Urinary kallikrein quantity and activity in normal pregnant women in the third trimester

In this study, urinary kallikrein quantity and activity were measured by the kallikrein direct RIA and kininogenase activity with human low molecular weight kininogen in 32 non pregnant healthy women and 20 normal 3rd trimester pregnant women. There was no significant difference in urinary kallikrein quantity between non pregnant healthy women (n=32, 64.0 +/- 6.3 micrograms/day, mean +/- S.E.) and normal pregnant women (n=20, 68.1 +/- 10.1 micrograms/day). There was a significant difference (p less than 0.05) in urinary kallikrein activity between non pregnant healthy women (n=32, 496.2 +/- 57.2 micrograms kinin/day) and normal pregnant women (n=20, 319.5 +/- 48.1 micrograms kinin/day). The reason for no significant difference in the urinary kallikrein quantity may be that neither non pregnant women nor normal pregnant women have renal damage. And, one of the reasons for significant low urinary kallikrein activity in normal pregnant women may be that the sensitivity of blood vessels to angiotensin II in normal pregnancy is less than in non pregnancy.     

Urinary tissue kallikrein excretion in black African women with severe pre-eclampsia

BACKGROUND: A study of tissue kallikrein excretion in African women with severe pre-eclampsia. METHODS: Random untimed urine samples were collected from all women (n=198) recruited to this study; 66 women with severe pre-eclampsia, 66 normotensive pregnant women of similar length of gestation and 66 normotensive non-pregnant women. Urine specimens were analyzed for urinary tissue kallikrein using a selective, synthetic chromogenic tripeptide substrate (S2266) having the sequence H-D-Val-Leu-Arg-pNA. RESULTS: Urinary tissue kallikrein levels were decreased in women with severe pre-eclampsia compared with those of gestation matched normotensive pregnant women at 28 weeks of gestation (1.55+/-0.95 vs. 3.02+/-1.35 ng TK/microg protein; p<0.0001) and at near delivery date (1.21+/-0.53 vis. 3.11+/-1.2 ng TK/microg protein; p<0.0001). In the normotensive pregnant group, there was no significance difference in urinary tissue kallikrein excretion close at delivery date compared to 28 weeks of gestation (3.02+/-1.35 vs. 3.11+/-1.21 ngTK/microg protein; p=0.23). No statistical difference in urinary tissue kallikrein excretion was observed between normotensive pregnant and normotensive non pregnant women (3.02+/-1.35 vs. 2.97+/-1.12 ngTK/microg protein; p=0.16). Urinary tissue kallikrein excretion correlated positively with urinary creatinine levels at 28 weeks of gestation (r=0.69; p<0.0001) and close to delivery date (r=0.84; p<0.0001). There was no correlation between neonatal birthweight and urinary tissue kallikrein levels (r=-0.44; p=0.41). CONCLUSION: The decreased levels of urinary tissue kallikrein excretion in pre-eclamptic patients suggests an etiological role for this serine protease in hypertensive disorders of pregnancy.     

Plasma fibronectin receptor levels during pregnancy complicated by preeclampsia and abruptio placentae.

The level of human fibronectin receptor (FNR) in plasma was measured by enzyme-linked immunosorbent assay in samples from normal pregnant women in the 1st trimester (n = 5), 2nd trimester (n = 7), 3rd trimester (n = 23), normal postpartum women day 1 (n = 4), day 2 (n = 5), day 3 (n = 8), nonpregnant women (n = 18), 20 preeclamptic patients in the 3rd trimester, and 8 patients with abruptio placentae in the 3rd trimester. In normal pregnancy, the mean value of FNR was 1.4 +/- 0.4 micrograms/ml in the 1st, 1.4 +/- 0.2 micrograms/ml in the 2nd, and 1.9 +/- 0.3 micrograms/ml (p less than 0.05) in the 3rd trimester. FNR values increased with pregnancy. During the puerperium, its level decreased with time, being 1.4 +/- 0.5 micrograms/ml (p less than 0.01) on day 1, 1.0 +/- 0.3 micrograms/ml on day 2, and 0.8 +/- 0.2 micrograms/ml on day 3. The level in preeclamptic patients was 2.0 +/- 0.4 micrograms/ml, and that in abruptio placentae was 2.7 +/- 0.4 micrograms/ml. There were significant differences between the levels in abruptio placentae versus preeclampsia (p less than 0.05) and 3rd-trimester normal pregnant women (p less than 0.01). In the immunohistochemical study, the surface of normal decidual cells stained weakly for FNR, and the decidual cell membranes of the cases of preeclampsia stained moderately or strongly. Decidual cells and their extracellular matrix close to hematomas of abruptio placentae stained very strongly for FNR.(ABSTRACT TRUNCATED AT 250 WORDS)     

