妊娠高血压综合征患者血管内皮生长因子的变化及其意义

目的　检测妊娠高血压综合征 (妊高征 )患者外周血中血管内皮生长因子 (VEGF)的水平 ,并探讨其与妊高征发病的关系。方法　应用双抗体酶联免疫吸附法 (ELISA)检测未妊娠妇女 (正常组 ,2 3例 )、正常妊娠妇女 (妊娠组 ,30例 )以及妊高征患者 (妊高征组 ,37例 )外周血中VEGF的水平。结果　 ( 1 )与正常组的 ( 1 1 .98± 3.99)ng/L相比 ,妊娠组VEGF水平明显上升 ,为 ( 1 49.39± 2 7.1 5 )ng/L ,两组比较 ,差异有极显著性 (P <0 .0 0 1 ) ;妊娠组至孕中期VEGF水平达高峰 ,为 ( 1 83.84± 49.0 2 )ng/L ,至孕晚期开始下降 ,为 ( 1 1 8.37± 34 .2 9)ng/L。 ( 2 )妊高征组VEGF水平 ( 6 4 .45± 2 4.33)ng/L ,明显低于妊娠组孕晚期水平 (P <0 .0 1 ) ,并随妊高征病情的加重 ,VEGF水平呈逐渐下降趋势 (P <0 .0 5 )。结论　妊娠后VEGF水平显著下降可能是妊高征发病机理中的一个重要因素。     

妊高征患者血清瘦素水平变化的研究

目的 :探讨妊娠高血压综合征 (妊高征 )患者血清瘦素 (leptin)水平的变化及其与妊高征发病的关系。方法 :采用放射免疫分析法测定了 36例妊高征患者 (妊高征组 )和 30例正常孕妇 (正常妊娠组 )产前及产后血清瘦素水平。结果 :中、重度妊高征患者产前瘦素水平为 15 .19± 6 .74 ng/ ml明显高于正常妊娠组的 10 .11± 2 .80 ng/ m l(P<0 .0 5 ) ;轻度妊高征组患者产前瘦素水平 12 .77± 4 .6 8ng/ ml与正常妊娠组比较 ,差异无显著性 (P>0 .0 5 )。妊高征患者产后瘦素水平为 5 .91± 2 .6 8ng/ ml,与产前 14 .5 6± 6 .30 ng/ ml相比 ,差异显著 (P<0 .0 5 )。妊高征组产后瘦素水平与正常妊娠组 5 .74± 2 .38ng/ ml相比 ,差异无显著性。结论 :妊高征患者血清瘦素水平升高 ,与妊高征的发生有关     

妊娠高血压综合征患者血浆C-型利钠肽水平变化的相关性研究

目的　探讨妊娠高血压综合征 (妊高征 )患者血浆C 型利钠肽水平的变化 ,及其与妊高征发病的关系。方法　采用放射免疫分析法测定了 89例妊高征患者 (妊高征组 )、193例正常妊娠妇女 (正常妊娠组 )和 46例正常孕龄妇女 (正常妇女组 )血浆C 型利钠肽水平。结果　妊高征组血浆C 型利钠肽水平明显升高 ,为 (30 .5 1± 33.6 1)ng/L ;正常妊娠组为 (19.43± 5 .13)ng/L ,正常妇女组为(17.15± 3.82 )ng/L。妊高征患者血浆C 型利钠肽水平明显高于正常妊娠妇女。妊高征组轻、中、重患者之间 ,血浆C 型利钠肽水平亦有极显著差别 ,分别为 (9.88± 2 .74)ng/L、(2 2 .15± 8.90 )ng/L和(6 4.2 6± 44 .0 3)ng/L ,3者比较 ,差异有极显著性 (P <0 .0 1)。结论　血浆C 型利钠肽水平由低到高的变化反映妊高征的疾病严重程度 ,可作为判断妊高征病情发展的一个生化指标。     

