中文摘要：

目的研究子痫前期孕妇出凝血功能包括血管内皮细胞、血小板活化、凝血及抗凝和纤溶功能的改变特点。方法选择2005年6月至2006年8月在复旦大学附属妇产科医院、中山医院和四川大学华西第二医院分娩的46例子痫前期孕妇作为病例组，同时选取40例正常孕妇作为对照组。采用酶联免疫吸附测定法（ELISA）检测孕妇分娩前后的血浆yonwillebrand因子（vWF）、组织因子（TF）、组织因子途径抑制物（TFPI）、P-选择素（Ps）、纤维蛋白肽A（FPA）、抗凝血酶-IU（AT-Ⅲ）和D-二聚体（DD）的含量。结果与正常孕妇相比，子痫前期孕妇血浆TF、vWF和P-选择素的含量均显著升高；TFPI和D-二聚体的含量有下降趋势；AT-Ⅲ的含量在分娩时和产后ld有下降趋势，产后5d有升高趋势；FPA的含量无显著性变化。无论是正常妊娠还是子痫前期，产后血浆TF、vWF和P-选择素的含量呈下降趋势，TFPI和D-二聚体的含量呈上升趋势，FPA的含量无明显变化。产后血浆AT．Ⅲ含量的变化，正常妊娠呈下降趋势，子痫前期产后1d呈下降趋势，产后5d呈上升趋势。结论子痫前期孕妇血管内皮细胞受到严重损伤，伴随着血小板活性和凝血功能显著增强，而抗凝和纤溶功能减弱，导致凝血与纤溶平衡失调，机体处于病理性高凝状态并具血栓形成倾向可能是子痫前期重要的病理生理改变。

英文摘要：

Objective To investigate the maternal changes of haemostasis and thrombosis in preeclampsia, including vas- cular endothelial functions, platelet activation, coagulant activation, anticoagulant activation and fibrinolytic activation. Methods Maternal serum concentrations of vWF, TF, TFPI, sP-selectin, AT- IU, FPA and D-Dimer were measured by ELISA in forty-six women with preeclampsia and forty normal pregnant women before and after delivery. Results Com- pared with maternal serum in normal pregnancy, higher concentrations of maternal serum TF, vWF and sP-selectin as well as lower concentrations of maternal serum TFPI and D-Dimer in preeclampsia were observed before and after deliver- y. Maternal serum levels of AT-]l[ decreased at delivery and one day after delivery,but increased at five days after deliv- ery. A lower trend of maternal serum concentrations of vWF, TF and sP-selectin were found after delivery, companied with a higher trend of maternal serum concentrations of TFPI and D- Dimer. Maternal serum concentrations of FPA were similar between two groups before and after delivery. Conclusions Pathological hypercoagulability and thrombophilias re- sulted from changes in the haemostatic system which included impaired endothelial functions, increased coagulation and platelet activation and decreased anticoagulation and fibrinolysis are the important pathophysiological alternations in pre- eelampsia.