彩超筛查早中孕期胎儿畸形的临床价值

目的探讨彩超在产前筛查和诊断早中孕期胎儿畸形中的临床价值。方法对817例早中孕期妊娠的孕妇进行彩超筛查。结果发现胎儿畸形16例,全部病例均经染色体及病理检查。结论彩超筛查早中孕期胎儿畸形有较高的临床价值,应作为早中孕期常规首选检查方法。     

孕期的超声检测与胎儿先天性畸形

胎儿先天性畸形系指形态结构发育异常,我国曾对124万余名围产儿畸形进行过调查,近年来,随着仪器分析能力的改进和扫描能力的提高,超声诊断先天性畸形更有其吸引力,其敏感性也较专家报≤30％,而提高到43．2％,现选择1452名中,晚期孕妇进行观察与分析。     

彩色B超筛查胎儿畸形最佳检查孕期的探讨

目的 对申请检查的孕妇,对胎儿进行全面、系统超声检查,筛查胎儿畸形,最终找到胎儿畸形筛查的最佳孕期.方法 对2009年1月至2010 年6月所有彩超检查的孕妇中检出的胎儿畸形进行统计,分别统计出中、晚孕期间胎儿畸形的检出率;并对漏误诊的胎儿畸形于中、晚孕期间的发生率进行统计,并对比分析,最终找到胎儿畸形筛查的最佳孕期.结果 彩超检查孕妇6400例中,检出各类胎儿畸形21例,超声检出率3.12‰.中孕期检出17例,检出率80.95% ;晚孕期检出4例,检出率19.05%.漏误诊胎儿畸形共2例,漏误诊率9.5%.发生于晚孕期1 例 50%,发生于中孕期1例(占50%).结论 中孕期(20周～27周)可选择作为胎儿畸形彩超筛查的最佳孕期.即中孕期间孕妇必须作一次全面、详细的彩超检查,必要时晚孕期(32周～36周)复查,动态观察.     

妊娠期糖尿病孕妇糖化血红蛋白水平与不良母婴结局的相关性

目的:通过分析妊娠期糖尿病(gestational diabetes mellitus,GDM)孕妇分娩前糖化血红蛋白(glycosylated hemoglobin,HbAlc)水平与不良母婴结局的关系,探讨HbAlc在血糖监测及预判母婴结局中的价值.方法:回顾性分析2019年1月至6月在安徽医科大学附属妇幼保健院住...     

糖化血红蛋白水平检测与妊娠期糖尿病孕妇妊娠结局相关性分析

目的 探讨分析糖化血红蛋白(glycosylated hemoglobin,HbA1c)水平与妊娠期糖尿病孕妇妊娠结局相关性.方法 选择广西区人民医院妇产科妊娠期糖尿病孕妇患者24例为观察组,同期血糖检测正常的健康孕妇24名为对照组,比较分析两组孕妇HbA1c和妊娠结局的相关性.结果 观察组HbA1c为(10.3±0.4)％,显著高于对照组的(4.9±0.3)％,P＜0.05.观察组中患者胎膜早破、羊水异常、胎儿窘迫和产后出血的发生率显著高于对照组.另外,统计学分析显示,观察组出现胎膜早破、早产等不良并发症概率与血清HbA1c呈正相关(P＜0.05).结论 HbA1c水平与妊娠期糖尿病孕妇的胎膜早破、早产、羊水异常、胎儿窘迫和产后出血的并发症呈正相关.     

早孕期超声异常胎儿的染色体核型分析北大核心CSCD

目的探讨早孕期（孕11～14周）不同的超声异常指标对于筛查胎儿染色体异常的价值。方法对159例孕11～14周超声发现异常的胎儿进行绒毛或羊水核型分析,比较不同的超声异常指标所对应的胎儿染色体异常的检出率。结果最常见的早孕期超声异常指标依次为颈部透明层（nuchal translucency,NT）增厚、全身皮肤水肿、颈部淋巴水囊瘤、鼻骨缺失或显示不清、心脏畸形和静脉导管a波倒置。NT增厚的染色体异常检出率为34．5％（39／113）,主要为21三体、18三体和45,x。全身皮肤水肿的染色体异常检出率为76．7％（23／30）,以45,X、18三体和21三体为主。颈部淋巴水囊瘤的染色体异常检出率为62．5％（10／16）,以45,x和21三体为主。鼻骨缺失或显示不清的染色体异常检出率为71．4％（10／14）,以21三体和18三体为主。心脏畸形的染色体异常检出率为72．7％（8／11）,以21三体和18三体为主。静脉导管a波倒置的染色体异常检出率为50．0％（4／8）,其中21三体2例、18三体和45,X各1例。结论NT增厚、全身皮肤水肿、颈部淋巴水囊瘤、鼻骨缺失或显示不清、心脏畸形、静脉导管a波倒置是最常见的与染色体异常相关的早孕期超声异常指征。全身皮肤水肿、心脏畸形、鼻骨缺失或显示不清、颈部淋巴水囊瘤是染色体异常检出率最高的4种指征。这些指征同时出现得越多,染色体异常检出率越高。     