妊高征患者白细胞介素6与免疫球蛋白的相关性研究

目的　探讨妊高征患者白细胞介素 6 (IL- 6 )与免疫球蛋白 (Ig)的相关性。　方法　用放射免疫法检测妊高征患者 5 0例 (妊高征组 ,其中中度 2 4例 ,重度 2 6例 )及正常足月妊娠 30例 (正常足月妊娠组 )的母血、脐血中的 IL- 6含量 ,采用速率散射比浊法检测同样标本中的 Ig G、Ig M、Ig A的含量。　结果　重度妊高征患者母血中 IL- 6的含量为 (16 7.2 0± 72 .5 2 ) ng/ L,脐血中 IL- 6含量为 (133.2 0±85 .5 5 ) ng/ L,均较正常孕妇显著增高 ,差异显著 (P<0 .0 1,P<0 .0 1) ,中度妊高征患者母血中 IL- 6的含量为 (12 4.40± 86 .37) ng/ L,脐血中 IL- 6含量为 (97.33± 74.16 ) ng/ L,均较正常孕妇显著增高 ,差异显著 (P<0 .0 5 ,P<0 .0 5 )。中度妊高征母血 Ig G含量为 (7.0 1± 2 .0 9) g/ L,而重度妊高征母血 Ig G含量为 (7.43± 1.6 6 ) g/ L,均显著低于正常妊娠组 (P<0 .0 1,P<0 .0 1) ,与母血 IL- 6含量呈显著负相关关系 (r=- 0 .779,P<0 .0 1;r=- 0 .80 6 ,P<0 .0 1)。　结论　 IL- 6与 Ig G协同作用 ,共同参与了妊高征的免疫损伤过程 ,提示 :如能使母血中 IL- 6降低 ,Ig G升高 ,有可能防治妊高征。     

妊娠高血压综合征患者血浆神经肽Y水平变化的相关性研究

目的　探讨妊娠高血压综合征(妊高征)患者血浆神经肽Y(NPY)水平的变化及其与妊高征发病的关系。方法　采用放射免疫分析法测定了30例妊高征患者(妊高征组)产前及产后、23例正常妊娠妇女(正常妊娠组)和20例正常育龄未孕妇女(正常非孕组)血浆NPY水平。结果　妊高征组产前血浆NPY水平［(164.16±68.32)ng/L］明显高于正常非孕组［(86.60±20.65)ng/L］和正常妊娠组［(82.42±12.46)ng/L］(P<0.01)。妊高征组轻、中、重患者之间,产前血浆NPY水平有显著差异,分别为(88.66±25.69)ng/L、(145.15±18.72)ng/L、(235.05±33.60)ng/L(P<0.01)。妊高征组中、重度患者产前与产后血浆NPY水平分别为(80.04±28.70)ng/L及(130.43±37.38)ng/L,两者比较,差异有显著性(P<0.01);重度患者产后NPY水平仍明显高于正常妊娠组(P<0.01)。结论　妊高征患者血浆NPY水平增高,NPY参与了妊高征的发生和发展。     

主动免疫治疗对不明原因习惯性流产患者辅助T细胞因子水平的影响

目的　探讨主动免疫治疗对不明原因习惯性流产 (UHA)患者辅助T细胞 (Th) 1 /Th2型细胞因子水平的影响。方法　采用酶联免疫吸附法 ,检测 30例半年内接受过淋巴细胞主动免疫治疗的UHA患者 (治疗组 ) ,及 2 5例未经治疗的UHA患者 (未治疗组 ) ,外周血单个核细胞 (PBMC)经滋养细胞抗原刺激产生的Th1型细胞因子白细胞介素 (IL) 2、γ干扰素 (IFN γ)及Th2型细胞因子产生IL 4、IL 1 0水平。并选取 1 5例正常非妊娠妇女作为对照 (对照组 )。结果　 (1 )在最佳诱导时间内 ,治疗组IL 2、IFN γ的水平分别为 (1 0 8± 37)ng/L、(1 1 0± 52 )ng/L ,明显低于未治疗组的 (2 2 3± 85)ng/L、(32 6±92 )ng/L(P值均 <0 .0 5) ;IL 4、IL 1 0水平分别为 (50± 1 1 )ng/L、(1 4 0± 37)ng/L ,明显高于未治疗组的(2 3± 1 1 )ng/L、(52± 2 8)ng/L(P值均 <0 .0 5)。未治疗组IL 2、IFN γ水平明显高于对照组的 (92± 32 )ng/L、(1 0 2± 35)ng/L(P值均 <0 .0 5) ;IL 4、IL 1 0水平低于对照组的 (62± 2 1 )ng/L、(1 50± 42 )ng/L(P值均 <0 .0 5)。治疗组与对照组各细胞因子水平比较 ,差异均无显著性 (P值均 >0 .0 5)。 (2 )治疗组30例患者治疗后半年内妊娠 2 6例 ,其中 8例自然流产 ,IL 2、IFN γ水平明显高于 1 8例妊娠     