Tissue kallikrein activity in pregnancy

To determine tissue kallikrein (TK) activity in black African women with hypertensive disorders of pregnancy; 140 women were recruited and divided into the following groups: group A--35 preeclamptic women, group B--35 mild to moderate hypertensive pregnant women and group C--35 normotensive pregnant women, and group D--35 normotensive non-pregnant healthy women. The activity of tissue kallikrein was determined from a random untimed urine sample using a selective, synthetic chromogenic tripeptide substrate having the sequence H-D-Val-Leu-Arg-pNA (S-2266). Urinary sodium and potassium levels was determined by flame photometry. Tissue kallikrein activity was decreased in women with preeclampsia (1.54 +/- 0.95 vs 3.05 +/- 0.83 ngTK/microg protein; p < 0.0001) and mild to moderate hypertensive group (2.03 +/- 0.76 vs 3.05 +/- 0.83 ngTK/microg protein; p < 0.0001) compared with normotensive pregnant women. There was also a significant difference in tissue kallikrein activity between the pregnancy groups (1.54 +/- 0.95 vs 2.03 +/- 0.76 ngTK/microg protein; p < 0.001). No difference in tissue kallikrein activity was observed between normotensive pregnant and normotensive non-pregnant healthy women (3.05 +/- 0.83 vs 3.14 +/- 0.88 ngTK/microg protein; p = 0.51). There was no difference in the excretion of urinary sodium and potassium in pregnancy groups compared to normotensive pregnant group. Tissue kallikrein activity is decreased in hypertensive disorders of pregnancy.     

Hypocalciuria in women with preeclampsia]

To assess the significance of hypocalciuria in pregnant women, 24-hour urinary calcium excretion and the calcium/creatinine ratio (mg/g) in random urine samples were measured with a Toshiba TDA-30R autoanalyzer in the following 4 groups: 3 mild preeclamptic patients, 5 severe preeclamptic patients, 4 patients with intrauterine growth retardation (IUGR), and 10 healthy pregnant women. The mean 24-hour urinary calcium excretion in the 4 groups was 44.3 +/- 21.3 mg/day, 11.6 +/- 2.7 mg/day, 161.4 +/- 80.4 mg/day and 145.0 +/- 45.0 mg/day, respectively. Calcium excretion was significantly lower in the mild and severe preeclamptic patients than in the women with IUGR and the normal pregnant women. There was also a significant difference between the value in the mild and severe preeclamptic patients. The mean calcium/creatinine ratio in random urine samples was 53 +/- 30 mg/g, 18 +/- 5.6 mg/g, 192 +/- 85 mg/g and 169 +/- 70 mg/g, respectively. Also, such significant as 24-hour urinary calcium excretion were found in the mean calcium/creatinine ratio. From these results we conclude that determination of the 24-hour urinary calcium excretion or the calcium/creatinine ratio in random urine samples is a reliable index of preeclampsia.     

