摘要
Objectives: Endothelial dysfunction contributes to the pathogenesis of pre-eclampsia as well as increased production of some factors such as tissue plasminogen activator (tPA) and plasminogen activator inhibitor type1 (PAI-1). These factors are said to be biomarkers of pre-eclampsia but their role in assessing the severity of pre-eclampsia is under-reported.
Methodology: A cross-sectional study involving 85 subjects with pre-eclampsia. They were classified clinically as having mild or severe pre-eclampsia using ACOG classification. Blood and urine samples were collected for determining tPA, PAI-1, D-dimer and proteinuria in the two groups. Clinical and laboratory values were compared using the IBM®SPSS 20.0 (2011) soft ware packages.
Results: The mean age of the respondents was 29.9±5.2 years. Forty-five (52.9%) of the subjects had severe pre-eclampsia while 40(47.1%) had mild pre-eclampsia. The median values of tPA and PAI-1 of subjects with severe pre-eclampsia were significantly higher than the corresponding values in subjects with mild preeclampsia (each p=0.001). There was a positive correlation between each of the tPA and PAI-1 levels with the degree of severity of pre-eclampsia (p=0.001 each).
Conclusion: Fibrinolytic proteins like tPA and PAI-1 are useful in assessing the severity of pre-eclampsia.
Keywords: Severe pre-eclampsia; fibrinolytic proteins, D-dimer, PAI-1,tPA.
Résumé
Objectifs: La dysfonction endothéliale contribue à la pathogénèse de la pré-éclampsie, ainsi que la production accrue de certains facteurs, tels que l’activateur tissulaire du plasminogène (tPA) et le type 1 d’inhibiteur de l’activateur du plasminogène (PAI-1). Ces facteurs sont censés être des biomarqueurs de la pré-éclampsie, mais leur rôle dans l’évaluation de la gravité de la pré-éclampsie est sous-déclaré.
Méthodologie: Une étude transversale comprenant 85 sujets avec pré-éclampsie. Elles ont été classées cliniquement comme ayant pré-éclampsie légers ou graves en utilisant la classification ACOG. Des échantillons de sang et d’urine ont été prélevés pour la détermination du tPA, PAI-1, D-dimère et la protéinurie dans les deux groupes. Les valeurs clinique et laboratoire ont été comparés en utilisant l’emballage logistique IBM®SPSS 20,0 (2011).
Résultats: L’âge moyen des répondantes était de 29,9 ± 5,2 ans. Quarante-cinq (52,9%) des sujets avaient prééclampsie sévère, tandis que 40 (47,1%) avaient une pré-éclampsie légère. Les valeurs médianes de tPA et de PAI-1 des sujets avec pré-éclampsie sévère étaient significativement plus élevés que les valeurs correspondantes chez les sujets présentant avec une pré-éclampsie légère (chaque p = 0,001). Il y avait une corrélation positive entre chacun des tPA et PAI-1 avec le degré de gravité de la prééclampsie (p = 0,001 chacun).
Conclusion: Les protéinesfibrinolytiques comme le tPA et le PAI-1 sont utiles pour évaluer la gravité de la prééclampsie.
Mots-clés: Pré-éclampsie sévère; protéines fibrinolytiques, D-dimère, PAI-1, tPA.
Correspondence: Dr. O.R. Oladosu-Olayiwola, Department of Haematology and Blood Transfusion, LAUTECH Teaching Hospital, Ogbomoso, Nigeria. E-mail:
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