妊娠妇女及围产儿巨细胞病毒感染的研究

应用酶联免疫法（ＥＬＩＳＡ），对不同孕周孕妇２５６例及其中８４例巨细胞病毒ＩｇＭ抗体（ＨＣＭＶ－ＩｇＭ）阳性的妊娠晚期孕妇所分娩新生儿的脐血，进行ＨＣＭＶ－ＩｇＭ检测。结果：妊娠早期、中期妇女的４２份血清标本中，ＨＣＭＶ－ＩｇＭ阳性１７例，感染率为４０．４８％。妊娠晚期２１４份标本中，ＨＣＭＶ－ＩｇＭ阳性８４例，感染率为３９．２５％。ＨＣＭＶ－ＩｇＭ阳性者围产儿死亡率、新生儿窒息抢救率、胎儿畸形及有异常妊娠病史的妊娠妇女的比例均增加（Ｐ＜０．０１）。提示：ＨＣＭＶ－ＩｇＭ阳性表明妊娠妇女近期有巨细胞病毒（ＨＣＭＶ）感染，或既往有隐性的ＨＣＭＶ感染，在妊娠期复发（活动性感染）。     

孕妇与胎儿巨细胞病毒感染的血清学研究

测定了１７３例孕妇及８１例胎儿血清ＣＭＶ抗体。结果：１７３例孕妇血清中ＣＭＶ－ＩｇＧ阳性率为７０．５％（１２２／１７３），ＣＭＶ－ＩｇＭ阳性率为０．５８％（１／１７３），孕妇早、中、晚孕期ＣＭＶ感染率分别为５２％、７２．９％，７４．４％，妊娠次数≥４次的孕妇ＣＭＶ感染率较高。８１例脐血血清中ＣＭＶ－ＩｇＧ阳性率为５４．３％（４４／８１），ＣＭＶ－ＩｇＭ阳性率为６．２％（５／８１），５例先天性ＣＭＶ感染儿分别为４例胎儿畸形及１例产前咨询者，后者取脐血查到ＩｇＭ阳性后１个月，胎死宫内。提示脐血中一旦查到ＣＭＶ－ＩｇＭ阳性，胎儿有严重后果。因此，产前诊断胎儿ＣＭＶ感染，早期发现ＣＭＶ感染儿，是非常重要的。     

胎儿血流速度波形预测围产儿预后的价值

应用彩色多普勒超声对１０４例晚期妊娠妇女进行胎儿脐动脉（ＵＡ）、肾动脉（ＲＡ）及大脑中动脉（ＭＣＡ）的血流速度波形（ＦＶＷｓ）检查。多普勒指标包括ＵＡ、ＲＡ和ＭＣＡ的搏动指数（ＰＩ）、ＭＣＡ与ＵＡ的ＰＩ比值（Ｍ／ＵＮ）和ＭＣＡ与ＲＡ的ＰＩ比值（Ｍ／ＲＰＩ）。围产儿预后不良的标准包括：（１）新生儿Ａｐｇａｒ评分＜７分。（２）新生儿出生体重≤相应胎龄的第１０百分位数。（３）羊水过少或羊水混浊。结果显示：所有多普勒指标与围产儿预后均有明显相关性（Ｐ＜０．０５）；作为预测围产儿预后的指标，它们的特异性差异均无显著性（Ｐ＞０．０５），Ｍ／ＲＰＩ和Ｍ／ＵＰＩ的敏感性明显高于ＵＡＰＩ、ＲＡＰＩ和ＭＣＡＰＩ（Ｐ＜０．０５）；而且，Ｍ／ＲＰＩ、Ｍ／ＵＰＩ、ＭＣＡＰＩ和ＲＡＰＩ预测围产儿预后的敏感性和特异性在正常妊娠和高危妊娠之间无明显差别，而ＵＡＰＩ在高危妊娠时的敏感性明显高于正常妊娠（Ｐ＜０．０５）。说明：所有多普勒指标与围产儿预后有关，但是作为预测围产儿预后的指标，Ｍ／ＲＰＩ和Ｍ／ＵＰＩ比其它指标准确，而且，不受各种高危因素影响。     