血管内皮生长因子及受体对妊娠高血压综合征发病的影响

目的:探讨血管内皮生长因子(VEGF)及受体(FLT-1)在妊娠高血压综合征(妊高征)发病中的作用。方法:选取妊高征孕妇51例,正常妊娠妇女44例(其中晚期妊娠23例),及非妊娠妇女10例为研究对象。采用ELISA方法测定其血清VEGF水平;以免疫组织化学方法观察VEGF及受体FLT-1在胎盘绒毛中的表达。结果:妊高征组血清VEGF水平为23.39±9.79ng/L,明显低于正常晚期妊娠组(40.62±14.85ng/L),(P<0.01)。胎盘中VEGF及肿-1的表达较正常晚期妊娠组弱,有显著性差异(P<0.05)。轻度妊高征组血清VEGF水平为33.79±5.97ng/L,与正常晚期妊娠组比较无明显差异(P>0.05)。中、重度妊高征组VEGF水平分别为21.44±2.07ng/L、16.45±5.56ng/L,与晚期妊娠组比较,差异有显著性(P<0.01)。结论:孕妇血清中VEGF水平下降、胎盘中VEGF及FLT-1表达降低可能与妊高征的发病机理有关。     

妊娠高血压综合征患者血清β绒毛膜促性腺激素及胎盘催乳素水平测定及其临

目的　探讨血清β绒毛膜促性腺激素 (β hCG)及胎盘催乳素 (HPL)的临床意义及其在妊娠高血压综合征 (妊高征 )发病中的作用。方法　用放射免疫法测定 142例正常妊娠妇女 (正常妊娠组 )及 43例妊高征妇女 (妊高征组 ,其中轻度 16例 ,中度 12例 ,重度 15例 )血清 β hCG及HPL水平。结果　 (1)轻、中、重度妊高征妇女血清 β hCG分别为 (2 5 33± 17 80 ) μg/L、(33 12± 4 91) μg/L、(42 19± 17 47) μg/L ;正常妊娠妇女为 (12 33± 7 92 ) μg/L ,妊高征组与正常妊娠组比较 ,差异有极显著性 (P <0 0 0 1)。β hCG水平与妊高征病情严重程度呈正相关(r=0 6 77,P <0 0 5 )。 (2 )轻、中、重度妊高征妇女血清HPL分别为 (14 73± 3 2 6 )mg/L、(11 44± 4 0 2 )mg/L、(12 73± 4 18)mg/L ;正常妊娠妇女为 (12 78± 4 6 7)mg/L。妊高征组与正常妊娠组比较 ,差异无显著性 (P >0 0 5 )。HPL水平与妊高征病情严重程度无相关 (r=- 0 30 0 ,P >0 0 5 )。结论　β hCG可反映妊高征时滋养细胞功能紊乱的程度及病情严重程度 ,可作为妊高征病情的监测指标之一。HPL水平的变化不能作为妊高征的检测指标。     

妊高征孕妇血清β-HCG及HPL水平测定

目的 :探讨血清 β绒毛膜促性腺激素 (β HCG)及胎盘泌乳素 (HPL)水平与妊娠高血压综合征 (妊高征 )之间的关系。方法 :用放射免疫法测定 1 1 8例正常妊娠妇女及 42例妊高征妇女血清 β HCG及HPL水平。结果 :正常妊娠妇女血清 β HCG为 1 2 .0 4± 5.62 μg/L ,妊高征妇女血清 β HCG为 2 2 .32± 9.40 μg/L,两组比较差异有显著性 (P <0 .0 5)。β HCG水平与妊高征病情严重程度呈正相关 (γ=0 .56P <0 .0 5) ;正常妊娠妇女血清HPL为 6.1 8± 3 .2 7mg/L ,妊高征妇女为 6 .35± 2 .79mg/L ,妊高征组与正常妊娠妇女组比较 ,差异无显著性 (P >0 .0 5)。结论 :β HCG可反映妊高征时胎盘滋养细胞功能紊乱程度及病情的严重程度     

妊娠高血压综合征患者血清sICAM-1含量测定及其在妊高征发病中的作用

目的　探讨可溶性细胞间粘附分子 1(soluble intercellular adhesion molecule- 1,s ICAM- 1)在妊娠高血压综合征 (简称妊高征 )发病中的作用。　方法　应用酶联免疫吸附法 (EL ISA)测定 6 5例妊高征患者 (妊高征组 ,包括轻度 15例 ,中度 2 4例 ,重度 2 6例 )及 2 5例同期正常妊娠孕妇(对照组 )外周血清中 s ICAM- 1的含量 ;应用化学发光酶联免疫分析法测定两组孕妇血清中白细胞介素 1(interleukin- 1,L I- 1β)及肿瘤坏死因子 (tum or necrosing factor alpha,TNF- α)含量 ;并记录新生儿体重及妊娠结局。　结果　轻、中、重度妊高征组母血清中 s ICAM- 1的含量 [(36 8.5 6± 6 2 .81) μg/L、(6 0 6 .6 3± 10 5 .0 4 ) μg/ L、(85 9.36± 2 0 0 .92 ) μg/ L]均显著高于对照组 [(2 36 .6 9± 96 .33) μg/ L](P<0 .0 5 ,P<0 .0 1,P<0 .0 1) ,中、重度妊高征组母血清中 IL- 1β及 TNF- α的含量均显著高于对照组(P<0 .0 5 ,P<0 .0 1) ;中、重度妊高征组 s ICAM- 1的水平与相应 IL- 1β及 TNF- α的水平呈显著的正相关 (r=0 .6 97,P<0 .0 1;r=0 .74 6 ,P<0 .0 1)。重度妊高征组伴胎儿生长受限 (fetal growth restric-tion,FGR)者血中 s ICAM- 1含量显著高于同组其他孕妇之含量 (P<0 .0 5 )。妊高征组     

