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刘家惠.妊娠驯化的血小板通过迁移促进孕妇高凝状态[J].内科急危重症杂志,2026,32(2):141-145
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| DOI：10.11768/nkjwzzzz20260208 |
| 中文关键词: 妊娠 高凝状态 血小板激活 血小板迁移 血栓弹力图 |
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| 摘要点击次数: 104 |
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| 中文摘要: |
| 摘要 目的:探究妊娠驯化下的血小板对血液高凝状态的影响及作用机制。方法: 回顾性分析59例育龄妇女和56例孕妇的临床数据，比较2组临床血栓弹力图(TEG)和凝血相关数据。并对妊娠和非妊娠状态下的小鼠血小板进行迁移运动和转录组测序实验。结果：临床回顾性分析结果以及孕鼠血小板功能实验均提示妊娠期的血小板处于高凝状态，且妊娠驯化下的血小板能够迅速地粘附形成血凝块。妊娠状态会导致血小板迁移距离更长[（30.36±5.91) μm vs. (13.06±0.97) μm]、迁移速度更快 [（1.033±0.164) μm/min vs. (0.348±0.027）μm/min]，并且血凝块形成也更多 [(37.18±2.90)% vs. (33.16±2.43)%]。此外，孕鼠转录组测序结果提示妊娠驯化下的血小板高度表达迁移相关基因，主要体现在血小板活化聚集、细胞粘附和细胞骨架相关基因的上调表达。结论：妊娠期的血液处于高凝状态，而在妊娠驯化下的血小板迁移速度更快、迁移距离更长，形成血块也更多。妊娠驯化血小板功能变化与血液高凝状态的关联，有助于早期识别血栓形成的高风险人群，优化治疗时机从而降低妊娠后血栓相关并发症风险。 |
| 英文摘要: |
| Abstract Objective: To investigate the effect and mechanism of pregnancy-acclimated platelets on the hypercoagulable state of blood during pregnancy. Methods: A retrospective analysis was conducted on clinical data from 59 women of reproductive age and 56 pregnant individuals. Thromboelastography (TEG) and coagulation data between the two cohorts, mouse platelet migration and transcriptome data were analyzed and compared between two groups. Results: Blood in pregnant women exhibited hypercoagulable state and characterized by extended migration distance [(30.36±5.91)μm vs. (13.06±0.97)μm]. Pregnancy markedly accelerated mouse platelet migration [(1.033 ± 0.164 ) μm/min vs. (0.348 ± 0.027) μm/min] and increased clot formation capacity [(37.18 ± 2.90)% vs. (33.16 ± 2.43)%]. Transcriptomic profiling revealed gestational adaptation primed platelets with a promigratory genetic signature, evidenced by the activation/aggregation of platelet and the upregulation of integrin-mediated cell adhesion and cytoskeletal remodeling pathway. Conclusion: The hypercoagulablestate in pregnancy is mechanistically linked to gestational adaptation of platelet dynamics, characterized by extended migration distance, accelerated migratory velocity and enhanced thrombogenic potential. This study reveals the link between gestational platelet adaptation and hypercoagulable states, facilitating the early identification of populations at elevated risk for thrombogenesis, thereby optimizing the antithrombotic prophylaxis timing to reduce pregnancy-related thrombotic events. |
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