胎盘α1-微球蛋白的检测在诊断胎膜早破的价值

目的探讨阴道液中α1-微球蛋白（PAMG-1）定性检测诊断胎膜早破的价值。方法分析62例胎膜早破病例和38例胎膜未破病例的阴道液中PAMG-1、pH和HCG检测结果。结果PAMG-1检测胎膜早破的灵敏度、特异性和准确性分别为98．39％、100％和99．00％，阳性预测值为100％，阴性预测值为97，44％，灵敏度、准确度和阴性预测值明显高于pH和HCG方法，差异有显著性（P〈0．01）。结论少量阴道液PAMG-1检测对胎膜早破的诊断优于pH和HCG，且同样具有简单、快速、无创伤、实用的优点。     

血清sFlt-1、Amphiregulin水平联合在预测子痫前期孕妇妊娠结局中的应用价值

目的 探讨可溶性血管内皮生长因子受体-1(sFlt-1)、双调蛋白（Amphiregulin）在子痫前期孕妇血清中的表达,以及在妊娠结局中的应用价值。方法 收集2020年2月至2021年6月张家口市第一医院收治的子痫前期62例患者作为研究对象;另选取同期正常妊娠产妇58例作为对照组。比较各组血清sFlt-1、Amphiregulin水平;分析子痫前期患者血清sFlt-1、Amphiregulin水平分别与24h尿蛋白定量、收缩压、舒张压的相关性;分析血清sFlt-1、Amphiregulin水平对妊娠结局的预测价值。结果 对照组、轻度组、重度组血清sFlt-1表达水平依次上升（P<0.05）,Amphiregulin表达水平依次下降（P<0.05）。妊娠不良组血清sFlt-1的表达水平高于妊娠良好组（P<0.05）;血清Amphiregulin的表达水平低于妊娠良好组（P<0.05）。子痫前期患者血清sFlt-1水平分别与24 h尿蛋白定量、收缩压、舒张压均呈正相关（P<0.05）;子痫前期患者血清Amphiregulin水平分别与24h尿蛋白定量、收缩压...     

测定尿β1、α1微球蛋白、视黄醇结合蛋白在新生儿高胆红素血症中的价值

新生儿高胆红素血症是指新生儿时期由于胆红素代谢异常引起血中胆红素水平升高而出现皮肤、巩膜及粘膜黄染的临床现象。它可以导致神经系统损害，智力和听力损害，这早已引起人们的重视，但对于高胆红素血症引起的肾小管功能损害，临床上报道较少，本文针对30例高胆红素血症的新生儿进行尿β2微球蛋白（β2-MG），     

α1—微球蛋白的分离纯化及其放射免疫分析直接测定方法？…

本文报道了α１－微球蛋白的分离纯化及其放射免疫分析，建立了不需稀释就直接测定人血及尿中α１－微球蛋白含量的方法。方法简单，快速、临床符合率高，方法灵敏度为１μｇ／ｍＬ批内、批间系数分别为６．３１％（＾－ｘ＝３８．８６，１２例），８．８５％（＾－ｘ＝３５．９８，１４例）。正常值：血清中为３５．３±７．８μｇ／ｍＬ（ｎ＝６０例），随意尿中在２０μｇ／ｍＬ以下。     

子痫前期胎盘低氧诱导因子1α的表达及其与血清胎盘生长因子的相关性

目的检测正常晚期妊娠和子痫前期患者胎盘低氧诱导因子1α(H IF-1α)和血清胎盘生长因子(P lGF)的水平,探讨它们的相关性及与子痫前期发病的关系。方法免疫组织化学SP法检测40例子痫前期患者及20例正常晚期妊娠胎盘H IF-1α表达,酶联免疫吸附试验(ELISA)检测血清P lGF的水平。结果轻度子痫前期组与重度子痫前期组胎盘H IF-1α表达高于正常晚期妊娠组,两组血清P lGF低于正常晚期妊娠组,差异均有显著性意义(P<0.05)。胎盘H IF-1α的表达与血清P lGF水平呈负相关关系。结论子痫前期患者血清P lGF水平依赖于胎盘H IF-1α表达,两者可能与子痫前期的发病有一定关系。     