Urinary corticotropin-releasing hormone immunoreactivity is elevated during human pregnancy

Plasma corticotropin-releasing hormone immunoreactivity (CRH IR) rises with gestational age in women. In order to investigate the physiological changes of the hormone in pregnant women's urine, CRH IR was measured by radioimmunoassay in urine collected over a 24-hour period, a blood sample and a subsequent single collection of urine after the 24-hour collection (spot urine). Plasma CRH IR in pregnant subjects, 8682.8 +/- 2063.0 pg CRH IR/ml plasma (mean +/- SEM, n = 25), was significantly higher than that in the non-pregnant controls (7.2 +/- 1.6 pg/ml, n = 5; separate t = 4.21, p = 0.0003, d.f. = 24). Similarly, pregnant women had higher spot urine CRH IR - 54.6 +/- 15.5 pg/mumol creatinine (Cr) versus 5.0 +/- 0.5 pg/mumol Cr (separate t = 3.20, p = 0.0038, d.f. = 24.0) - and 24-hour urine CRH IR - 13.7 +/- 1.2 pg/mumol Cr compared with 7.7 +/- 0.8 pg/mumol Cr (separate t = 4.28, p = 0.003, d.f. = 24.4) than the non-pregnant cohort. The difference between urinary excretion of CRH IR as estimated by 24-hour urine (13.7 +/- 1.2 pg/mumol Cr) and spot urine (54.6 +/- 15.5 pg/mumol Cr) indicated that CRH IR in 24-hour urine may be degraded during storage. The weak associations between plasma and 24-hour urine CRH IR of pregnant women (correlation coefficient r = 0.34, p greater than 0.1), and total 24-hour urine and spot urine CRH IR (r = 0.25, p less than 0.1) further indicate CRH degradation. Plasma and spot urinary CRH IR, however, were strongly correlated (r = 0.80, p = 0.001). The total CRH IR excreted as estimated from the spot urine value (0.5 +/- 0.1 micrograms/day) compared with the total filtered load of CRH IR in the pregnant group (1306.9 +/- 324.6 micrograms/day) showed that 99.97% of the filtered CRH IR was reabsorbed or metabolized by the kidneys. Acidic gel chromatography of spot and 24-hour urine samples showed a CRH IR peak at CRH41 standard elution position (Kd = 0.5), indicating that the molecular form in urine is similar to the 41-residue standard. Pregnancy-induced hypertension correlated positively with plasma CRH IR (r = 0.62, p less than 0.001) and spot urine CRH IR (r = 0.46, p less than 0.01), and negatively with parity (r = -0.60, p less than 0.001). Plasma CRH IR and parity also negatively correlated (r = -0.41, p less than 0.05).(ABSTRACT TRUNCATED AT 400 WORDS)     

Serum unconjugated 2-hydroxyestrone and erythrocyte catechol-O-methyltransferase activity in pregnancy toxemia

To clarify the significance of catecholestrogens in toxemia of pregnancy, plasma unconjugated 2-hydroxyestrone (2-OHE1) was measured by a specific radioimmunoassay. In addition, catechol-O-methyltransferase (COMT) activity in erythrocytes was compared between normal and toxemic pregnancies. The following results were obtained. There was no significant difference in the plasma 2-OHE1 level between normal and toxemic pregnancies in the 3rd trimester, these being 220 +/- 53(SD,n = 7), 162 +/- 138(n = 9) pg/ml, respectively. However, the plasma 2-OHE1, level was quite low in all three subjects in toxemic pregnancy with placental dysfunctions. Liver dysfunction was found in only one case of toxemic pregnancy, whose plasma 2-OHE1 was within the normal range. In two cases of mild toxemia and one case of severe toxemia with placental dysfunctions there was no significant difference in COMT activity as compared with normal pregnancy. The COMT activity of a diabetic woman with pregnancy toxemia without placental dysfunctions was slightly higher than that of a normal pregnant woman. From these results it is suggested that the lower plasma 2-OHE1 level in toxemic pregnancy may be caused by placental dysfunctions.     

Placental isoferritin: a new serum marker in toxemia of pregnancy

The serum concentrations of placental isoferritin and normal ferritin were determined in 20 patients with preeclamptic toxemia of pregnancy and were compared with the level measured in normal pregnant women at the third trimester and in labor at term. The mean serum concentration of placental isoferritin for the women with preeclamptic toxemia was found to be low: 7.5 +/- 23 U/ml compared with 81.6 +/- 89.3 U/ml in normal pregnancy during the third trimester and 54.8 +/- 53 U/ml in term delivery. In comparison, there was no significant difference in the serum levels of normal ferritin in both pregnant women with toxemia and in those without toxemia. These results suggest that placental isoferritin may be a useful marker for preeclamptic toxemia of pregnancy.     

