外周血NK，IL-12，CRP在子痫前期中的测定及意义

目的测定子痫前期孕妇外周血NK、IL-12、CRP水平的变化并探讨其意义。方法选择子痫前期患者42例，正常晚孕组20例，正常未孕育龄妇女20例，测定外周血NK细胞、IL-12及CRP水平并行统计学分析。结果子痫前期组NK细胞平均值及IL-12，CRP水平明显高于正常晚孕组和正常未孕组；各组血中NK细胞值与IL-12水平呈正相关关系，NK与CRP之间相关性不明显。结论NK细胞参与了子痫前期的发病，IL-12通过激活NK细胞，诱发免疫介导性血管内皮炎症、损伤引起子痫前期疾病；CRP水平在子痫前期时显著增加，可能成为临床早期发现子痫前期发病的一个灵敏指标。     

A study of changes in homocysteine levels during normal pregnancy and pre-eclampsia

To find out changes in homocysteine levels that occur during normal pregnancy and pregnancy with pre-eclamptic toxaemia and also to find out correlation between homocysteine concentration and preeclamptic toxaemia a study was carried out among 90 women of which 30 were control which included normotensive non-pregnant women and the study group I comprised 30 pregnant normotensive women and the study group II comprised 30 pregnant women with pre-eclamptic toxaemia. Serum homocysteine was measured in all subjects using fluorescence polarisation immuno-assay. Control group had highest mean homocysteine levels while the study group I had least mean homocysteine levels (p < 0.001). Levels were significantly higher in subjects with BP > 146/100 mm Hg as compared to subjects with BP >140/90 and <146/100 mm Hg (p=0.017). There was significant difference between study group I and II at same gestational age. Hyperhomocysteinaemia was observed in pre-eclamptic females, also it was found that homocysteine levels were directly correlated with severity of pre-eclampsia.     

妊高征母血LPo、GSH水平及SOD、GSH－Px活性研究

测定了正常未孕妇女３３例，正常妊娠妇女３３例，妊高征６７例（轻度３３例、中重度各１７例）母血脂质过氧化物（ＬＰｏ）、谷胱甘肽（ＧＳＨ）水平及超氧化物歧化酶（ＳＯＤ）、谷胱甘肽过氧化物酶（ＧＳＨ－Ｐｘ或ＧＰｘ）活性。结果：与正常非孕组比较其他各组各项指标均显著增高（Ｐ＜０．０１），正常妊娠与轻度妊高征组差异不显著（Ｐ＞０．０５），中重度组ＬＰｏ、ＳＯＤ显著高于轻度，ＧＳＨ、ＧＰｘ显著低于轻度（Ｐ＜０．０１），重度组ＳＯＤ显著低于中度（Ｐ＜０．０１），余各项指标均有增高趋势但差异不显著（Ｐ＞０．０５），妊高征组ＬＰｏ与妊娠病指数（ＧＩ）呈显著正相关，与ＳＯＤ、ＧＳＨ、ＧＰｘ呈显著负相关（Ｐ＜０．０１）。提示：妊娠妇女体内氧化与抗氧化失衡，脂质过氧化作用（ＬＰ）增强是导致妊高征的一个重要原因。     

妊娠及妊娠期哮喘对呼出气一氧化氮的影响

目的：探讨妊娠及妊娠期哮喘对呼出气一氧化氮（FeNO）水平的影响。方法：选取2012年10月-2013年4月健康非妊娠女性（HNP组）19例、健康妊娠女性（HP组）18例和哮喘妊娠女性（AP组）17例,比较各组间FeNO水平的差异,并分析AP组FeNO水平、第1秒用力呼气量占预计值的百分比（FEVI％）、哮喘控制测试（ACT）评分间的相关关系。结果：与HNP组相比,HP组的FeNO水平略有降低,但差异无统计学意义（P〉0．05）;与HNP组相比,AP组FeNO水平明显升高（P〈0．01）：与HP组相比,AP组FeNO水平亦明显升高（P〈0．01）。相关关系分析示,AP组FeNO水平与FEVI％无相关关系（P〉0．05）：FeNO水平与ACT评分间亦无相关关系（P〉0．05）;FEVI％与ACT评分间无相关关系（P〉0．05）,但在ACT评分〈20时,ACT评分值与FEVI％存在正性相关关系（r=0．555,P〈0．05）。结论：妊娠对FeNO水平并无显著影响,妊娠期哮喘患者FeNO明显升高,故FeNO是诊断妊娠期哮喘的重要检查指标。     

