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关键词：妊娠并发症，心血管；肝素辅助因子Ⅱ；胎盘
摘要 目的 揭示肝素辅助因子Ⅱ(HCⅡ)体内抗凝的生理意义,探讨妊娠高血压综合征(妊高征)并发血栓形成时的部分发病机制。方法 ①采用发色底物法测定18名正常人，18名正常妊娠妇女及29例妊高征患者分娩前、后血浆HCⅡ活性；②用Western印迹法检测29例妊高征患者分娩前、后血浆HCⅡ抗原；③免疫荧光定位检测HCⅡ在胎盘组织上的分布。结果 妊高征患者产前血浆HCⅡ活性及抗原含量显著降低，其降低程度与妊高征分期相关，产后恢复接近正常；在正常及病理妊娠胎盘未检测到HCⅡ。结论 ①HCⅡ参与妊高征患者妊娠期高凝状态下凝血酶的灭活过程；②胎盘并非HCⅡ蛋白的锚定部位；③血浆HCⅡ可作为反映妊高征病情严重度或预后判定的指标之一。
Dynamic changes andlocalization of plasma heparin cofactor Ⅱ before and after delivery in hypertensive pregnancy
CHEN Xiaoqin, ZHANG Guangsen, WANG Chenhong.
Molecular Hematology Research Department, The Second Affiliated Hospital, Hunan MedicalUniversity, Changsha 410011
Abstract Objective To explore thephysiological significance of the anticoagulation effect of heparin cofactor Ⅱ(HCⅡ) invivo and investigate the pathogenesis of the development of thrombosis in hypertensivepregnancy. Methods ①Plasma level of HCⅡ activity was measured by chromogenic assayin 18 healthy adults, 18 normal pregnant women and 29 hypertensive pregnant women beforeand after delivery . ②Plasma level of HCⅡ antigen was measured by Western blot in 29hypertensive pregnant women before and after delivery.③The distribution of HCⅡin theplacenta was determined by immunofluorescent method. Results The plasma HCⅡ activityand antigen content in hypertensive pregnancy decreased significantly before delivery.They correlated with the severity of hypertensive pregnancy, and restored to normal afterdelivery. No HCⅡ was found in normal and pathological placenta. Conclusion ① PlasmaHCⅡ activity decreased during pregnancy in hypertensive pregnancy. ②The placenta isnot the target of HCⅡ. ③Dynamic determination of plasma HCⅡ level can reflect theseverity of hypertensive pregnancy and be used as one of prognostic indices.
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