伴有胎盘功能障碍的妊娠期间凝血激活过程中纤溶电位增高

Y. Tsaryk
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引用次数: 0

摘要

的目标。止血平衡的分子机制研究是临床生物化学最重要的课题之一。在目前的交流中,我们旨在强调凝血和纤溶之间的持续联系。方法。通过可溶性纤维蛋白积累估计凝血激活。采用夹心ELISA法测定。我们使用纤维蛋白特异性单抗FnI-3C作为捕获抗体。作为标签抗体,我们使用了另一个单抗(II-4d),其表位位于纤维蛋白(原)分子d区γ链的nh2末端片段。通过测定纤溶电位(Fibrinolytic Potential, FP)估计纤溶激活率。采用比浊法测定,在芬兰的微孔板读取器Multiscan上记录纤维蛋白凝块在405 nm处的光散射。在t-PA存在或不存在的情况下,APTT试剂激活血浆微孔中形成血块。结果。12例胎盘功能障碍孕妇血浆中检测到SF。6例研究患者SF小于4µg/ml,假设为对照意义。根据该参数将患者分为两组。结果表明,第一组(SF≤4)患者FP为24 ou/s。同时,第二组(SF≥4)患者FP - 62 ou/s明显高于对照组。差异有统计学意义,P = 0.05。结论。在胎盘功能障碍的孕妇中,凝血激活(通过SF测量估计)显示伴随着纤维蛋白溶解活性增加(通过FP评估测量)。这些发现可以证明凝血和纤溶之间的持续平衡,在病理条件下稳定止血,避免血栓形成或出血。
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FIBRINOLYTIC POTENTIAL INCREASING DURING ACTIVATION OF BLOOD COAGULATION IN THE COURSE OF PREGNANCY WITH PLACENTAL DYSFUNCTION
Aim. The study of molecular mechanisms of hemostasis balance is one of the most vivid tasks for clinical biochemistry. In present communication we aimed to underline the constant connection between blood coagulation and fibrinolysis. Methods. Blood coagulation activation was estimated by the soluble fibrin accumulation. For it determination we used the sandwich ELISA method. As the catch-antibody we used fibrin-specific mAb FnI-3C. As the tag-antibody we used another mAb (II-4d) that has an epitope in the NH 2 -terminal fragment of the γ-chain of the D-region of the fibrin(ogen) molecule. The rate of activation of fibrinolysis was estimated by measuring of Fibrinolytic Potential (FP). It was measured by turbidimetric method with recording the scattering of light by a fibrin clot at 405 nm on a microplate reader Multiscan (Finland). The clot was formed in the microplate wells in blood plasma activated by APTT reagent in the presence or without t-PA. Results. SF was found in blood plasma of 12 pregnant women with placenta dysfunction. Six of studied patients had SF less than 4 µg/ml that were assumed as the control meanings. We divided patients on two groups according to this parameter. It was shown that patients of the 1st group (SF ≤ 4) exhibited FP as 24 ou/s. In the same time patients of the 2nd group (SF ≥ 4) had much higher FP – 62 ou/s. The level of statistical significance was P = 0,05. Conclusions. Blood coagulation activation (estimated by SF measurement) was shown to be accompanied by fibrinolysis activity increasing (measured by FP evaluation) in pregnant women with placental dysfunctions. These findings can be evidence of constant balance between blood coagulation and fibrinolysis that stabilize hemostasis in pathological conditions for avoiding thrombosis or hemorrhages.
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