自然流产妇女人巨细胞病毒感染的调查

采用酶联免疫吸附法（ＥＬＩＳＡ），对自然流产的６５８例妇女血清进行了人巨细胞病毒（ＨＣＭＶ）ＩｇＧ、ＩｇＭ的检测，并和正常妊娠妇女作比较；应用ＥＬＩＳＡ对１５例流产后绒毛进行ＨＣＭＶ－ＩｇＧ、ＩｇＭ检测。结果显示：流产组ＨＣＭＶ－ＩｇＧ，ＨＣＭＶ－ＩｇＭ，ＨＣＭＶ－ＩｇＧ与ＨＣＭＶ－ＩｇＭ双阳阳性率分别为２７．２０％、１３．８３％、８．５１％，其中ＨＣＭＶ－ＩｇＭ、ＨＣＭＶ－ＩｇＧ及ＨＣＭＶ－ＩｇＭ双阳阳性率与正常孕妇相比，差异有显著性（Ｐ＜０．０１）；１５例流产绒毛，阳性率８０％。说明ＨＣＭＶ通过胎盘传给胎儿，引起流产。孕妇原发与激发感染与自然流产有相关性，ＨＣＭＶ－ＩｇＭ和ＨＣＭＶ－ＩｇＧ与ＨＣＭＶ－ＩｇＭ双阳阳性率与发生流产次数成正相关。     

胰岛素样生长因子—I与胎儿出生体重的关系

目的 了解胰岛素生长因子－Ｉ（ＩＧＦ－Ｉ）在胎儿生长发育中所起的作用,方法 选择１７１例产妇及其所分娩的新生儿１６４例,根据出生体重将新生儿分为大于胎龄儿（ＬＧＡ）组,产妇７７例,新生儿６４例,适于胎龄儿（ＡＧＡ）组：产妇５９例,新生儿５９例;小儿胎龄儿（ＳＧＡ）组：产妇３５例,新生儿４３例,用放射免疫法测定血清中ＩＧＦ－Ｉ的浓度。结果 母血中ＩＧＦ－Ｉ浓度均高于脐血,两者间存在浓度梯度（Ｐ〈０．     

胎儿胰岛素样生长因子-Ⅰ的检测及意义

目的评估胰岛素样生长因子Ⅰ（ＩＧＦⅠ）在胎儿、胎盘生长发育中的作用。方法用放射免疫分析法（ＲＩＡ）测定大于胎龄儿（ＬＧＡ）组３０例,适于胎龄儿（ＡＧＡ）组３６例及小于胎龄儿（ＳＧＡ）组３６例的脐血清ＩＧＦⅠ的水平。用线性相关分析法分析各组变量之间的相关关系。结果３组胎儿脐血清ＩＧＦⅠ与胎龄、胎儿体重、胎盘重量均呈显著正相关（ｒ＝０．３２,Ｐ＜０．００１;ｒ＝０．６８,Ｐ＜０．００１;ｒ＝０．７５,Ｐ＜０．０１）,其中与胎盘重量呈高度正相关。脐血清ＩＧＦⅠ水平,ＡＧＡ组为１４４５９±４６．７３μｇ／Ｌ;ＳＧＡ组为９０．８０μｇ／Ｌ（ｔ＝４．７,Ｐ＜０．００１）,ＬＧＡ组为２０９１７μｇ／Ｌ（ｔ＝７．９７,Ｐ＜０．００１）。结论ＩＧＦⅠ是胎儿、胎盘生长发育的重要调节因子,对巨大儿、小于胎龄儿的形成有重要作用。     