Atrial natriuretic peptide concentrations in pre-eclampsia

The concentration of plasma immunoreactive atrial natriuretic peptide is positively associated with right atrial and pulmonary capillary wedge pressure, suggesting that blood volume and hence atrial pressure govern its release. Expansion of plasma volume is a central physiological adjustment in normal pregnancy. Conversely, pregnancies complicated by pre-eclampsia are associated with a reduction in plasma volume and central venous pressure. A study was therefore undertaken to test the hypothesis that plasma atrial natriuretic peptide concentrations are low in pre-eclampsia owing to deficient secretion. Concentrations of the peptide were measured by a specific radioimmunoassay. The mean plasma immunoreactive atrial natriuretic peptide concentration in healthy pregnant women (n = 22; third trimester) was higher (56 (1 SD 29) ng/l) than in 25 young, non-pregnant controls (37 (19) ng/l). Concentrations in patients suffering from mild pre-eclampsia (n = 9) were higher (127 (60) ng/l) than in normal pregnant women, and in patients with severe pre-eclampsia (n = 6) concentrations were higher still (392 (225) ng/l). Despite failure of plasma volume expansion and low central venous and pulmonary capillary wedge pressures in pre-eclampsia this condition is associated with greatly increased plasma concentrations of plasma immunoreactive atrial natriuretic peptide, which increase still further with the severity of the disease. These findings are clear evidence that atrial pressure may not be the principal determinant of the release of the natriuretic peptide in pre-eclampsia.     

正常妊娠及子痫前期患者外周血中白介素-12、白介素-18的检测意义

目的 检测非孕妇女、正常妊娠孕妇及子痫前期患者外周血中白介素-12(IL-12)和白介素-18(IL-18)的水平,探讨Th1/Th2细胞因子在妊娠高血压疾病发病中的作用.方法 孕20周后的子痫前期组34例(轻度子痫前期15例,重度子痫前期19例),正常妊娠组32例,非孕对照组16例.取外周血进行流式细胞仪检测,选取CD28表达量最高者的淋巴细胞作为试验对象.采用ELISA法测定IL-12、IL-18,流式细胞仪测定Th1/Th2细胞比.结果 正常妊娠组、非孕组及子痫前期组IL-12比较均有显著性差异(P＜0.001).轻度子痫前期组、重度子痫前期组与正常妊娠组IL-18比较均无显著性差异(P＞0.05).正常妊娠组与子痫前期组IL-18/IL-12比较有显著性差异(P＜0.001).IL-18/IL-12浓度比与Th1/Th2细胞比的相关性比较,呈显著负相关(P＜0.01).结论 正常妊娠的IL-18/IL-12浓度比显著高于子痫前期患者,与Th1/Th2细胞比呈反向变化.     

Thrombin Activatable Fibrinolysis Inhibitor in Preeclmapsia and Gestational Hypertension throughout the Gestation

To clarify the role of TAFI in hypertensive disorders in pregnancy, 22 subjects, including 10 with pre-eclampsia （PE） and 12 with gestational hypertension were examined for the levels of TAFI and thrombin-antithrombin （TAT） complex. Thirty normal pregnant women served as controls. ELISA was employed for the detection. The results showed that the TAFI antigen levels in normal pregnancy group, gestational hypertension group and PE group were （85.35±24.69）%, （99.65±18.27）%, （110.12±23.36）%; （97.06±21.40）%, （114.08±27.76）%, （125.49±24.70）%; （106.6±19.21）%, （129.2±25.07）%, （139.1±30.12）%, in the 1st, 2nd and 3rd trimester respectively. No significant differences were found between the normal pregnancy group and gestational hypertension group but significant difference existed between normal pregnancy group and PE group in each trimester （P〈0.05）. TAT complexes were significantly higher in patients with PE than that in controls （P〈0.05）, but no correlation was found between TAT and TAFI. It is concluded that TAFI may contributed to the impairment of fibrinolysis in the patients with PE and may serves as a sensitive indicator for PE, but it may not help in the diagnosis of the gestational hypertension.     