Th1/Th2漂移与子宫内膜异位症

子宫内膜异位症(EMs)是妇科常见病,其发病机制尚不明确,机体的免疫状态与其发生发展关系密切.近年来关于Th1/Th2细胞功能与子宫内膜异位症的关系成为研究热点.研究证实,EMs患者体内存在Th1/Th2漂移,机体免疫功能减退,异位内膜细胞发生免疫逃逸继而种植生长.通过追溯Th1/Th2概念并分析Th1/Th2漂移对免疫系统造成的影响,揭示了Th1/Th2细胞功能失衡与子宫内膜异位症发病的关系.纠正机体免疫失调、恢复Th1/Th2平衡成为治疗EMs的可能手段.     

Th1/Th2 balance in preeclampsia

The syndrome of preeclampsia has previously been ascribed to generalized maternal endothelial dysfunction, poor placentation and excessive maternal inflammatory response. Recent reports suggest that preeclampsia is associated with a Th1 predominant profile and may be considered as a failure of the tolerance system allowing the second physiological trophoblastic invasion. In this review, we discuss that Th1 predominant immunity is closely related to inflammation, endothelial dysfunction and poor placentation.     

Th1, Th2, Th17 and Treg levels in umbilical cord blood in preeclampsia

Introduction: Preeclampsia is one of the major causes of maternal and neonatal mortality. During pregnancy, the immune system must maintain the tolerance to the fetus, thus changes in the cytokine balance may result in a disturbed pregnancy. T helper cells play an important role in modulation of the immune system and are involved in this cytokine balance.

Objective: Many studies have been performed to study the T cell composition in different compartments during pregnancy, although this is the first study in which T cells are evaluated in umbilical cord blood.

Study design: Intracellular expression of INF-gamma, IL-17, IL-4 and forkhead foxP3 in CD4+ T cells was evaluated in umbilical blood from healthy pregnant and preeclamptic women using a flow cytometer.

Results: Th2 and Treg cells levels were significantly diminished in preeclamptic compared to the healthy women, but no difference in Th1 and Th17 levels were found between both groups.

Conclusions: Our data suggest that the cytokine balance is broken, encouraging the development of an exacerbated inflammatory response. Our results show that there is a shift, in the Th1/Th2, and the Th17/Treg balance, favoring skewness towards a proinflammatory status in the umbilical cord blood in preeclampsia.     

Th1/Th2 cytokines balance--yin and yang of reproductive immunology

For years conception of Th2 overbalance during pregnancy has been a paradigm for immunology of reproduction, while Th1 activity has been presented as unwanted component. Studies concerning Th1/Th2 balance in physiological and complicated pregnancy have been reviewed. Th1 activity during early peri-implantation period, premature and term labour not only accompanies but even predominates over Th2 activity. Th1 activity plays important role in promotion of Th2 response, regulation of placentation process, defense against infections and initiation of delivery. Together with Th2 activity it is necessary component of immunological reactions during pregnancy, both activities being inseparable like yin and yang. So paradigm of "Th1-Th2 cooperation" is much closer to reality than "Th2 phenomenon".     

Th1/Th2比率变化与子痫前期相关性研究

目的:探讨Th1/Th2比率变化与子痫前期相互关系.方法:采用流式细胞技术分别检测15例正常妊娠孕妇(正常妊娠组)和40例子痫前期患者(子痫前期组)外周血和蜕膜组织中的Th1、Th2及Th1/Th2细胞比率,同时测定其肝、肾功能.结果:①子痫前期组Th1细胞、Th1/Th2比率明显高于正常妊娠组(P<0.01);②外周血Th1/Th2比率与蜕膜Th1/Th2比率间呈显著正相关(r=0.818,P<0.01);③Th1细胞、Th1/Th2比率与肝、肾功能损害呈正相关,且随病情的严重程度有升高趋势.结论:子痫前期患者局部的Th1/Th2比率平衡被打乱,Thl/Th2比率改变可能是其发病的重要原因,在一定程度上也反映了病情的轻重.     