妊娠晚期三种病毒活动性感染与低出生体重儿先天性感染率调查研究

目的观察妊娠晚期三种病毒活动性感染对低出生体重儿的垂直传播及先天性感染率。方法观察组为出生体重＜２５００ｇ早产儿和足月小于胎龄儿（ＳＧＡ）,对照组为同期出生单胎足月正常新生儿;两组均与生母配对分别于分娩后４８小时采血,用间接法ＥＬＩＳＡ检测巨细胞病毒（ＣＭＶ）、风疹病毒（ＲＶ）、单纯疱疹病毒Ⅱ型（ＨＳＶ－Ⅱ）、特异性ＩｇＧ和ＩｇＭ抗体。结果产妇三种病毒活动性感染率观察组和对照组差异无显著性意义（Ｐ＞００５）;但母婴传播率早产组三种病毒均明显高于对照组（直接概率＜００２５）。三种病毒先天性感染率早产儿组均明显高于足月儿组（Ｐ＜００５）,胎龄愈小,出生体重愈低先天性感染率愈高。结论妊娠晚期孕母病毒活动性感染,小胎龄早产儿胎盘屏障发育不完善,病毒容易通过胎盘传播给胎儿,因而早产儿组先天性感染率高于足月儿组。     

妊娠期巨细胞病毒感染

本院对７４８７例孕妇使用ＥＬＩＳＡ检测，发现ＣＭＶＩｇＭ阳性者１７４例，阳性率为２．３５％。对ＣＭＶＩｇＭ阳性孕妇，分为治疗组和对照组，治疗组用人脾转移因子治疗。ＣＭＶＩｇＧ阳性者重复检测ＣＭＶＩｇＧ，产后取脐血测ＣＭＶＩｇＧ及ＩｇＭ，其中７３例新生儿作了尿ＣＭＶＰＣＲ检测。脐血ＣＭＶＩｇＧ阳性率为９８．６％，ＣＭＶＩｇＭ阳性率为４．９％，新生儿尿ＣＭＶＰＣＲ阳性率为３７％。随访５５例新生儿，２２例有ＣＭＶ感染体征。结果示治疗组孕妇ＣＭＶＩｇＭ阳性转阴数明显高于对照组（Ｐ＜０．０５），同时受影响新生儿尿ＣＭＶＰＣＲ阳性率及有新生儿ＣＭＶ感染体征者均比对照组为低（Ｐ＜０．０２５及＜０．０１），故转移因子治疗妊娠期ＣＭＶ感染有一定效果。     

脐动脉血流速度比值评估胎儿生长迟缓

对１４０例经Ｂ型超声诊断为胎儿生长迟缓（ＩＵＧＲ）的妊娠期妇女进行了２２０次脐动脉血流速度比值（Ｓ／Ｄ）测定。分娩后证实：小于胎龄儿（ＳＧＡ）的Ｓ／Ｄ值明显高于适于胎龄儿（ＡＧＡ）；预测ＳＧＡ的敏感性为８２％，阳性预测率为８１％，阴性预测率为８７％。在ＳＧＡ中，Ｓ／Ｄ值增高者的早产率、难产率、胎儿窘迫发生率及围产儿死亡率均显著高于Ｓ／Ｄ值不增高者；足月后，Ｓ／Ｄ值≥４者，新生儿中度以上窒息的发生率     

妊娠晚期三种病毒活动性感染与低出生体重儿先天性感 …

目的 观察妊娠晚期三种病毒活动性感染对低出生体重儿的垂直传播及先天性感染率。方法 观察组为出生〈２５００ｇ早产儿和足月小于胎龄儿（ＳＧＡ）对照组为同期出生单胎足月正常新生儿;两组均与生母配对分别于分娩后４８小时采血,用间接法ＥＬＳＩＡ检测巨细胞病毒（ＣＭＶ）,风疹病毒（ＲＶ０,单纯疱疹病毒Ⅱ型（ＨＳＶ－Ⅱ）,特异性ＩｇＧ和ＩｇＭ抗体。     