The effect of hospitalisation on ambulatory blood pressure in pregnancy

METHODS: Twenty-four-hour ambulatory blood pressure monitoring was performed on 40 women (20 hypertensive, 20 normotensive) on a hospitalised and non-hospitalised day. Mean blood pressure differences were calculated for the awake, sleeping and 24-hour periods on both days. RESULTS: Mean heart rate was higher at home (1.79, p = 0.04) than in hospital, but there were no significant differences in mean systolic (1.30 mmHg, p = 0.06), diastolic (0.78 mmHg, p = 0.21) or mean arterial blood pressure (0.81 mmHg, p = 0.19) between the hospitalised and non hospitalised day for the group overall. Nevertheless, the range of individual responses was wide (-8.5 mmHg to 15.4 mmHg mean arterial blood pressure). Hypertensive women receiving antihypertensive therapy had significantly greater differences in mean arterial blood pressure between the hospital and non-hospital day when compared to the rest of the group (5.8 mmHg, compared to 3.3 mm Hg, p = 0.02). CONCLUSIONS: Although hospitalisation does not significantly lower blood pressure in pregnant women as a group, women receiving antihypertensive therapy demonstrate significant differences in blood pressure between hospital and home. Based on conventional blood pressure measurements alone, these women may be at risk of either under treatment, or over treatment, of blood pressure.     

Intraocular pressure in pregnant and non-pregnant Nigerian women

A number of hormones are known to affect intraocular pressure. Of these, the female sex hormones are the predominant ones to cause variations in intraocular pressure. The aim of this study was to determine if variation in sex hormones in pregnancy affects intraocular pressure. This study was a longitudinal one. 117 pregnant women aged 20 to 35 years in their first trimester of pregnancy were followed longitudinally throughout the course of pregnancy, and six weeks post partum. One hundred non pregnant women with a regular menstrual cycle of 26-29 days were also recruited and examined for changes in intraocular pressure. Intraocular pressure was measured with the handheld Kowa applanation tonometer. Mean Intraocular Pressure (MIOP) was 14.7 +/- 2.2 mmHg, 13.2 +/- 2.0 mmHg and 11.0 +/- 1.3 mmHg in the three trimesters respectively. There was thus a fall in Intraocular Pressure during pregnancy and this was highly statistically significant (P<0.0001). At 6 weeks postpartum MIOP increased to 14.2 +/- 1.8 mmHg. The difference between the mean values of Intraocular Pressure in the third trimester and 6 weeks postpartum was also statistically significant P<0.0001. Intraocular pressure decreased as pregnancy advanced. Postpartum, there was increase in intraocular pressure to near pre pregnant level. The difference in mean IOP between the pregnant and non pregnant women was statistically significant (P<0.05).     

Renal arterial Resistance Index in pregnant and nonpregnant women: evaluation with color and pulse Doppler ultrasound.

The Resistance Index (RI) was studied in the main renal arteries in normal nonpregnant women and its change during normal pregnancy. One hundred and seventy color and pulse Doppler sonographic examinations were performed on 31 nonpregnant and 54 pregnant women. The range of gestation was 5-39 weeks, and patients divided into three groups; 5-12, 13-25 and 26-39 weeks of pregnancy, respectively. The RI was calculated in both main renal arteries. In nonpregnant women the left main renal artery RI mean = 0.587 +/- 0.021, and the right main renal artery RI mean = 0.584 +/- 0.028. In pregnant women the left main renal artery RI mean was 0.681 +/- 0.029, and the right main renal artery RI mean was 0.697 +/- 0.034. There was a significant difference between the main renal artery RI in pregnant and nonpregnant women (P less than 0.01). There was no significant difference between left and right main renal artery in pregnant and nonpregnant women (P less than 0.01). There was no correlation between gestational age and RI in the right main renal artery but a statistically significant correlation with gestational age in the left main renal artery (P less than 0.05).     

