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The Changes and Significance of vWF、AT in Low-molecular-weight-heparin Used in Severe Pre-eclampsia Patients

Author: LanShuHai
Tutor: NiuXiuMin
School: Tianjin Medical University
Course: Obstetrics and Gynaecology
Keywords: severe pre-eclampsia antithrombin von Willebrand factor low molecular weight heparin endothelial cell
CLC: R714.2
Type: Master's thesis
Year: 2011
Downloads: 62
Quote: 0
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Abstract


Objective:Evaluate the treatment of severe Preeclampsia with the low molecular weight heparin. Use the clinical and laboratory examinations to demonstrate whether it can reduce the development and prevent the complications. By testing the changes of vWF and AT:A between before and after treatment to explore the affection of the low molecular weight heparin, in order to provide a new theoretical basis.Methods:(1) Choose severe pre-eclampsia pregnant women 39. Dividing into 2groups:One group accept the treatment of LMWH n=19(By the base of tradition treatment give the patients moreover LMWH 0.4ml per day); the other one accept the tradition treatment n=20. Choose another 29 normal pregnancy as the control group. (2) Gather the vein blood from antetheca prior(before and after the treatment), detect the vWF and AT by the IL ACL9000 plasma coagulation and the routine coagulation test using the SYSMEX CA 1500. (3) Record the blood pressure, blood, urine, urinary protein, intrapartum, postpartum bleeding and the conditions of the fetal. All relevant information was statistical analyzed by the SPSS 17.0 software. The measurement data is expressed by means±standard deviation. T test is used to compared the extended pregnancy dates, blood pressure. PLT and the indicators of the coagulation tests. It uses the analysisi of variance to compare two groups of all.I It has statistically significant if the P<0.05.Results:(1) The level of vWF in pre-eclampsia is higher than normal group and the level of AT is lower. The difference has statistically significant (P<0.01). No significant sifference between 2pre-eclampsia group (P>0.05).(2) The level of vWF after using LMWH is lower than before treatment, and the AT is higher. The difference has statistically significant (P<0.05).(3) There no difference between the tradition treatment. The difference has no statistically significant (P>0.05).(4) Compared with the tradition treatment, the birth weight in LMWH has no statistically significant(P>0.05).But the asphyxia in LMWH is much lower than that of tradition treatment(P<0.05).(5) The MAP in LMWH group is lower than tradition group, the urine is more. The difference has statistically significant (P<0.05). The urinary protein has no statistically significant (P>0.05). The LMWH group prolong 6±1 days is higher than tradition group (3±1), the difference has statistically significant (P<0.05). The changes of PLT, PT, APTT and FIB have no statistically significant (P>0.05). Conclusion:The increased of vWF in pre-eclampsia indicate the patients have endothelial injury and dysfunction, this lead the development of disease. The reduced of AT indicate that the patients break the balance of the coagulation-anticoagulation system. The LMWH can inhibit the conversion of fibrinogen into fibrin, prevent platelet aggregation, and improve blood coagulation. The LMWH can prolong the time of pregnancy, reduce the perinatal mortality. The LMWH is relatively safe.

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CLC: > Medicine, health > Obstetrics and Gynaecology > Obstetrics > Pathological pregnancy ( abnormal pregnancy )
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