HIF-2α、VEGF在子痫前期患者胎盘组织中的表达及意义

目的探讨HIF-2α、VEGF蛋白在胎盘中的表达与子痫前期发病的关系。方法应用免疫组化方法检测30例正常妊娠组,25例轻度子痫前期组及35例重度子痫前期组HIF-2α、VEGF蛋白表达。结果 HIF-2α、VEGF蛋白在正常妊娠组的表达低于子痫前期组,差异有显著性,两者在重度子痫前期组与轻度子痫前期组的表达差异无显著性(P0.05)。结论 HIF2α、VEGF可能参与子痫前期的发病过程。     

子痫前期及子痫期患者联合检测血小板膜糖蛋白及凝血酶原的临床意义

目的研究子痫前期及子痫期患者血管内皮损伤和血小板活化状态及凝血系统活跃程度。方法采用全血流式细胞术分别检测32例重度子痫前期／子痫患者、16例轻度子痫前期患者、22例孕晚期妇女剖宫产术前及剖宫产术后72h内血小板膜糖蛋白Ⅰbα（GPⅠbot）、Ⅱb（GPⅡb）水平变化,采用血凝仪同期检测血浆凝血酶原时间（PT）和活化部分凝血活酶时间（APTT）。结果剖宫产术前,与轻度子痫前期组、正常孕晚期组比较,重度子痫前期及子痫组GPⅠbα和PT明显降低（P〈0．01）,术后两者72h内恢复至正常孕晚期水平,与术前比较差异显著（P〈0．01）;各组间剖宫产术前或术后GPⅡb变化无显著性差异（P〉0．05）;正常孕晚期组、轻度子痫前期组及重度子痫前期子痫组APTT递次延长但无统计学差异（P〉0．05）;术后上述三组APTT递次降低,但无显著性差异（P〉0．05）。GPⅠbα与PT呈正相关（r=0．371,P〈0．01）。结论孕晚期子痫前期及子痫患者存在血管内皮细胞损伤及血小板活化状态,引起外源性凝血系统活跃,而内源性凝血系统由于肝脏产生的凝血因子相对减少而活跃性相对降低。     

青海地区子痫前期孕妇lncRNA HIF1A-AS1的表达及临床意义

目的 探讨长链非编码RNA(lncRNA)缺氧诱导因子-1α-反义链1(HIF1A-AS1)在青海地区子痫前期（PE孕妇中的表达及临床意义。方法 收集2019年1月至2021年1月在青海红十字医院产科产检并确诊为PE的患者288例为研究组,同期选取247例正常妊娠的健康孕妇为对照组。采用实时荧光定量PCR(qRT-PCR)法检测胎盘组织及血清中lncRNA HIF1A-AS1表达水平;Pearson法分析PE患者胎盘组织lncRNA HIF1A-AS1表达与临床资料的相关性;受试者工作特征（ROC）曲线分析血清中lncRNA HIF1A-AS1水平对PE的诊断价值。结果 PE患者胎盘组织和血清中lncRNA HIF1A-AS1水平均低于健康对照组,差异有统计学意义（P<0.05）;重度组PE患者胎盘组织及血清中lncRNA HIF1A-AS1表达水平均低于轻度组PE患者,差异有统计学意义（P<0.05）;汉族PE组、汉族正常组、藏族PE组、藏族正常组、回族PE组、回族正常组6组研究对象胎盘组织中lncRNAHIF1A-AS1表达水平比较,差异有统计学意义（P<0.05...     

可溶性Flt-1在子痫前期患者胎盘组织中的变化及意义

目的研究可溶性血管内皮生长因子受体1(soluble fms-like tyrosine kinase receptor 1, sFlt-1)mRNA在子痫前期患者胎盘组织中的表达与定位,探讨其与子痫前期的关系.方法通过半定量RT-PCR及原位杂交方法分别检测子痫前期患者和健康孕妇胎盘组织中sFlt-1 mRNA的表达及定位.结果正常胎盘组织和子痫前期胎盘组织中均存在sFlt-1 mRNA,子痫前期胎盘组织中sFlt-1 mRNA表达明显高于正常胎盘组织(P<0.01).sFlt-1 mRNA主要分布在胎盘绒毛滋养细胞及血管内皮细胞胞浆内.结论胎盘组织中sFlt-1的高表达可能参与了子痫前期的病理生理过程.     

