Endothelium and platelets in pregnant women with chronicglomerulonephritis and therapeutic efficacy of acetylsalicylicacid and dipiridamol

Aim. To estimate platelet and endothelial condition in pregnant women with chronic glomerulonephritis (CGN), prognostic value of these changes and efficacy of acetylsalicylic acid (ASA) and dipiridamol in prevention of unfavourable outcomes of pregnancy in CGN. Material and methods. The examinatio...

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Main Authors: V A Rogov, Е М Shilov, N L Kozlovskaya, N В Gordovskaya, I S Sidorova, M Yu Krylova, V B Artemyeva
Format: Article
Language:Russian
Published: "Consilium Medicum" Publishing house 2004-12-01
Series:Терапевтический архив
Subjects:
Online Access:https://ter-arkhiv.ru/0040-3660/article/view/29964
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author V A Rogov
Е М Shilov
N L Kozlovskaya
N В Gordovskaya
I S Sidorova
M Yu Krylova
V B Artemyeva
author_facet V A Rogov
Е М Shilov
N L Kozlovskaya
N В Gordovskaya
I S Sidorova
M Yu Krylova
V B Artemyeva
author_sort V A Rogov
collection DOAJ
description Aim. To estimate platelet and endothelial condition in pregnant women with chronic glomerulonephritis (CGN), prognostic value of these changes and efficacy of acetylsalicylic acid (ASA) and dipiridamol in prevention of unfavourable outcomes of pregnancy in CGN. Material and methods. The examination covered 74 CGN pregnant patients, 14 non-pregnant CGN patients, 11 pregnant women with preeclampsia, 19 healthy pregnant women. The levels offlbronectin, endothelin -1,2, 6-keto-PGFla, thromboxane B/TxB^ secretory beta-thromboglobulin in the blood, activity of intrathrombocytic lactatedehydrogenase (LHG), platelet aggregation. ASA (125 mg/day) was given to 33 CGN pregnant women in combination with dipiridamol (150-225 mg/day). Control group consisted of 32 CGN pregnant women. Results. Content of fibronectin, endothelin, TxB2 and beta-thromboglobulin in blood plasm, aggregation with ADP in CGN pregnant women were higher than in healthy pregnant women and nonpregnant CGN patients. Plasmic 6-keto-PGFla was low. Preeclampsia was accompanied with elevated fibronectin, TxB2 and beta-thromboglobulin, hyperactive LDH. Platelet aggregation was suppressed. Blood beta-thromboglobulin directly correlated with systolic and diastolic arterial pressure, 24-h proteinuria and blood creatinine. Reverse Correlation was seen in blood beta-thromboglobulin with albuminemia, glomerular filtration rate, body mass of the newborn and term of labor. A direct correlation was found between the activity of intrathrombocytic LDH and systolic and diastolic arterial pressure, a weak reverse correlation - between platelet count in capillary blood and systolic pressure, platelet aggregation with ADP and terms of labor. Of the highest prognostic value were the level of beta-thromboglobulin and fibronectin, the activity of intrathrombocytic LDH and platelet aggregation in response to ADP. ASA and dipiridamol reduced the risk of fetal retardation and fetal loss. Conclusion. Pregnant women with CGN have endothelial-thronbocytic dysfunction because of unidirectional influence of both CGN and pregnancy. We think that endothelial-platelet dysfunction connects renal impairment and placental failure in pregnant women with CGN deteriorating a gestational CGN and pregnancy complications. Correction of endothelial-platelet state with ASA and dipiridamol is effective in prevention of fetal retardation and fetal loss in pregnant women with CGN.
