Relationship Between Gamma Chain And Fragments Of Plasma Fibrinogen And Pre-eclampsia

Background/AimsPre-eclampsia is a muti-organ syndrome which occurs in human pregnancy,itis a big threat to the maternal and fetal health,and it is one of the first leading causeof maternal morbidity and mortality. The early prediction and diagnosis to the diseaseis a major issue in this area. With the development of modern biotechnology,especially the advance in proteomics,a lot of markers related to pre-eclampsia havebeen found,but they have low specificity and sensitivity. In September2009,M.Blumenstein in New Zealand discovered that the concentration of fibrinogen γ inthe plasma of pre-eclampsia patients was higher than controls and two fibrinogenfragments corresponding to25kDa and27kDa appeared to be highly up-regulated intwo of the four pre-eclampsia patients when he did the research about expressingspecific plasma proteins by proteomics technology.It prompted that fibrinogenmetabolism was related to pre-eclampsia.But only the article is reported on this aspect,and the number of cases was too small,it needed further studies.We studied therelationship between fibrinogen metabolism, coagulation status and pre-eclampsia.Methods1. Followed-up the clinical features of HCG-positive women in ourhospital,and collected their urine and blood specimens.2. Detected the concentration of fibrinogen γ and its fragments by Western blot.3. Detected coagulation status by a coagulation analyzer,which is adetermination by scattered light.Results1. The concentration of fibrinogen γ had no difference in the plasma of normalpregnant women during pregnancy.2. The concentration of fibrinogen γ in the plasma of patients on2-7weeksbefore the onset of pre-eclampsia began to rise,and it rose more when pre-eclampsiahappened.3. Three fibrinogen fragments corresponding to25kDa,27kDa and23kDa appeared in the plasma of one patient on two weeks before pre-eclampsia happenedand two patients when pre-eclampsia happened in sixteen patients who developedsevere pre-eclampsia.These fragments appeared in only one patient in fifteen patientswho developed mild pre-eclampsia,and these fragments did not appeared in thirty-onecontrols.4. The coagulation index: the value of PT of the plasma in women both whodeveloped severe PE and mild PE were lower than healthy controls withuncomplicated pregnancies.The value of APTT of the plasma in women whodeveloped severe PE was higher than healthy controls with uncomplicatedpregnancies. The value of TT of the plasma in women both who developed severe PEand mild PE were higher than healthy controls with uncomplicated pregnancies. Theconcentration of FIB in the plasma had no difference in women who developedsevere PE,mild PE or healthy controls with uncomplicated pregnancies.Conclusions1. Patients on2-7weeks before the onset of preeclampsia had a synthesis anddegradation fibrinogen disorder,the synthesis of fibrinogen γ increased, and it rosemore when pre-eclampsia happened, and three fibrinogen fragments corresponding to25kDa,27kDa and23kDa appeared when the fibrinogen degradated in some patientsespecially in severe pre-eclampsia patients.2. Preeclampsia was accompanied by a aggravated coagulation status,it hadprolonged APTT and TT,shorten PT,but fibrinogen had no significant change.