T淋巴细胞亚群在妊高征患者胎盘床肌层的表达与临床意义

目的:观察妊高征患者胎盘床肌层T淋巴细胞亚群的表达情况,探讨妊高征的免疫发病机制。方法:收集正常妊娠30例,妊高征患者60例,其中轻度28例,中度17例,重度15例,用免疫组化方法对妊高征和正常妊娠的胎盘床肌层浸润的淋巴细胞进行CD3、CD4、CD8的标记。结果:CD3在妊高征胎盘床肌层段浸润的淋巴细胞的表达与正常妊娠无明显差别(P>0.01),CD4在妊高征胎盘床肌层浸润的淋巴细胞的表达明显高于正常妊娠(P<0.05);CD8在妊高征胎盘床肌层浸润的淋巴细胞的表达明显低于正常妊娠(P<0.05)。结论:妊高征的发生与T淋巴细胞亚群的变化有着密切的关系,胎-母间免疫失衡是妊高征发病的重要因素。     

妊娠期甲状腺功能及抗体筛查对妊娠结局的影响

目的探讨甲状腺功能及抗体筛查对孕妇妊娠结局的影响。方法 2012-10/2013-10月对750例孕妇行产前甲状腺功能筛查,另选取750名非妊娠妇女为对照组,分别采用免疫吸附法测定两组甲状腺过氧化酶抗体（thyroid peroxidase antibody,TPOAb）、促甲状腺素（thyrotropin,TSH）、总甲状腺素（total thyroxine,TT4）、血清游离甲状腺素（serum free thyroxine,FT4）、游离三碘甲腺原氨酸（free triiodothyronine,FT3）以及总三碘甲腺原氨酸（total triiodothyronine,TT3）水平。结果 750例孕妇中共发现甲状腺功能亢进（甲亢）78例（10.40%）,甲状腺功能减退（甲减）62例（8.27%）,TPOAb阳性25例（3.33%）,而对照组中甲亢12例（1.60%）、甲减8例（1.07%）,TPOAb阳性78例（10.40%）,两组甲亢、甲减及TPOAb阳性率具有统计学差异（P〈0.05）。与正常妊娠组相比,甲减组患者早产、妊娠高血压、孕期贫血、孕期低体重、胎儿窘迫、孕期糖代谢异常发生率显著升高（P〈0.05）,而甲亢组患者子痫前期、孕期心脏病、流产、早产、胎儿窘迫、新生儿生长受限发生率显著升高,差异有统计学意义（P〈0.05）。结论与正常妇女相比,妊娠妇女甲状腺功能异常发生率较高,应引起孕妇及医生的重视。妊娠期甲状腺功能异常患者不良妊娠结局发生率较高,因此临床工作者应重视妊娠期甲状腺功能筛查,做到早筛查,早诊治,以改善患者妊娠结局。     

Plasma total and ultrafiltrable calcium in normal pregnancy, hypertension in pregnancy and pre-eclampsia

OBJECTIVE: To measure the ultrafiltrable and total plasma calcium in normal pregnancy and pregnancies complicated with hypertension and pre-eclampsia. PATIENTS AND METHODS: Total and ultrafiltrable calcium concentrations were measured in maternal plasma from non-pregnant (35), normal pregnant (35), Pregnancy induced hypertension (35) and pre-eclamptic (20) women. Plasma total calcium level was measured by the o'cresolphthalein method. Ultrafiltrate of plasma was obtained using the Amicon MPS-1 micro-partition device. RESULTS: There was no significant difference in the plasma total calcium level between the non- pregnant group and the pregnant group (normal, hypertensive and pre-eclamptic). However there was a significant reduction in the ultrafiltrable (protein free and complexed) calcium level in the pregnant group compared to the non-pregnant group (1.15mmol/L +/- 0.23 Vs 1.25mmol/L +/- 0.13) p<0.05. CONCLUSION: Measurement of the ultrafiltrable calcium in addition to total calcium assay may be more useful in assessing calcium status in normal and complicated pregnancies.     