Prolactin in severe toxemia of pregnancy

Plasma PRL levels were measured in 111 normal pregnant women and in 21 patients with severe toxemia of pregnancy. Twelve of 21 patients with severe toxemia of pregnancy showed high PRL levels in zone A (greater than mean value + 1 S.D. of PRL values in normal pregnancy). These 12 were significantly lower (P less than 0.02) in the Ccre rate, at 70.2 +/- 19.2 ml/min, than 5 toxemia patients (101.4 +/- 26.7 ml/min) in zone B (mean + 1 S.D. approximately mean) and 4 toxemia patients (110.0 +/- 35.3 ml/ml) in zone C (mean approximately mean -1 S.D.). Also, BUN, proteinuria and uric acid levels in zone A patients were higher than in those in zone B and C. However, no correlation was found between PRL levels and mean diastolic and systolic blood pressure. These results suggest that high PRL concentrations in toxemia of pregnancy may be associated with renal dysfunction.     

Urinary kallikrein excretion in non-insulin-dependent diabetes mellitus.

To investigate the status of urinary kallikrein excretion (UKE) in patients with non-insulin-dependent diabetes mellitus (NIDDM), we measured UKE in 31 NIDDM patients. They ranged in age from 40 to 70 years (mean, 54.3 +/- 7.8 years), comprising 18 males and 13 females. Their creatinine clearance (Ccr) was 91.6 +/- 5.5 mL/min, and the daily excretion rate of protein was 1.15 +/- 0.72 g/24 hours. Twenty-five normal persons, aged from 37 to 63 years (mean, 51.7 +/- 8.2 years), comprising 14 males and 11 females, were enrolled as controls. The NIDDM patients were further divided into two groups. Group A (n = 21) had regular blood sugar control, while Group B (n = 9) had poor blood sugar control. The autonomic nervous function was tested in 15 patients to study its relationship with UKE. UKE was measured by spectrophotometric assay of the kallikrein enzymatic product on the synthetic substrate S-2266. Autonomic function was evaluated by cardiovascular reflex tests. The results showed that UKE was elevated in Group B, but depressed in Group A (normal vs A vs B: 9.6 +/- 1.0 vs 4.8 +/- 0.9 vs 14.4 +/- 2.7 nkat/24 hours). The UKE/Ccr ratio was similarly elevated in Group B and reduced in Group A (normal vs A vs B: 0.1 +/- 0.01 vs 0.05 +/- 0.01 vs 0.18 +/- 0.04 nkat. mL/day.minute). There was no significant correlation between UKE or the UKE/Ccr ratio and the Valsalva ratio, the 30:15 ratio, or postural blood pressure change. These results suggest that NIDDM patients have abnormal urinary kallikrein excretion levels that are influenced by blood sugar control. The abnormal UKE/Ccr ratio suggests that intrarenal abnormality in the renal kallikrein-kinin system exists in NIDDM patients.     

妊娠高血压综合征患者血清可溶性白细胞介素6受体和可溶性糖蛋白的检测

目的　观察妊娠高血压综合征（妊高征）患者血清可溶性白细胞介素6受体（sIL-6R）和可溶性糖蛋白(sgp130)的变化。方法　应用酶联免疫吸附法（ELISA）检测40例妊高征患者（妊高征组）和20例正常非孕妇女（对照组I）、20例正常妊娠妇女（对照组II）血清sIL-6R和sgp130水平。结果妊高征组血清sIL-6R为(196.7±12.9)μg/L,sgp130为(379.4±79.3)μg/L;对照组I血清sIL-6R为(174.8±46.2)μg/L,sgp130为(273.6±28.3)μg/L;对照组II血清sIL-6R为(174.4±48.3)μg/L,sgp130为(254.4±34.7)μg/L。妊高征组血清sIL-6R和sgp130水平均高于对照组I和对照组II,差异有极显著性（P<0.01）。妊高征组中,随病情加重,血清sIL-6R、sgp130水平逐渐升高。差异有极显著性（P<0.01）。对照组II血清sIL-6R和sgp130水平与对照组I比较,差异无显著性（P>0.05）。结论　血清sIL-6R和sgp130水平变化与妊高征的病情发展有关。     

Evidence supporting that the excess of the sVEGFR-1 concentration in maternal plasma in preeclampsia has a uterine origin.