Alterations in Th1/Th2 cytokine concentrations in early neonatal life

Objective:?To determine postnatal changes in neonatal serum concentrations of interferon-γ (IFN-γ), interleukin-4 (IL-4) and its soluble receptor (sIL-4R). Methods:?Forty-five healthyterm neonates, 25 of the neonates' mothers and 27 healthyadults (controls) participated in the study. Cytokine concentrations were measured in blood samples from the umbilical cord, from the neonates on the 1st and 5th dayafter birth, from mothers and from controls. Results:?IFN-γ concentrations were significantlylower in the umbilical cord, compared to concentrations in the controls (p?<?0.04), and increased significantlyfrom the umbilical cord to levels in neonates on day5 (p?<?0.03). In mothers and the umbilical cord, IFN-γ concentrations were dependent on the mode of delivery, being higher after vaginal delivery than after elective Cesarean section (p?<?0.005; p?<?0.006, respectively). IL-4 concentrations in the umbilical cord for 1-day and 5-day neonates were significantlyelevated compared to those in mothers (p?<?0.001; p?<?0.0007; p?<?0.0001, respectively) and controls (p?<?0.05; p?<?0.01; p?<?0.006, respectively). sIL-4R concentrations in all neonatal samples were significantlyelevated compared to those in controls (p?<?0.0001), the highest being found in 1-day-old neonates. A strong negative correlation was found between IL-4 and sIL-4R concentrations in 1- and 5-day-old neonates (r?=??0.48, p?<?0.002; r?=??0.45, p?<?0.0065, respectively). Moreover, IFN-γ/IL-4 ratio increased significantly from the umbilical cord to 5 days of life (p?<?0.03). Conclusion:?Our findings indicate an earlier development of IL-4 than IFN-γ, which could be viewed as a developmental characteristic in the ontogeny of the immune system.     

Placental imbalance of Th1- and Th2-type cytokines in preeclampsia

OBJECTIVES: To characterize the changes in the level of T helper 1 (Th1)- [interleukin (IL)-2 and tumor necrosis factor (TNF)-alpha] and Th2-type cytokine (IL-10) and the ratios of Th1/Th2 (IL-2/IL-10 and TNF-alpha/IL-10) in placentae from women with preeclampsia and women with gestational hypertension. METHODS: Placental levels of IL-2, TNF-alpha, and IL-10 were determined with radioimmunoassay and Th1/Th2 ratios (IL-2/IL-10 and TNF-alpha/IL-10) calculated in the placentae from 22 women with preeclampsia, 15 women with gestational hypertension, and 32 normal term pregnant women. RESULTS: Although preeclampsia had the trend of the increase in the placental levels of IL-2 and TNF-alpha and the trend of the decrease in placental IL-10, there were not significant difference in placental levels of IL-2, IL-10, and TNF-alpha among preeclampsia, gestational hypertension, and normal pregnancy (P > 0.05 for all). Placental ratios of IL-2/IL-10 and TNF-alpha/IL-10 were significantly higher in preeclampsia than in normal pregnancy (P = 0.035 and P = 0.005, respectively). No differences of Th1/Th2 ratios were found between preeclampsia and gestational hypertension and between gestational hypertension and normal pregnancy (P > 0.05 for all). CONCLUSIONS: Alterations of placental balances of cytokines with Th1 predominance were demonstrated in preeclampsia. These associations may offer insights into the pathogenesis of preeclampsia.     

T helper (Th)1, Th2, and Th17 interleukin pathways in infertile patients with minimal/mild endometriosis

In the present study, interleukin (IL)-10, IL-12, IL-17, and IL-23 levels were measured in serum and peritoneal fluid of women with minimal or mild endometriosis and compared with levels in controls without endometriosis. Higher IL-23 levels were encountered in the peritoneal fluid of women with endometriosis, suggesting a possible role of this cytokine in these women's infertility.     

Th1/Th2细胞平衡及NK细胞对胚胎种植的影响

目的:通过研究反复种植失败(RIF)患者与首次移植妊娠成功患者种植窗口期外周血中Th1、Th2型细胞因子及自然杀伤(NK)细胞的表达差异,探讨Th1/Th2细胞平衡及NK细胞对胚胎种植的影响及调节机制.方法:选取2020年3月至2020年9月于山东大学齐鲁医院不孕不育诊疗中心就诊的35例RIF患者(RIF组)和首次行体...