CLINICAL SIGNIFICANCE OF LYMPHOCYTE-PLATELET ADHESION, CYTOKINES AND ENDOTHELIAL DYSFUNCTION IN THE DEVELOPMENT OF GESTATIONAL HYPERTENSION

摘要

The aim of our study was to determine the significance of lymphocyte-platelet adhesion (LPA), interleukins, transforming necrosis factor - α (TNF-α), and endothelial dysfunction in the development of gestational hypertension (GH). The study included 139 pregnant women aged between 17 and 27 years (21.3±4.22 years). GH was diagnosed in 119 women after 20 weeks of pregnancy. 20 patients (control group) were with physiological course of pregnancy. The distribution of patients by groups was carried out according to the level of blood pressure (BP) in accordance with ICD-10 (Geneva, WHO, 2002). The survey was conducted at the moment of detection pregnancy from 7 to 10 weeks and in dynamics of I, II and III trimesters of gestation. In the dynamics of gestation, were studied the number of desquamated endothelial cells circulating in the systemic circulation (CECs), nitrates levels, the adhesion of platelets by estimation their ability to form co-aggregates with lymphocytes by determining the percentage of lymphocytes aggregates with thrombocytes (lymphocyte-platelet plugs), the concentrations of IL-Iβ and TNF-α by immunoenzymatic method. Results of the study showed that in pregnant women at risk of hypertensive disorders, especially after 20-22 weeks of gestation and later, lymphocytes ability to platelets adhesion is rose, the concentrations of pro-inflammatory cytokines and NO level are increased. The direct relationship between DBP high level with degree of LPA, CECs, NO, IL-Iβ and TNF-α cytokines at gestation period of 20-22 weeks indicates their importance in the pathogenesis of hypertensive disorders in pregnant women.