胎儿宫内生长迟缓患者的胎盘免疫病理学观察

目的：观察胎儿宫内生长迟缓（IUGR）患者的胎盘免疫病理学改变,并探讨IUGR的发病机理。方法：采用免疫组织化学技术,对22例不明原因IUGR（不明原因IUGR组）、10例妊娠高血压综合征（妊高征）合并IUGR（妊高征合并IUGR组）、23例正常产妇（正常妊娠组）的胎盘免疫病理学改变进行观察。结果：⑴3组胎盘绒毛内血管IgG的阳性例数分别为：不明原因IUGR组19例,妊高征合并IUGR组10例,正常妊娠组17例,3组比较,差异无显著性（P＞0.05)。⑵不明原因IUGR组与妊高征合并IUGR组的绒毛内血管IgG阳性例数分别为8例及4例,而正常妊娠组则无一例阳性。⑶不明原因IUGR组与妊高征合并IUGR组的胎盘蜕膜血管IgG、IgM阳性例数,以及滋养细胞IgM染色强度均高于正常妊娠组。而不明原因IUGR组与妊高征合并IUGR组之间比较,差异显著性（P＞0.05)。⑷不明原因IUGR组中,抗心磷脂抗体（ACA）阳性与阴性患者的胎盘免疫复合物沉积状况比较,差异无显著性（P＞0.05)。结论：胎盘免疫复合物沉积在IUGR的发病中起重要作用。不明原因IUGR与妊高征合并IUGR具有相似的胎盘免疫病理改变。ACA导致IUGR的机理是否与胎盘免疫复合物的沉积有关,尚需进一步证实。     

抗心磷脂抗体阳性产妇胎盘的病理观察

目的 探讨抗心磷脂抗体阳性产妇与不良妊娠的关系。方法 选ＡＣＡ阳性产妇胎盘１６例（不良妊娠及正常妊娠结果各８例）为研究组。ＡＣＡ阴性产妇产胎盘８例为对照组,用免疫荧光法标记。     

Maternal anti-protein Z antibodies in pregnancies complicated by pre-eclampsia,SGA and fetal death

Objective.?Low maternal plasma protein Z (PZ) concentrations were reported in patients with pre-eclampsia (PE), a small for gestational age (SGA) neonate, and a fetal demise (FD). Anti-protein Z antibodies (APZ-AB) have been proposed as a possible underlying mechanism leading to low plasma PZ concentrations. The objective of this study was to determine the maternal plasma concentration of APZ-AB in women with a normal pregnancy, and patients with PE, an SGA neonate or a FD.

Study design.?A cross-sectional study included women in the following groups: (1) non-pregnant women (n = 45); and pregnant women with: (2) normal pregnancies (n = 70); (3) PE (n = 123); (4) SGA neonates (n = 51); and (5) a FD (n = 51). Plasma concentrations of anti-protein Z IgM and IgG antibodies were measured by ELISA. Elevated APZ-AB was defined as >75th, 90th and 95th percentile of the normal pregnancy group. Non-parametric statistics were used for analyses.

Results.?(1) Patients with an SGA neonate had a higher median maternal plasma IgG APZ-AB concentration than women with normal pregnancies (p < 0.001), and patients with PE (p < 0.001) or with a FD (p = 0.001). (2) The proportion of patients with a maternal plasma IgM APZ-AB concentration >90th percentile was higher in the SGA group than in the PE group (p = 0.01). (3) Patients with PE maternal plasma IgM APZ-AB concentration >90th percentile had a higher rate of villous thrombosis (p = 0.03) and persistent muscularisation of basal plate arteries (p = 0.01) than those with IgM APZ-AB concentration <90th percentile; and (5) Patients with FD and maternal plasma IgM APZ-AB concentration >90th percentile had a higher rate of umbilical phlebitis and arteritis than those with IgM APZ-AB concentration <90th percentile (p = 0.003).