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spelling doaj.art-e4b7c19bb7b845f6a828d1d67cc621e02022-12-21T18:46:58Zrus"Consilium Medicum" Publishing houseТерапевтический архив0040-36602309-53422004-12-017912586426992Endothelium and platelets in pregnant women with chronicglomerulonephritis and therapeutic efficacy of acetylsalicylicacid and dipiridamolV A RogovЕ М ShilovN L KozlovskayaN В GordovskayaI S SidorovaM Yu KrylovaV B ArtemyevaAim. To estimate platelet and endothelial condition in pregnant women with chronic glomerulonephritis (CGN), prognostic value of these changes and efficacy of acetylsalicylic acid (ASA) and dipiridamol in prevention of unfavourable outcomes of pregnancy in CGN. Material and methods. The examination covered 74 CGN pregnant patients, 14 non-pregnant CGN patients, 11 pregnant women with preeclampsia, 19 healthy pregnant women. The levels offlbronectin, endothelin -1,2, 6-keto-PGFla, thromboxane B/TxB^ secretory beta-thromboglobulin in the blood, activity of intrathrombocytic lactatedehydrogenase (LHG), platelet aggregation. ASA (125 mg/day) was given to 33 CGN pregnant women in combination with dipiridamol (150-225 mg/day). Control group consisted of 32 CGN pregnant women. Results. Content of fibronectin, endothelin, TxB2 and beta-thromboglobulin in blood plasm, aggregation with ADP in CGN pregnant women were higher than in healthy pregnant women and nonpregnant CGN patients. Plasmic 6-keto-PGFla was low. Preeclampsia was accompanied with elevated fibronectin, TxB2 and beta-thromboglobulin, hyperactive LDH. Platelet aggregation was suppressed. Blood beta-thromboglobulin directly correlated with systolic and diastolic arterial pressure, 24-h proteinuria and blood creatinine. Reverse Correlation was seen in blood beta-thromboglobulin with albuminemia, glomerular filtration rate, body mass of the newborn and term of labor. A direct correlation was found between the activity of intrathrombocytic LDH and systolic and diastolic arterial pressure, a weak reverse correlation - between platelet count in capillary blood and systolic pressure, platelet aggregation with ADP and terms of labor. Of the highest prognostic value were the level of beta-thromboglobulin and fibronectin, the activity of intrathrombocytic LDH and platelet aggregation in response to ADP. ASA and dipiridamol reduced the risk of fetal retardation and fetal loss. Conclusion. Pregnant women with CGN have endothelial-thronbocytic dysfunction because of unidirectional influence of both CGN and pregnancy. We think that endothelial-platelet dysfunction connects renal impairment and placental failure in pregnant women with CGN deteriorating a gestational CGN and pregnancy complications. Correction of endothelial-platelet state with ASA and dipiridamol is effective in prevention of fetal retardation and fetal loss in pregnant women with CGN.https://ter-arkhiv.ru/0040-3660/article/view/29964endotheliumplateletspregnancychronic glomerulonephritispreeclampsiaacetylsalycylic aciddipiridamolfetal retardation and loss
spellingShingle V A Rogov
Е М Shilov
N L Kozlovskaya
N В Gordovskaya
I S Sidorova
M Yu Krylova
V B Artemyeva
Endothelium and platelets in pregnant women with chronicglomerulonephritis and therapeutic efficacy of acetylsalicylicacid and dipiridamol
Терапевтический архив
endothelium
platelets
pregnancy
chronic glomerulonephritis
preeclampsia
acetylsalycylic acid
dipiridamol
fetal retardation and loss
title Endothelium and platelets in pregnant women with chronicglomerulonephritis and therapeutic efficacy of acetylsalicylicacid and dipiridamol
title_full Endothelium and platelets in pregnant women with chronicglomerulonephritis and therapeutic efficacy of acetylsalicylicacid and dipiridamol
title_fullStr Endothelium and platelets in pregnant women with chronicglomerulonephritis and therapeutic efficacy of acetylsalicylicacid and dipiridamol
title_full_unstemmed Endothelium and platelets in pregnant women with chronicglomerulonephritis and therapeutic efficacy of acetylsalicylicacid and dipiridamol
title_short Endothelium and platelets in pregnant women with chronicglomerulonephritis and therapeutic efficacy of acetylsalicylicacid and dipiridamol
title_sort endothelium and platelets in pregnant women with chronicglomerulonephritis and therapeutic efficacy of acetylsalicylicacid and dipiridamol
topic endothelium
platelets
pregnancy
chronic glomerulonephritis
preeclampsia
acetylsalycylic acid
dipiridamol
fetal retardation and loss
url https://ter-arkhiv.ru/0040-3660/article/view/29964
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AT nlkozlovskaya endotheliumandplateletsinpregnantwomenwithchronicglomerulonephritisandtherapeuticefficacyofacetylsalicylicacidanddipiridamol
AT nvgordovskaya endotheliumandplateletsinpregnantwomenwithchronicglomerulonephritisandtherapeuticefficacyofacetylsalicylicacidanddipiridamol
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