BACKGROUND: Preeclampsia has been considered an anti-angiogenic state. Two factors have been implicated in the genesis of this state: soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) and placental growth factor (PlGF). Indeed, the concentrations of PlGF, an angiogenic factor, are lower in preeclampsia than in normal pregnancy, while the opposite is the case for the anti-angiogenic factor, sVEGFR-1. The source of the excess sVEGFR-1 has not yet been determined. Since the placenta could be a source of sVEGFR-1, we conducted a study to determine whether there is a gradient in the plasma concentration of sVEGFR-1 and PlGF between the uterine vein and the antecubital vein in both patients with preeclampsia and normal pregnant women. METHODS: A cross-sectional study was performed to determine the plasma concentrations of sVEGFR-1 and PlGF in the uterine and antecubital vein of patients with preeclampsia (n = 9) and normal pregnant women at term (n = 9). Plasma samples were collected from antecubital and uterine veins at the time of cesarean section. The concentrations of sVEGFR-1 and PlGF were determined using specific enzyme-linked immunoassays. The differences of plasma concentrations of sVEGFR-1 and PlGF between uterine and antecubital veins in both groups were compared by paired t-tests. RESULTS: Patients with preeclampsia had a significantly higher mean plasma concentration of sVEGFR-1 in the uterine vein than in the antecubital vein (uterine vein: mean 13,675 +/- 5,684 pg/ml vs. antecubital vein: mean 10,234 +/- 4,700 pg/ml; paired t-tests, p = 0.04). In contrast, among normal pregnant women at term, there was no significant difference in plasma concentrations of sVEGFR-1 between the uterine and antecubital veins (uterine vein: mean 1,918 +/- 665 pg/ml vs. antecubital vein: mean 1,750 +/- 475 pg/ml; paired t-tests, p = 0.1). The mean plasma concentration of sVEGFR-1, either in the antecubital or uterine vein, was significantly higher in preeclampsia than in normal pregnancy (unpaired t-tests; both p < 0.001). There was no significant difference in the mean plasma concentration of PlGF between the uterine and the antecubital veins in both the preeclamptic (uterine vein, mean +/- SD: 129 +/- 106 pg/ml vs. antecubital vein, mean +/- SD: 82 +/- 43 pg/ml; paired t-tests, p = 0.2) and normal pregnancy groups (uterine vein, mean +/- SD: 331 +/- 254 pg/ml vs. antecubital vein, mean +/- SD: 319 +/- 259 pg/ml; paired t-tests, p = 0.4). The mean plasma concentration of PlGF, either in the uterine or antecubital vein, was lower in preeclampsia than in normal pregnancy (unpaired t-tests; p = 0.008 and 0.02 respectively). CONCLUSIONS: Plasma concentration of sVEGFR-1 was higher in the uterine vein than in the antecubital vein in women with preeclampsia. This provides evidence supporting the concept that the uterus is a potential source of the excess circulating sVEGFR-1 concentration in preeclamptic women.     