Conclusions.?(1) Patients with SGA neonates have a higher median plasma concentration of IgG APZ-AB than normal pregnant women, or patients with PE or FD; and (2) maternal plasma IgM APZ-AB concentration >90th percentile was associated with vascular placental lesions in patients with PE, but not in those with an SGA neonate, suggesting that in a subset of patients, these antibodies can be associated with abnormal placentation and pregnancy complications.     

卵巢早衰患者自身免疫反应性指标的检测及其意义

目的:检测卵巢早衰患者自身免疫反应状态,寻求有意义指标,为临床诊治提供指导。方法:49例卵巢早衰并不孕症患者为实验组,20例输卵管性不孕症患者为对照组,分别检查血清抗核抗体(antinuclear antibodies,ANA)、抗卵巢组织抗体(antiovarianantibodies,AOAb)、抗心磷脂抗体(Anticardiolipin,ACA)、抗甲状腺微粒体抗体(antithyroidmicrosomal antibodies,A-TG)、抗双链DNA抗体(ds-DNA)、免疫球蛋白(IgG,IgA,IgM,IgE)和补体(C3,C4)含量,并进行统计学分析。结果:实验组ANA、AOAb、ds-DNA、A-TG、C3阳性率分别为40.8%、42.9%、36.7%、46.9%和26.5%,均显著性高于对照组(P<0.05);试验组ACA、IgM异常率较高,分别30.6%、24.5%,但与对照组无显著差别(P>0.05);实验组IgG、IgA、IgE和C4异常率较低,分别为6.1%、2%、12%、4.1%,与对照组无显著差异(P>0.05)。结论:卵巢早衰患者有多种自身免疫性抗体,如ANA、AOAb、ds-DNA、A-TG、C3等,检测上述抗体对诊断自身免疫性卵巢早衰有临床意义。     

Preliminary results of the heparin treatment in anticardiolipin and antihistone antibodies seropositive pregnant women

The presence of elevated titres of anticardiolipin antibodies (ACA) and antihistone antibodies (AHA) in the blood serum is considered as one of serious reasons of repeated pregnancy losses. According to some reports, heparin significantly improves live birth rates in these cases. The aim of the work is an evaluation of the results of the heparin therapy in pregnant women with elevated titres of ACA and/or AHA in blood and bad obstetric anamnesis, or after sterility treatment. Our material consisted of three groups: the first one was composed of 25 ACA- and/or AHA-seropositive pregnant women 30.0 +/- 4.1 years old with 1-5 early miscarriages in past, the second one of six seropositive patients 31.3 +/- 2.8 years old, actually pregnant after the treatment of unexplained sterility (two of them after assisted reproduction) and, finally, in the third group were placed five pregnant ACA- and AHA-seronegative pregnant women 30.8 +/- 2.2 years old with 2-4 abortions of unexplained etiology in past. The ACA IgA, IgM and IgG and AHA IgG levels in blood sera were determined by ELISA. As a positive titre ACA in the class IgA was considered > 7 APL/ml, in the class IgM > 4 MPL/ml, IgG > 7 GPL/ml and in case of AHA IgG > 25 GPL/ml. The patients were treated by heparin 7500-30,000 units daily during all the pregnancy under the control of kaolin-kephalin time. In the first group, where 53 pregnancies from 56 were miscarried (94.6%), after the heparin therapy in 10 women 9 pregnancies of 11 (81.8%) were terminated by live birth (p < 0.001). One of the patients died three days after cesarean section because of myocardial infarction, probably due to sudden stopping of heparin. In the second group three women after heparin treatment delivered live babies, but three untreated aborted. In the last group only two women treated by heparin delivered live babies and three, despite treatment, miscarried. It should be concluded, that heparin therapy in ACA- and/or AHA-positive pregnant women might be a recommended therapeutic method. In cases of antiphospholipid syndrome a special precaution should be undertaken, when stopping the heparin. It seems, that double assay of ACA and AHA in patients with conception troubles might be usefull.     

