孕妇血清妊娠相关血浆蛋白A水平与不良妊娠的关系

目的 :确定不同孕周的孕妇其妊娠相关血浆蛋白A(PAPP A)的正常参考值 ,分析PAPP A水平与不良妊娠的关系。方法 :用酶联免疫吸附试验 (ELISA)测定孕妇血清PAPP A浓度 ,统计各孕周孕妇PAPP A值 ,并分组讨论不良妊娠与PAPP A的关系。结果 :获得 4～ 4 2周PAPP A浓度中位数、0 5倍中位数、2 5倍中位数。PAPP A低值与胎儿核型异常、难免流产、死胎有关 ;PAPP A高值与双胎、中重度妊高征有关 ;先兆流产预后差者PAPP A值低于先兆流产预后佳者。结论 :从 14 0 0例孕妇血清中得到的PAPP A浓度统计值 0 5～ 2 5MoM可作为正常参考 ,试用于我省产前筛查 ;母体血清PAPP A的测定值可作为胎儿染色体异常、流产、死胎、妊高征及双胎的辅助诊断指标。     

血清孕酮诊断难免流产及异位妊娠的价值

目的 探讨血清孕酮测定在诊断难免流产及异位妊娠中的价值。方法 ８８例因早孕先兆流产入院的病人，每周测定１次血清孕酮，直至流产或安胎成功出院。测定２０例异位妊娠病人血清孕酮。测定５２例正常宫内早孕妇女血清孕酮作为对照。结果 正常早孕各孕周间孕酮值无显著性差异（Ｐ〉０．０５）。正常早孕、先兆流产与难免流产间孕酮值有显著差异（Ｐ〈０．０５，Ｐ〈０．０００５），正常早孕、先兆流产、难免流产与异位妊娠间均有     

检测妊娠区带蛋白临床意义的研究

采用血清妊娠区带蛋白（ＰＺＰ）单向免疫扩散法时７０８例正常妊娠孕妇，２０７例异常妊娠孕妇及１８８例妇科肿瘤患者进行测定。结果表明：正常妊娠孕妇血清ＰＺＰ含量在妊娠第５周即可测出，其含量随孕周的增加而增加，至妊娠４０周达高峰；先兆流产预后佳者，８１．５％分布在正常范围内；妊高征、胎儿宫内生长迟缓、无脑儿、异位妊娠时，ＰＺＰ多在正常范围内；５１．６％恶性葡萄胎患者血清ＰＺＰ含量低于正常范围，绒毛膜癌低值者占８０．０％，在妇科肿瘤中，卵巢癌患者血清ＰＺＰ明显高于卵巢瘤（Ｐ＜０．０１），子宫内膜癌和宫颈癌高于子宫肌瘤（Ｐ＜０．０１）。本研究认为，测定血清ＰＺＰ含量可作为判定先兆流产预后，鉴别滋养细胞肿瘤及妇科良恶性肿瘤的一项重要参考指标。     

血清孕酮及β—hCG测定诊断异位妊娠的价值

测定了１０１例异位妊娠、４９例正常宫内孕、２４例先兆流产及３２例难免流产妇女血清孕酮和β－ｈＣＧ水平及２６例ＥＰ间隔４８－７２小时的血清β－ｈＣＧ水平。     

产前行妊娠相关血浆蛋白A筛查联合FISH诊断Down综合征

目的 :应用单项妊娠相关血浆蛋白A(PAPP A)筛查与羊水间期荧光原位杂交 (FISH)产前诊断相结合预防妊娠Down综合征胎儿。方法 :采用酶联免疫方法 (ELISA)对孕周分别为 6～ 2 7周的 1839例孕妇进行母血PAPP A单项筛查 ,以低于同一孕周的中位数时视为可能妊娠Down综合征胎儿的高风险孕妇。取高风险孕妇羊水细胞直接进行间期FISH产前诊断并同时用部分羊水细胞遗传学检查作对照。结果 :检出 1例孕 7周孕妇其PAPP A值为 0 0 5 1U/L ,低于同一孕周中位数 2 0多倍。羊水细胞间期FISH结果显示 ,含 5个杂交信号的核占所有杂交核的 38 5 % ,与细胞遗传学分析的 2 1三体核型完全一致。结论 :单项PAPP A筛查与羊水间期细胞FISH相结合是早期防治妊娠Down综合征有效可行的方法。     

苗勒管抑制物在妊娠妇女血清中的表达

苗勒管抑制物（MIS）是生育年龄女性卵巢颗粒细胞产生的一种性激素，也称抗苗勒管激素（AMH），是一种双聚体糖蛋白激素，属转化生长因子β（TGF—β）超家族，近年不断发现它和一些不良妊娠结局的产生有关，包括妊娠的各个时期。我们收集了正常早期宫内妊娠者和异常妊娠包括先兆流产、妊娠中止及异位妊娠患者共91例的血清样本，分别测定了MIS水平及其它与妊娠相关的激素如妊娠相关蛋白（PAPP—A）、孕酮（P）及β绒毛膜促性腺激素（β—HCG）初步探讨了它们和早期异常妊娠的关系。     

血绒毛膜促性腺激素β对早期诊断异位妊娠的价值

目的　探讨血绒毛膜促性腺激素 β (β -HCG)在早期诊断异位妊娠的价值。 方法　采用前瞻性方法对比研究了不同停经周数的异位妊娠和先兆流产患者的血 β-HCG值 ,取静脉血以BayerAcs180HCG双抗体夹心光化学测定法测定 β-HCG值。 结果　 84例异位妊娠 β-HCG值与停经天数无显著相关 (r=0 2 1,P =0 0 6 38) ,78例先兆流产的 β-HCG值与停经天数正相关 (r =0 5 9,P =0 0 0 0 1)。两组的平均 β -HCG分别为 2 0 14 5U/L和 4 172 6U/L ,异位妊娠组的平均 β-HCG值显著低于流产组 ,P <0 0 0 1,差异有极显著性。 结论　相对较低的血 β-HCG值和较低幅度的上升变化 ,对异位妊娠的早期诊断有肯定价值。     