妊娠高血压综合征患者的免疫功能与内分泌相关性、分析

目的探究妊娠高血压综合征患者免疫功能与内分泌之间的相关性。方法该研究对该院2011年3月-2013年3月间收治的347例妊娠高血压综合征患者作为研究组,将同期155例正常妊娠孕妇与89例未孕女性作为对照组与正常组,回顾性分析它们临床资料。结果通过对IgG、IgA、IgM、C3、FSH、LH、PRL及cD相关指标等对比分析可知,研究组与对照组和正常组相较,以及对照组与正常组相较,差异有统计学意义（P〈0．05）。结论妊娠高血压综合征患者治疗时,应注重免疫状态及其内分泌功能的稳定。     

漳州地区妊娠期妇女甲状腺激素水平参考值范围初建与分析*

目的: 初步建立漳州地区妊娠期妇女血清甲状腺激素水平的参考范围并进行分析,为妊娠妇女孕期检查及后续研究提供依据。方法: 筛选2019年12月~2021年5月到漳州市医院产检正常的孕妇983例作为研究对象,其中孕早期269例,孕中期400例,孕晚期314例,同时留取健康体检非孕期妇女血清标本368例作为非孕期对照组,用化学发光免疫学方法分别测定甲状腺激素FT3、FT4及TSH的含量,统计分析其变化情况及正常参考值范围。 结果: 随着孕期的发展,孕妇血清FT3、FT4呈逐渐下降的趋势,其中FT3和FT4孕早期分别与非孕期对照组无明显区别,而孕中期和孕晚期均明显低于非孕期对照组(P＜0.05),且孕期三组之间两两分别比较,差异均有统计学意义(P＜0.05)。TSH在孕早期、孕中期时显著降低,孕早期最低,之后随着孕期的发展逐渐升高,孕晚期接近于非孕期对照组(P＞0.05)。非孕期对照组、孕早、中、晚期妊娠组血清FT3的参考值范围分别为3.96~6.16、4.08~6.20、3.51~5.86、3.57~5.53 pmol/L,FT4的参考值范围分别为 8.15~13.59、8.04~13.34、6.46~11.60、6.16~10.66 pmol/L,TSH的参考值范围分别为0.58~4.73、0.33~4.18、0.33~3.96、0.47~4.06 mIU/L。结论: 妊娠期孕妇血清甲状腺激素水平有所变化,本研究初步建立漳州地区不同妊娠期特异性甲状腺激素水平参考值范围,以供正常妊娠常规筛查及后续研究。     

孕期高危型人乳头瘤病毒的流行病学特征及对妊娠结局的影响

目的 探讨妊娠妇女孕期高危型人乳头瘤病毒（high risk-human papillomavirus, HR-HPV）的流行病学特征及其对妊娠结局的影响。方法 采用平行对照研究的方法,对首都医科大学附属北京朝阳医院2013年3月至2017年12月间建立孕产妇保健档案并接受HR-HPV 检查的3 967例孕妇,与同期、同年龄的非孕妇按照1∶3配对,分析孕期HR-HPV感染的流行病学特征,采用队列研究的方法分析孕期HR-HPV感染对妊娠结局的影响。结果 孕期HR-HPV的总感染率、多重混合感染、高病毒载量感染分布低于非孕期（P<0.05）,型别分布与非孕期差异无统计学意义（P>0.05）。孕期HR-HPV感染率与年龄无明显相关性。HR-HPV感染的孕妇羊水过少发生率增高,急产发生率降低,差异有统计学意义（P<0.05）。结论 孕期HR-HPV感染不增加除羊水过少外其他不良妊娠结局的危险,孕期HR-HPV感染率及严重程度均低于非孕期女性。     