Anti-phosphatidylserine, anti-cardiolipin, anti-β2 glycoprotein I and anti-prothrombin antibodies in recurrent miscarriage at 8-12 gestational weeks

Objective

To investigate the association of antibodies to β2-glycoprotein I (anti-β2GPI), cardiolipin (ACA), phosphatidylserine (anti-PS) and prothrombin (anti-PT) with recurrent spontaneous miscarriage (RSM).

Study design

Case–control study involving 277 RSM cases and 288 controls: autoantibody levels were measured by ELISA. Differences between cases and controls were analyzed by nonparametric Mann–Whitney test, and logistic regression was used in analyzing the association of autoantibodies with RSM.

Results

Anti-PS IgG, ACA IgM and IgG, and anti-PT IgM were significantly associated with RSM risk, and differential antibody association was noted according to BMI and primary and secondary RSM. Higher prevalence of elevated anti-PS IgG was seen in cases, with the strongest risk above the 99th percentile. For ACA IgM, 28 cases (10.1%) and 5 controls (1.7%) were positive, with increasing OR for increasing cut-off points, which was significant at antibody titers >99th percentile. For ACA IgG, 101 cases (36.5%) and 13 controls (4.5%) were positive, with graded increase in OR for increasing cut-off points, which was significant at titers >90th percentile (maximal at titers >99th percentile). For anti-PT, 23 cases (12.0%) and 9 controls (6.1%) were positive, with increased OR at titers >90th percentile. Regression analyses confirmed the independent association of anti-PS IgG, ACA IgM and IgG with RSM, and significant RSM risk was associated with high anti-PS IgG (P < 0.001) and ACA IgM (P < 0.001) titers, and a dose-dependent increase in RSM risk was seen with progressively increased ACA IgG titers. No significant association existed between anti-PT IgM and RSM.

Conclusion

Elevated ACA IgM and IgG, and anti-PS IgG antibodies are positively associated with RSM.     

Tubal factor infertility: an association with prior chlamydial infection and asymptomatic salpingitis

In 265 Canadian women, with and without tubal factor infertility (TFI), we compared Chlamydia trachomatis cultures of endocervical swabs, endotubal swabs and biopsies, serology, and past history. A history of pelvic inflammatory disease (PID) was absent in 69.2% of TFI women, despite visual evidence of tubal damage. C. trachomatis was not isolated in any of 52 patients with TFI (TFI group), 114 having tubal ligation (STER group), or 99 patients having hysterectomy (HYST group). However, chlamydial antigen was detected with an immunochemical method in 1 of 16 tubal biopsy specimens from TFI women. The prevalence of chlamydial IgM or IgG antibody in serum was significantly higher (P less than 0.0001) in the TFI group (79.1%) than in the other two groups (relative odds, 6.3; 95% confidence interval: 2.5, 16.8). In seropositive (IgG or IgM) subjects, there was a significant (P = 0.003) and strong (relative odds, 5.1; 95% confidence interval: 1.5, 18.1) association between chlamydial IgA antibody and TFI. In women with TFI, there was no significant association between IgM or IgG seropositivity (P = 0.56). or IgA seropositivity (P = 0.53), and a negative history for PID. These findings are consistent with the hypothesis that C. trachomatis is a major cause of TFI following PID, which may or may not be asymptomatic.     

