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Characterization of five marker levels of the hemostatic system and endothelial status in normotensive pregnancy and pre‐eclampsia
Author(s) -
Hayashi Masatoshi,
Inoue Teruo,
Hoshimoto Kazunori,
Negishi Hideaki,
Ohkura Takeyoshi,
Inaba Noriyuki
Publication year - 2002
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1034/j.1600-0609.2002.02691.x
Subject(s) - platelet activation , eclampsia , platelet , platelet factor 4 , endothelial activation , thrombomodulin , medicine , hemostasis , endocrinology , urinary system , preeclampsia , creatinine , pregnancy , thrombin , beta thromboglobulin , von willebrand factor , endothelium , biology , genetics
Objectives: Pre‐eclampsia is associated with changes in the hemostatic system and endothelial status. Urinary 11‐dehydrothromboxane B2/creatinine (11‐DTXB2/Cr) is a marker for platelet activation and vascular constriction, thrombin–antithrombin complex (TAT) for thrombin formation, serum thrombomodulin (TM) for endothelial damage, and β‐thromboglobulin(β‐TG) and platelet factor 4 (PF‐4) for platelet activation and releasing reaction. The present study attempted to evaluate these five markers in normotensive pregnancy and pre‐eclampsia. Methods : These five markers were simultaneously measured in urine and blood samples from 25 women who were not pregnant (group 1, controls), 31 women with normotensive pregnancy (group 2, second controls), 22 women with mild pre‐eclampsia (group 3), and 21 women with severe pre‐eclampsia (group 4). The average gestational age was 36 wk. Results : The 11‐DTXB 2 /Cr, TAT, and β‐TG levels were significantly higher ( P < 0.01) in groups 2, 3, and 4 than in group 1. The TM and β‐TG levels were significantly higher ( P < 0.05) in group 3 than in group 2. The TM, β‐TG, and PF‐4 levels were increased significantly ( P < 0.05–0.01) in group 4 compared to those in groups 1, 2, and 3. Conclusions : Platelet aggregation, vascular constriction, and thrombin formation (detected by 11‐DTXB 2 /Cr and TAT) may be markedly enhanced even in group 2, but further enhancement may be relatively slight in groups 3 and 4. In contrast, endothelial damage (determined by TM) and platelet release of PF‐4 may not increase significantly in group 2, but they may increase in group 4. Platelet‐release of β‐TG may be enhanced in groups 2, 3, and 4. Endothelial damage and platelet‐releasing reaction (detected by PF‐4 and β‐TG) may be significantly more enhanced in group 4 than in group 3.