产前系统超声检查对中孕期胎儿畸形筛查的临床应用价值

目的:对产前系统超声检查在中孕期胎儿畸形筛查中的应用价值进行分析.方法:回顾性分析2018年6月至2020年6月前收治中孕期孕妇数据资料,共计600例,均进行系统超声检查,分析检查结果与胎儿畸形类型.结果:经分娩或引产证实胎儿畸形共16例,系统超声检出15例,检出准确率为93.8％,漏诊1例,漏诊率为6.3％,无误诊....     

影响胎儿血红蛋白表达水平的分子因素

胎儿血红蛋白(fetal hemoglobin,HbF)是在胎儿期间大量存在的血红蛋白,成年人体内含量极少,低于1％.但是不少成年人的HbF表达水平较高.根据一系列的研究表明,HbF表达水平增高的分子机制主要是β珠蛋白基因簇自身变异和其他基因的影响.了解这些分子因素,可为阐明HbF的内在调控机制提供新的线索,并有助于开发新的地中海贫血治疗方法.     

妊娠期糖尿病患者糖化血红蛋白水平与凝血功能分析

目的:检测分析妊娠期糖尿病(GDM)患者临产时糖化血红蛋白(HbA1c)水平和凝血功能变化及其相关性。方法:659例GDM患者,采用高效液相色谱法检测HbA1c,依据其水平分为HbA1c6.5%组(n=584)和HbA1c≥6.5%组(n=75),另选同期正常孕妇作为对照组(n=120)。采用Clauss凝固法平行检测三组血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)和纤维蛋白原(Fib)浓度。统计学分析组间差异及凝血指标与HbA1c的相关性。结果:HbA1c≥6.5%组PT时间短于对照组和HbA1c6.5%组,Fib水平高于对照组和HbA1c6.5%组,差异均有统计学意义(P0.05)。相关性分析显示Fib与HbA1c呈正相关关系(r=0.192,P0.01)。结论:GDM患者可能存在血栓前状态。     

早孕期胎儿颈项透明层增厚与不良妊娠结局关系的研究

颈项透明层（nuchal translucency,NT）是指在早孕期利用超声观察到的胎儿颈后部的无回声层。国外研究已表明NT增厚与染色体异常、心脏畸形等结构异常有关。国内对NT各文献报道较少。本文回顾我院1652例单胎NT厚度数据,探讨NT增厚与不良妊娠结局之间的关系,为进一步产前筛查、诊断提供参考。     

Epidemiological analysis of outcomes of pregnancy in diabetic mothers: Identification of the most characteristic and most frequent congenital anomalies

Using data from the Spanish Collaborative Study of Congenital Malformations (ECEMC), consisting of 19,039 consecutive malformed infants of unselected pregnancies, we have analyzed the relationship between nongestational maternal diabetes and different groups of congenital anomalies. The total sample of malformed babies was separated into two groups: children of nongestational diabetic mothers, and those of nondiabetic women. Analysis of the proportion of children identified in each group with different types of anomalies allows us to demonstrate that the most characteristic group of congenital anomalies observed in the children of diabetic women belongs to the caudal dysgenesis complex, while congenital heart defects are the most frequent malformations in these children. On the other hand, these children also present a multiple congenital anomalies (MCA) pattern more frequently than those of nondiabetic women. From this study it is also clear that the proportion of blastogenic malformations is higher in the offspring of diabetic mothers. © 1994 Wiley-Liss, Inc.     