血清孕酮及β-HCG值对异常妊娠早早孕阶段患者妊娠结局的意义

目的探讨分析血清孕酮和β-HCG值的测定对于预测异常妊娠的早早孕阶段患者妊娠结局的作用。方法选取2013年9月~2014年9月我院妇产科收治的疑为异位妊娠患者50例,将其分为异位妊娠组20例,先兆流产组20例,难免流产组10例,对比三组患者血清孕酮和β-HCG值。结果先兆流产组患者的血清孕酮和β-HCG值明显高于异位妊娠组和难免流产组患者,异位妊娠组的血清孕酮和β-HCG值与难免流产组患者相比,差异无统计学意义(P0.05)。结论血清孕酮和β-HCG值测定对于预测早早孕阶段异常妊娠患者的妊娠结局具有比较重要的意义,可以作为早期对异常妊娠进行诊断的一种重要手段。可以和B超等其他的辅助检查相结合,在临床的诊治中作用较大。     

子宫内膜厚度、β-HCG和孕酮联合检测对异位妊娠与早早孕诊断价值的探讨

目的:探讨异位妊娠与早早孕鉴别诊断的特征性依据,避免误诊误治。方法:对132例疑似异位妊娠的病例测量子宫内膜厚度及测定血清-βHCG及孕酮值。结果:本研究的所有病例血清-βHCG及孕酮值高于正常非妊娠者。但宫内妊娠组子宫内膜厚度及孕酮值明显大于异位妊娠组,P<0.01;正常宫内妊娠的子宫内膜厚度、-βHCG及孕酮值大于宫内妊娠流产组。结论:血清-βHCG及孕酮值是确定妊娠的指标,但难以鉴别异位妊娠和尚未形成宫内孕囊的早早孕及宫内妊娠流产,结合子宫内膜厚度则能预测妊娠的趋向,提示妊娠的着床部位,为防止误诊提供了一个有价值的临床早期诊断指标。     

胎儿及新生儿的超声监测

超声检查是一项无损伤性的诊断方法 ,适用于孕期及围产期对胎儿及新生儿的监测。主要可分下述几方面。一、产前检查排除胎儿先天畸形及异常1 妊娠早期 :孕 12周前 ,应对凡有高危因素的孕妇 ,包括高龄初孕、有遗传病史、畸胎史、习惯性流产史或有先兆流产史等孕妇进行超声检查。以了解胚胎发育是否正常 ,尽早排除异常妊娠 (如葡萄胎、胎停育、异位妊娠等 )及严重的胎儿畸形如无脑儿、单腔心等。2 妊娠中期 :除上述适应证外 ,对妊娠期糖尿病、妊娠高血压综合征 (妊高征 )、妊娠过程中突发羊水过多或临床检查可疑胎儿发育迟缓 (ＩＵＧＲ)以及…     

Blood lead and cadmium and birth weight among sub-arctic and arctic populations of Norway and Russia

BACKGROUND: Delivering women and their newborns in the Kola Peninsula of Russia and the neighboring arctic area of Norway were studied to explore relationships between maternal cadmium and lead status and birth weight as a pregnancy outcome. METHODS: Life-style information, maternal blood and cord blood specimens were collected from 50 consecutive mother-infant pairs from hospital delivery departments in three Russian and three Norwegian communities. Pregnancy outcomes were verified by consulting medical records. Lead and cadmium were determined in the blood samples by electrothermal atomic absorption spectrometry. RESULTS: The median blood-cadmium concentration for the Russian mothers was 2.2 nmol/L (n = 148) versus 1.8 nmol/L in the Norwegian group (n = 114, p = 0.55). A weak association was observed between maternal cadmium and amount smoked (r = 0.30, p<0.001); no correlation was found between maternal blood cadmium and birth weight. The corresponding maternal lead values were 0.14 (Russia) and 0.06 micromol/L (Norway), p<0.001. The latter lead concentration constitutes one of the lowest adult population values reported to date. Maternal and cord blood lead levels were strongly correlated (r = 0.88, p<0.001). In a multivariate linear regression model, maternal blood lead was recognized as a negative explanatory variable (p<0.05) for birth weight and child's body mass index (BMIC), with or without adjustment for gestational age. A similar association was suggested by ANOVA-analysis of maternal blood lead by quartiles. CONCLUSION: Maternal blood-lead level as an environmental factor is an apparent predictor of low birth weight and BMIC. It reduced substantially the contribution of a country factor in explaining the observed differences in birth weight.     

Pharmacokinetics and endometrial and tubal tissue penetration of cefalotin and cefazolin

The pharmacokinetics and concentrations of the two antibiotics cefazolin and cefalotin were studied during gynecologic operations in endometrial and tubal tissue. The patients received 0.05 g/kg of the antibiotics by intravenous injection. Under the given conditions, pharmacokinetic calculation of the plasma elimination gave half-lives of 24.8 min for cefalotin and of 63 min for cefazolin. Fitting of the tissue levels to the Bateman function showed that the two antibiotics diffuse rapidly into both tubal and endometrial tissue and attain peak concentration levels between 10 and 25 min. In both tissues the concentrations of cefazolin were higher than those of cefalotin. Higher tissue concentrations of cefazolin could also be demonstrated in experiments of longer duration.