Subclassification of small-for-gestational-age fetus using fetal Doppler velocimetry

Our purpose was to determine whether small-for-gestational-age (SGA) fetus can be divided to subclassified groups using fetal Doppler velocimetry. Fifty-four pregnant women with SGA infant delivered after 37 weeks of gestation were studied. After 24 weeks of gestation, fetal middle cerebral artery puslatility index (MCAPI) and umbilical artery pulsatility index (UAPI) were measured at 2- to 3-week intervals using Doppler ultrasound. Perinatal outcomes [operative delivery due to fetal distress, abnormal fetal heart rate (FHR) pattern, meconium staining, low Apgar score (<7), neonatal acidosis (umbilical artery blood pH <7.15), neonatal intensive care unit (NICU) admission due to neonatal asphyxia, and decreased amniotic fluid] were compared in subclassified SGA groups using fetal Doppler velocimetry. The number of SGA fetuses with normal MCAPI and UAPI (normal SGA group) was 39, and those with significantly low MCAPI but normal UAPI (eventful SGA group) 15, respectively. Birth age and birth weights in the eventful SGA group were significantly earlier and lower than those in the normal SGA group, respectively (p < 0.05, and p < 0.005). There were significant increases in operative deliveries, abnormal FHR patterns and decreased amniotic fluid in eventful SGA group, when compared with events related to normal SGA group. However, there were no significant differences in meconium staining of amniotic fluid, low Apgar score, neonatal acidosis, and NICU admission between the two groups. These results suggest that SGA fetus with abnormally low MCAPI but normal UAPI has more poor perinatal outcomes, compared with that with normal MCAPI and UAPI.     

妊高征患者外周血B细胞体外分泌抗体能力的研究

目的研究妊高征患者Ｂ细胞的功能变化,从免疫学的角度探讨妊高征的发病机理。方法采用密度梯度离心法分离妊高征组（１５例）和正常妊娠组（１５例）的外周血Ｂ淋巴细胞,并在有或无美洲商陆有丝分裂原（ＰＷＭ）存在的情况下培养１０天后,收集上清液,采用酶联免疫吸附试验（ＥＬＩＳＡ）测定每１×１０６个Ｂ淋巴细胞所分泌的ＩｇＧ和ＩｇＭ的量。结果在无ＰＷＭ存在的情况下,妊高征组Ｂ淋巴细胞ＩｇＧ和ＩｇＭ的自发分泌量（１２０±６８ｎｇ,３３７±１１９ｎｇ）分别与正常妊娠组ＩｇＧ和ＩｇＭ的自发分泌量（１５４±８９ｎｇ,３７１±１３５ｎｇ）无显著差异;而在ＰＷＭ的刺激下,妊高征组Ｂ淋巴细胞分泌ＩｇＧ（９４７±５１８ｎｇ）和ＩｇＭ（２０２３±８７９ｎｇ）的量分别显著低于正常妊娠组分泌的ＩｇＧ（１３６７±５９８ｎｇ）和ＩｇＭ（２８４０±１０５７ｎｇ）的量（Ｐ＜０．０５）。结论妊高征患者Ｂ淋巴细胞针对有丝分裂原的刺激信号而产生应答反应的能力下降,提示妊高征患者Ｂ淋巴细胞免疫功能低下     

妊娠期肾病综合征62例临床特点及围生结局分析

目的:分析妊娠期肾病综合征的临床特点及其围生结局。方法:回顾性分析2009年1月至2010年12月在湘潭市妇幼保健院住院的273例重度子痫前期患者,将62例妊娠期肾病综合征和随机选择的70例重度子痫前期无合并肾病综合征患者分别作为肾病组和对照组,分析两组临床资料,比较血压、低蛋白血症情况、肾功能指标和围生结局。结果:肾病组多为年龄较轻的初产妇,病情重,以舒张压升高为主。肾病组血浆总蛋白和白蛋白低于对照组(P<0.05);24小时尿蛋白定量、尿素氮和肌酐均高于对照组(P<0.05)。肾病组早产率、小于胎龄儿发生率、围生儿死亡率和新生儿并发症发生率高于对照组,差异均有统计学意义(P<0.05)。结论:妊娠期肾病综合征病情重、进展快,对母婴的影响大,适时终止妊娠可减少妊娠期并发症及围生儿发病率和死亡率。