妊娠期高血压疾病患者血浆线粒体偶联因子6的变化

目的:探讨血浆线粒体偶联因子6(mitochondrial coupling factor6,CF6)与妊娠期高血压疾病的关系。方法:43例妊娠期高血压疾病孕晚期妇女,放免法测定血浆CF6和前列环素I2(PGI2)的浓度,并与正常晚孕妇女及正常未孕育龄妇女相比较。结果:⑴妊娠期高血压疾病组产前血浆CF6浓度高于正常晚孕组(t=9.25,P<0.001),而PGI2的浓度(t=4.23,P<0.001)及PGI2/CF6(t=5.66,P<0.001)低于正常晚孕组,差异均有显著性。产后1周,两组产妇血浆CF6与PGI2水平均接近于正常未孕妇女,但妊娠期高血压疾病组PGI2/CF6比值仍然低于正常晚孕组(t=3.02,P<0.05)。⑵分娩前血浆CF6浓度及PGI2呈负相关(r=-0.59,t=5.8,P<0.001)。结论:CF6可能通过抑制PGI2合成,参与妊娠期高血压的发生。     

重度子痫前期患者胎盘中EPO及EPOR的表达

目的：研究重度子痫前期患者胎盘中促红细胞生成素及促红细胞生成素受体的表达。方法：选择重度子痫前期患者20例和正常妊娠孕妇10例,采用免疫组化染色SP法观察两组胎盘中EPO及EPOR的定位和表达量的差异。用逆转录-聚合酶链反应检测两组胎盘组织中的EPO及EPOR的mRNA表达水平的差异。结果：EPO及EPOR主要表达于胎盘合体滋养细胞和血管内皮细胞,绒毛间质无明显的阳性染色。重度子痫前期组患者胎盘中E-PO、EPOR的表达水平与正常孕妇组比较明显升高,差异有统计学意义（P〈0.05）。重度子痫前期组中EPO及EPOR表达水平呈正相关（r=0.86,P〈0.05）。结论：重度子痫前期患者胎盘中EPO及EPOR的表达明显高于正常妊娠组,且EPO及EPOR表达呈明显的正相关。EPO及EPOR表达改变在妊娠高血压疾病中有重要的作用。     

血清抗米勒管激素水平与子痫前期的发生及其妊娠结局的相关性

目的 探讨妊娠30~32周血清抗米勒管激素（anti-Müllerian hormone,AMH）水平对子痫前期发生的预测意义及妊娠结局的相关性。方法选取104例正常妊娠者设为对照组;同期58例子痫前期孕妇设为病例组。回顾性分析两组孕30~32周血清样品,通过ELISA方法检测AMH水平,比较两组妊娠结局及母儿并发症等的差异。结果（1）对照组血清AMH水平高于病例组;（2）血清AMH值与子痫前期的发生及低出生体重儿的发生有一定的负相关性（P<0.05）;（3）对照组新生儿体重大于病例组,剖宫产率低于病例组,差异有统计学意义（P<0.05）;（4）妊娠结局方面,病例组发生产后出血、胎盘早剥、新生儿窒息率等与对照组相比,差异无统计学意义（P＞0.05）。结论妊娠30~32周血清低AMH水平可以预测子痫前期的发生,通过严密监护可改善妊娠结局。     