可溶性血管内皮生长因子受体-1的mRNA在妊娠高血压胎盘组织中的表达及意义

目的探讨妊娠高血压疾病患者中可溶性血管内皮生长因子受体-1mRNA在胎盘组织中的表达。方法23例妊娠高血压疾病孕妇(其中妊娠期高血压7例,轻度子痫前期3例,重度子痫前期9例,子痫4例)为妊娠高血压疾病组,足月妊娠血压正常孕妇作为对照组。应用半定量逆转录-聚合酶链反应(RT-PCR)技术检测两组孕妇分娩后胎盘组织中sF lt-1的表达强度。结果妊娠高血压疾病组sF lt-1mRNA(1.45±1.47),与对照组(1.04±0.69)比较,差异无显著性(P>0.05)。子痫组(2.99±2.47),明显高于对照组(P<0.01)。结论sF lt-1是维持正常妊娠所必需的因子。它表达水平的高低与妊娠高血压的发病相关,在子痫患者它的表达明显增高。     

ICAM-1、P—selectin、D—dimer在子痫前期胎盘和血浆表达研究

目的探讨细胞间黏附分子（ICAM-1）、P-选择素（P—selectin）、D二聚体（D—dimer）在子痫前期发生发展中的作用。方法随机选取子痫前期患者39例为研究组,37例正常妊娠孕妇为对照组,采用免疫组织化学技术检测两组胎盘组织中ICAM-1、P—selectin的表达情况;采用酶联免疫吸附法（ELISA）检测两组血浆ICAM-1、P—selectin和D—dimer的表达水平。结果子痫前期组胎盘ICAM-1、P—selectin的表达明显高于对照组（P〈0．05）;两组血浆均有ICAM-1、P—selectin和D—dimer的表达,子痫前期组的血浆ICAM-1、P—selectin和D—dimer表达明显高于对照组（P〈0．05）。结论子痫前期患者ICAM-1、P—selectin和D～dimer表达升高可能与子痫前期的发生发展有关,监测这些指标对病情判断及指导治疗具有重要意义。     

The levels of circulating vascular endothelial growth factor and soluble Flt-1 in pregnancies complicated by preeclampsia

To evaluate the role of vascular endothelial growth factor (VEGF) in the pathogenesis of preeclampsia, we measured total VEGF, free VEGF and soluble Flt-1 (sFlt-1) concentrations and determined their relationships. Maternal serum samples were collected from 20 patients with preeclampsia and 20 normotensive women with uncomplicated pregnancies matched with the patients with preeclampsia for gestational age and parity. The serum concentrations of total VEGF (2.39+/-0.75 vs. 0.28+/-0.14) and sFlt-1 (934.5+/-235.5 vs. 298.0+/-161.2) were significantly increased in the patients with preeclampsia compared to the women with uncomplicated pregnancies. However the serum concentration of free VEGF (21.5+/-6.3 vs. 134.0+/-16.3) was lower in patients with preeclampsia. There was a positive correlation between the serum concentrations of total VEGF and sFlt-1 with systolic and diastolic blood pressure, respectively. There was a negative correlation between the serum concentration of free VEGF and systolic and diastolic blood pressure. There was a strong negative correlation between free VEGF and sFlt-1 concentrations. In conclusion, we found VEGF and sFlt-1 were related to the pathogenesis of preeclampsia. Although reduced concentrations of free VEGF might interfere with endothelial cell function and survival, further studies are required to clarify its specific role in the pathogenesis of preeclampsia.     

