-two patients with PIH were selected as research group randomly, The control group included Seventy-one, normal pregnancy women and twenty-two normal non-pregnant women. The expression of CD62P and CD63 in peripheral blood were measured by flow cytometry,the quantities of the blood platelet were determined by Cell-DNY 3700,the antithrombosis and thrombolysis system were measured by thrombosis auto-analyze. Results CD62P in PIH was significant higher than that of early and middle and latepregnancy women (F<0. 01 ,P< 0. 01 ,P<0. 05). The expression of CD63 in PIH was higher than others normal pregnancy women without significant deference(P >0. 05). The CD62P and PLT in late-pregnant women were higher than that of early and middle, pregnant women significantly . The Platelet count in PIH declined, without significant difference comparing with ohters pregnancy women(P>0. 05). Platelet count was negative correlated with CD62P(r= - 0. 256, P<0. 05) and CD63 (r= - 0. 336, P<0. 01) remarkably. The level of CD62P was positive correlated remarkably with CD63(r=0. 303,P<0. 01). CD62P、CD63、PLT、MPV、PCT、PDW、PT、Fbg existed significant difference among late-pregnant women,PIH and normal controls(P<0. 01). MPV、PDW、PT、Fbg were increased obviously in late-pregnant women(P<0. 01)comparing with control, but TT was declined significantly(P<0. 01),CD62P、CD63、 PDW、Fbg were increased obviously , but PLT and PCT were dropped in PIH women(P<0. 01)comparing with normal control, as to CD62P, it was increased obviously(P<0. 01), but MPV、PCT、PT、Fbg were dropped in PIH women(P<0. 01)comparing with late-pregnant women. Combined with CD62P and CD63,the sensitivity was 77. 3% ,the specificity was 67. 6% ,the false positive ratio was 32. 4%, the false negative ratio was 22. 7%, the positive predictive value was 42. 5%, the negative predictive value was90. 6%. Conclusion Detecting CD62P and CD63 by flow cytometry could indicate the pre-thromb better than that of platelet parameters and coagulation function parameters, it play an important role in preventing and treating PIH.