Serum zinc and copper concentrations in Nigerian women with normal pregnancy

The impact of normal pregnancy on serum zinc and copper concentrations and on copper/zinc ratio has been determined in a cross-sectional study of eighty-four healthy pregnant Nigerian women. Fifty-seven healthy non-pregnant women served as controls. Serum zinc and copper levels were determined by atomic absorption spectroscopy. Mean serum copper concentration is significantly higher (P < 0.001) in the pregnant group than in controls [19.74(4.65) and 11.87(2.61) micromol/L respectively], while mean zinc level is significantly lower (P< 0.001) than in controls [4.40(1.34) and 5.54(1.04) micromol/L respectively. Copper/Zinc ratio is also significantly higher than (P<0.001) in the test subject [4.87(1.77) and 2.23(0.75) micromol/L respectively]. One-way analysis of variance shows that the mean serum zinc and copper concentrations and copper/zinc ratio differ significantly (P < 0.01, P < 0.05, and P < 0.05 respectively) between any two of the trimester groups. Furthermore, there is a significant positive correlation between gestational age and copper/zinc ratio (r- 0.201; P < 0.05), and a significant negative correlation between gestational age and serum zinc concentration (r = -0.274; P < 0.01). In normal pregnancy, a negative and positive linear relationship exists between gestational age and serum zinc level and copper/zinc ratio respectively. Serum copper does not show any significant trend throughout gestation, though pregnant subjects have higher mean serum copper level than controls.     

子痫前期患者血清尿酸水平与围产儿结局的关系

目的 探讨子痫前期患者血清尿酸水平与围产儿预后的关系.方法 将228例子痫前期患者分为轻度子痫前期及重度子痫前期,并选择120例正常单胎妊娠孕妇作为对照.分析三组患者血压,尿酸,肌酐,尿素氮水平,并观察三组围产儿结局.结果 1、子痫前期患者血清尿酸水平高于正常对照组,重度子痫前期患者血清尿酸水平高于轻度子痫前期患者,差异均具有显著性意义.2、随着尿酸水平的升高,新生儿体重,阿氏评分逐渐降低,S/D逐渐升高,IUGR,胎儿窘迫,新生儿窒息发生率逐渐升高.3、同一妊娠状态,随着尿酸水平升高.新生儿体重及阿氏评分降低,同一尿酸水平,随着子痫前期病情加重,新生儿体重及阿氏评分也降低.结论 子痫前期患者血清尿酸水平升高,且与病情严重程度成正比.随着血清尿酸水平升高,围产儿不良结局增加.     

NT—proBNP水平与子痫前期孕妇左心室舒张功能的相关性

目的研究子痫前期孕妇的左心室舒张功能变化及其与血清氨基末端脑钠肽前体（Amino-terminal fragment of pro-BNP（NT-proBNP））水平的相关性。方法子痫前期孕妇35例,并随机选择同期正常晚期妊娠孕妇32例及正常未孕育龄妇女30名作为对照。采用彩色多普勒超声测定左心室舒张功能指标,磁性微粒化学发光免疫定量测定技术测定血清NT-proBNP浓度。结果NT-proBNP浓度子痫前期组、正常妊娠及对照组分别为（316．31±155．83）pg/ml、（87．00±24．36）pg／ml和（55．00＋13．90）pg/ml,前两组比较及后两组比较均P〈0．01。子痫前期患者二尖辩血流舒张早期血流峰速度（E）、EIA比值均显著低于正常妊娠组和对照组,而舒张晚期血流峰速度（A）E峰减速时间（DT）、及等容舒张时间（IVRT）则显著升高（P〈0．01）。子痫前期组及正常妊娠组的E、E/A比值、DT及IVRT与NT-proBNP浓度显著相关（P〈0．01）。结论子痈前期孕妇心脏舒张功能受损,NT-proBNP浓度是反应子痫前期孕妇左心室舒张功能状态的敏感指标之一。     

妊高征患者胰岛素样生长因子水平及对胎儿生长发育的影响

目的：探讨妊娠高血压综合征(妊高征)患者血清胰岛素样生长因子(IGF-1)和胰岛素样生长因子结合蛋白-3(IGFBP-3)水平与疾病程度及新生儿出生体重之间的关系。方法：用放射免疫方法测定33例妊高征和32例正常血压妊娠妇女的血清IGF-1、IGFBP-3的水平。结果：重度妊高征组IGF-1显著低于正常组，IGFBP-3在各组间的水平浓度差异均无显著性，但IGF-1与IGFBP-3之间呈正相关。新生儿出生体重随妊高征严重程度的加剧而降低，各组间比较差异有显著性(F=5．453，P=0．002)。结论：妊高征患者的发病及严重程度与IGF-1有明显的关系，IGF-1与胎儿的发育及新生儿出生体重有明显的相关性。