先兆子痫患者HLA-DQA1、-DQB、-DPA1基因多态性

目的：探讨人类白细胞抗原HLA-DQA1、-DQB1、-DPA1基因多态性与先兆子痫发病的关系。方法：采用序列特异性引物技术（PCR-SSP） 对46例先兆子痫患者和105例正常孕妇及其新生儿进行HLA-DQ-DPA1等位基因分型。结果：所有标本共检出11种HLA-DQA1基因表型、16种HLA-DQB1基因表型、6种HLA-DPA1基因表型。先兆子痫患者HLA-DQB1＊0301基因频率高于正常孕妇，差异有显著性（Pc=0．032，RR=2．43，AR=0．30），其余各基因表型频率两组比较差异均无显著性。结论：HLA-DQB1＊0301基因可能是一种先兆子痫发病的易感基因。     

先兆子痫患者HLA-DQA1、-DQB1、-DPA1基因多态性

目的:探讨人类白细胞抗原HLA-DQ-A1、DQB1、DPA1基因多态性与先兆子痫发病的关系。方法:采用序列特异性引物技术(PCRSSP)对46例先兆子痫患者和105例正常孕妇及其新生儿进行HLA-DQ-DPA1等位基因分型。结果:所有标本共检出11种HLADQA1基因表型、16种HLADQB1基因表型、6种HLADPA1基因表型。先兆子痫患者HLA-DQ-B10301基因频率高于正常孕妇,差异有显著性(Pc=0.032,RR=2.43,AR=0.30),其余各基因表型频率两组比较差异均无显著性。结论:HLADQB10301基因可能是一种先兆子痫发病的易感基因。     

Laminin-1 (LM-111) in preeclampsia and systemic lupus erythematosus

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the production of antibodies. SLE has been associated with placental pathology, a finding that is also the determinant in preeclampsia (PE). Genetic evidence and serologic reports suggest laminin-1 (LM-111) as an immunogenic molecule and its polymorphic gene as a candidate gene for both disorders. Objective: To evaluate the association between LAMA1 (rs543355) and LAMC1 (rs20563) polymorphisms and the presence of SLE and PE as well as to determine serum levels of anti-LM-111 autoantibodies in the PE group. Methods: Group A: 169 women with PE and 172 healthy pregnant women. Group B: 204 women with SLE and 204 healthy women. Anti-LM-111 for group A was measured by ELISA and the genotyping was done by using a PCR system. Results: Group A: Levels of anti-LM-111 was similar in women with PE and the control group (p = 0.3). The allelic frequencies and genotypes did not show statistically significant differences for LAMA1 and LAMC1 polymorphisms. Group B: Significant differences between SLE patients and controls for rs543355 polymorphism were not observed. Nevertheless, LAMC1 rs20563 A-allele provided protection against the development of SLE (OR 0.73, 95%CI 0.55-0.96). Conclusions: Serum levels of anti-LM-111 at the third trimester of gestation do not seem to have any direct relationship with the presence of PE, and the SNPs evaluated are not associated with the risk of developing this disorder. LAMC1 polymorphism could be a protective factor for SLE.     

Fibronectin, plasminogen activator inhibitor type 1 (PAI-1) and uterine artery Doppler velocimetry as markers of preeclampsia

Objective: The purpose of this study was to examine plasma levels of fibronectin and plasminogen inhibitor type 1 (PAI-1), and alterations in uterine artery (UtA) waveforms throughout normotensive and preeclamptic pregnancies and to analyze its predictive value for the detection of preeclampsia within the second trimester of pregnancy. Material and methods: Blood samples were collected from 102 healthy, nulliparous women between the 24th and 26th gestational week. Preeclampsia developed in 13 patients; 89 normotensive control subjects were matched from the same cohort. Plasma samples were assayed for fibronectin and PAI-1 by enzyme-linked immunosorbent assay. Color pulsed Doppler examinations of UtA were performed after blood sampling. Trends were compared between two groups. Results: Maternal plasma fibronectin and PAI-1 levels and average PI, RI and S/D ratios of patients with preeclampsia were significantly higher (p < 0.05). The best cut-off values for predicting preeclampsia of fibronectin, PAI-1, PI, RI, S/D ratio based on ROC curve analysis were 290 mg/ml, 77.3 ng/ml, 1,0615, 0.605 and 2,59 respectively. The areas under the curve equal to 0.705, 0.753, 0.689, 0.695 and 0.699 for fibronectin, PAI-1 and uterine artery Doppler PI, RI, S/D ratio were determined for the prediction of preeclampsia. Conclusions: Fibronectin, PAI-1 and UtA Doppler are potentially useful predictors of preeclampsia. Maternal plasma PAI-1 combinated with fibronectin had the highest predictive values in our study.