Urinary PGE2 levels in toxemia of pregnancy

Urinary PGE2 levels in urine collected over 24 hours were measured by radioimmunoassay after chloroform extraction. In normal pregnancy, urinary PGE2 levels did not change during pregnancy. After 36 gestational weeks, urinary PGE2 levels in severe hypertensive pregnancy (616 +/- 91 ng/day (mean +/- S.E., n = 18)) were significantly decreased compared to those of normal pregnancy (1,039 +/- 85 ng/day, n = 13, p less than 0.005) and mild hypertensive pregnancy (1,025 +/- 140 ng/day, n = 8, p less than 0.03). We then analyzed the urinary PGE2 levels by noting clinical symptoms and their severity. Urinary PGE2 levels in the severe blood pressure group were significantly decreased compared to those of the mild group. There was a significant negative correlation between urinary PGE2 and mean blood pressure, systolic pressure and diastolic pressure. Diastolic pressure in particular had the most significant negative correlation with the urinary PGE2 level (n = 33, r = -0.593, p less than 0.001). Urinary PGE2 levels in the severe proteinuria and edema groups were significantly decreased compared to those in the mild group. These results suggested that renal synthesis of PGE2 may be decreased in severe hypertensive pregnancy and closely related to blood pressure, especially to diastolic pressure, and also related to the occurrence of edema.     

NK cell activity and subsets in women with a history of spontaneous abortion. Cause, number of abortions, and subsequent pregnancy outcome

OBJECTIVE: The aim of this study was to assess the role of NK cells in nonpregnant women with a history of spontaneous abortion. STUDY DESIGN: 113 nonpregnant women with a history of spontaneous abortion were assessed for peripheral NK cell activity and percentage of NK cell subsets, in relation to the cause of abortions, the number of spontaneous abortions, and subsequent pregnancy outcome (n = 56). RESULTS: Neither NK cell activity nor subsets showed a significant difference in relation to the cause or number of spontaneous abortions. NK cell activity in nonpregnant women who later experienced subsequent abortion with normal chromosomes (n = 10) (mean +/- SD: 42.8 +/- 15.8%) was relatively higher than that in women with subsequent live birth (control, n = 39) (32.1 +/- 13.7%) (p = 0.099). NK cell activity in women who later experienced subsequent abortion with abnormal chromosomes (n = 7) (28.7 +/- 21.4%) was the same as the level in the control. CONCLUSION: Peripheral NK cell activity or subsets during nonpregnant status were not related to the cause or number of previous spontaneous abortions. A relation between preconceptional NK cell activity and later experiencing abortion with normal chromosomes should be further studied.     

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。     

Immunoreactive circulating endothelin-1 in normal and hypertensive pregnancies.

OBJECTIVE: The purpose of this study was to measure the circulatory levels of endothelin-1 in the serum of pregnant women with hypertension. STUDY DESIGN: Endothelin-1 levels were measured by means of radioimmunoassay in the serum of 26 pregnant women with hypertension (14 with pregnancy-induced preeclamptic toxemia, 12 with chronic hypertension) and in the serum of 17 control pregnant women and 18 control nonpregnant women. The mean levels in the different groups were subject to statistical analysis with the analysis of variance. RESULTS: The mean level among the women with preeclampsia (29.9 +/- 13.2 fmol/ml) was significantly higher than those of the chronically hypertensive women (16.1 +/- 7.3 fmol/ml, p = 0.002) and of the control pregnant women (19.7 +/- 9.2 fmol/ml, p = 0.011). The mean level of the control nonpregnant women (26.9 +/- 9.3) was significantly higher than that of the control pregnant women (p = 0.029). Among the patients with preeclampsia there was no correlation between endothelin-1 levels and the mean arterial blood pressure. Six to 10 weeks after delivery the mean levels of 15 studied patients (7 with preeclampsia, 8 with chronic hypertension) were similar to the levels of the nonpregnant control women. CONCLUSION: We conclude that increased endothelin-1 production may play a role in the pathogenesis of preeclampsia.     

妊娠高血压综合征患者血浆P-选择素和一氧化氮含量变化及意义

目的　探讨妊娠高血压综合征（妊高征）患者血浆P-选择素和一氧化氮(nitricoxide,NO)含量的变化及其在妊高征发病中的意义。方法　采用酶联免疫吸附法测定36例妊高征患者（妊高征组,其中轻度妊高征患者11例,中重度妊高征患者25例）、18例正常晚孕妇女（正常晚孕组）和19例正常非孕妇女（正常非孕组）血浆P-选择素含量。用镀铜镉还原法测定血浆中代表NO水平的亚硝酸盐及硝酸盐（nitrite and nitrate,NO