Abstract
Objective: to evaluate changes in characteristics of spontaneous platelet (Pt) aggregation in patients with obstetric complications associated with hereditary thrombophilia. Materials and methods. Blood samples were taken from 52 recently confined women on the first day after labor; at that, ethic regulations for the preanalytical phase were followed. Determination of PlA1/ PlA2 polymorphism enotype was performed by means of amplificationrestriction analysis. Geometrical characteristics of patients' peripheral blood Pt aggregation were studied by means of AFM Integra Prima. The degree of confidence of the parameters under test was determined using the ttest, and the significance level was considered valid at P<0.05. Results . A statistical analysis of the findings demonstrated that the length of Pt aggregates in healthy pregnant women was significantly higher than that in healthy nonpregnant women at all study phases. Patients with the P1A1/P1A2 polymorphism in the GP IIb/IIIa Pt receptor gene demonstrated increased widthm height, and density of Pt aggregates. The changes were most significant during the incubation phase lasting for 15 and 30 minutes. The study of geometric parameters of different exposures demonstrated the following: the longer the incubation period, the greater the difference between geometric parameters of the aggregates (e.g. height, length, and width). Conclusion. The analysis of obtained data demonstrated that the presence of P1A1/P1A2 polymorphism in GP IIb/IIIa Pt gene receptor contributes to the decrease in the platelet response threshold and enhances the spontaneous Pt aggregation. The imaging of aggregates provides strong evidence for the accelerated growth of the aggregates in thrombotic complications of pregnancy.
Highlights
Проблема ранней диагностики, лечения и профилактики артериальных и венозных тромбо зов является одной из приоритетных междисцип линарных проблем
The enrolled patients were divided into 3 groups: 1 — patients with thrombotic complications and heterozygous polymorphism P1A1/P1A2 (n=28); 2 — women with a normal course of pregnancy and labor, carrying a normal gene of GP IIb/IIIa Pt receptor subunits (P1A1/P1A1) (n=24)
The third group consisted of healthy, non pregnant women without GP IIb/IIIa Pt receptor polymorphism (n=18), who were volunteers in this study
Summary
Лечения и профилактики артериальных и венозных тромбо зов является одной из приоритетных междисцип линарных проблем. Активация системы гемостаза является важнейшим патогенетическим фактором целого ряда заболеваний внутренних органов [1]. Особое значение эта проблема приобретает в акушерстве. В экономически развитых странах, где за последние 30 лет удалось снизить материн скую смертность от кровотечений и сепсиса, тромбоэмболии заняли лидирующие позиции в ее структуре [2,3,4]. Беременность с первых дней сопровождается рядом динамических системных адаптационных изменений. Физиологические механизмы, лежа щие в основе этого, направлены на поддержание гомеостаза и обеспечение нормального развития плода. Что при бе ременности повышен риск развития тромбозов [5]
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