孕妇凝血参数监测诊断算法的验证

D. Korolova, A. Pavlenko, Á. Altorjay, S. I. Zhuk, I. Us, Y. Tsaryk, A. Surányi, V. Chernyshenko
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引用次数: 1

摘要

血栓形成事件是妊娠最危险的并发症之一。因此,选择合适的检测方法和标准化技术用于凝血系统状态的准确诊断是非常重要的。在本研究中,我们监测了几种血管内血栓形成危险的分子标志物,并估计了妊娠期间孕妇的血小板功能。我们使用相同的方法对在基辅(乌克兰)和塞格德(匈牙利)招募的不同队列患者进行独立测量。采用ELISA法测定d -二聚体和可溶性纤维蛋白含量。用显色底物法测定蛋白C (PC)水平。采用凝血酶样酶分光光度法测定纤维蛋白原浓度。血小板功能用聚集法测定。统计数据分析采用Kruskal-Wallis检验。在两组研究的患者中,从妊娠早期到妊娠晚期,纤维蛋白原浓度均有统计学意义上的显著升高(妊娠晚期平均为5-6 mg/ml)。应用的方法使我们能够检测到PC水平下降的相同趋势,以及适量d -二聚体(高达300 ng/ml)和SF(高达10-15 ug/ml)的出现。血小板功能在妊娠前三个月增加,在妊娠后三个月略有下降。结果表明,孕妇在妊娠期间凝血系统的变化具有相同的有效性,独立于所选择的队列,时间和地点的测量。所提出的诊断算法的应用可能允许估计妊娠期间血栓并发症的风险。关键词:d -二聚体,纤维蛋白原,血小板,妊娠,可溶性纤维蛋白,血栓形成
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Validation of the diagnostics algorithm to monitor coagulation parameters in pregnant women
Thrombotic events are among the most dangerous complications of pregnancy. Therefore, selection of appropriate tests and standardization of techniques used for accurate diagnostics of blood coagulation system state is of great importance. In this present study, we monitored several molecular markers of the dangers of intravascular thrombus formation and estimated the platelet function in pregnant women during­ gestation. We performed independent measurements using the same methodology for different cohorts of patients recruited in Kyiv (Ukraine) and in Szeged (Hungary). D-dimer and soluble fibrin were measured using ELISA. Protein C (PC) level was estimated using chromogenic substrate assay. Fibrinogen concentration was measured by spectrophotometry using thrombin-like enzyme. Platelet function was estimated by aggregometry­. Statistical data analysis was performed using the Kruskal-Wallis test. Statistically significant increases of fibrinogen concentration from first to third gestational trimester was shown for both studied cohorts of patients (5-6 mg/ml at third trimester on average). Applied methods allowed us to detect the same tendencies of decreases in PC level as well as the appearance of moderate amounts of D-dimer (up to 300 ng/ml) and SF (up to 10-15 ug/ml). Platelet function was increased on the first trimester of pregnancy and decreased during­ following trimesters slightly. Results indicated the changes in the blood coagulation system of pregnant women during gestation with the same effectiveness independently of the selected cohorts, time and place of measurements. The application of the proposed diagnostics algorithm may allow estimating the risk of thrombotic complications during pregnancy. Keywords: D-dimer, fibrinogen, platelets, pregnancy, soluble fibrin, thrombosis
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