胎儿心脏畸形孕早期筛查中脐静脉导管血流频谱参数与染色体异常的关系分析

目的探讨胎儿心脏畸形孕早期筛查中脐静脉导管血流频谱参数与染色体异常的关系。方法本研究回顾性分析了2013年1月至2018年5月期间1326例孕11~14w胎儿的临床资料。采用GE E8型彩色多普勒超声诊断仪检查胎儿脐静脉导管血流频谱参数,其中包括心室收缩期波峰(S波)、心室舒张早期波峰(D波)、心房收缩期波峰(a波)、阻力指数(RI)、搏动指数(PI)和S/a比值。结果1326例孕11~14w胎儿中共有1267例为正常胎儿,59例为异常胎儿。随着孕周的升高,胎儿的RI、PI和S/a比值均逐渐降低。43例脐静脉导管异常胎儿中38例为a波反向,5例为a波消失。脐静脉导管异常组的胎儿异常率(18.60%)显著高于正常组(3.98%),差异有统计学意义(P<0.001)。脐静脉导管正常组和异常组的染色体异常具有显著差异(P<0.05)。脐静脉导管血流频谱参数诊断染色体异常的特异度为0.74%,阴性预测值为96.08%。结论在孕11~14w胎儿的早期筛查中,脐静脉导管血流频谱参数异常主要表现为a波反向和消失。脐静脉导管血流频谱参数诊断胎儿染色体异常的特异度和阴性预测值较高,可作为胎儿染色体异常早期筛查的诊断指标。     

血清绒毛膜促性腺激素及孕酮检测在妊娠早期中的诊断及治疗意义

目的探讨血清孕酮与绒毛膜促性腺激素联合检测在妊娠早期中的诊断及治疗意义。方法分别采用ECL／RIA技术对300例早期妊娠者血清孕酮与绒毛膜促性腺激素进行检测。结果血清P值〉60nmol／L，血β－HCG〉50mIU／ml患者85例，占28．33％，经卧床休息，未用药治疗，均胚胎发育正常；血清P值在30-60nmol／L，血β-HCG10—50／mIU／ml患者155例，占51．67％，经黄体酮与绒毛膜促性腺激素保胎治疗后均胚胎发育正常；血清P值〈30nmol／L，血β-HCG〈10mIU／ml患者45例，占15％，终止妊娠者均可见清除宫内组织物中几乎不见新鲜绒毛并伴有不同程度的陈旧性出血；血清孕酮与β-HCG上升不同步患者15例，占5．0％，均最终难免流产。结论对于妊娠早期者动态观察血清孕酮与β—HCG，对于妊娠结局的预测及指导治疗具有重要的临床价值。     

Evaluation of seasonal changes in hemoglobin A1c in diabetic patients

In order to evaluate seasonal changes in hemoglobin A1c (HbA1c) values, we examined HbA1c values among 34,590 patients in 2010, and calculated the monthly average of HbA1c values through the year. HbA1c values were the highest in March and the lowest in October with a difference of 0.30%. The similar annual pattern was observed in HbA1c values from 2006 to 2009. Then we selected 453 diabetic patients whose treatment did not change through the year, and calculated average HbA1c values in four seasons each. There were also significant seasonal changes in diabetic patients, which were the highest in the spring and the lowest in the autumn, especially found in patients with insulin therapy. These effects may be caused by cold climate, decreased physical activity, over food intake and body weight gain in the winter. These seasonal changes in HbA1c should be concerned in the case of health service research, clinical trials and evaluation of the effects of medical treatment.     

Neutralization of early pregnancy factor by passive immunization alters normal embryonic development and cytokine balance

The aim of this study was to evaluate the effects of passive immunization with polyclonal anti-swine early pregnancy factor (EPF) antibody in pregnant rats during the pre-implantation period, and to analyse the regional distribution of EPF in placenta of rats. The immunodetection of EPF in rat placenta, as well as fertilization, development and immunological parameters, was evaluated. The average number of embryos and the embryo/corpora lutea ratio of rats treated with anti-EPF antibody were significantly lower than control groups. Also, as expected, the embryos showed a delay in their development. Furthermore, while IL-10 and INF-γ levels increased, serum and placental TGF-β decreased significantly in the group treated with anti-EPF. EPF was present in giant and decidual cells, as well as in blood vessels and trophoblastic lacuna cells, as demonstrated by positive immunostaining. This study provides new results on the function and location of EPF, and has demonstrated the usefulness of polyclonal anti-swine EPF antibody.     

早孕期外周血及蜕膜淋巴细胞CD28/CTLA-4的表达

目的：探讨人早孕期外周血及蜕膜淋巴细胞协同刺激分子表达水平在母．胎免疫调节中的作用。方法：以15例正常育龄妇女黄体期外周血为对照，应用流式细胞仪分析15例正常人早孕期外周血及蜕膜淋巴细胞CD28和CTLA-4的表达水平。结果：各组淋巴细胞几乎不表达表面CTLA-4分子；而表达细胞内CTLA-4分子（CTLA-4i）。蜕膜组织淋巴细胞CTLA-4i^＋／CD28^＋的比例显著高于早孕期及黄体期外周血。早孕期与黄体期外周CTLA-4i^＋／CD28^＋的百分率比较无显著性差异。结论：母胎界面局部高表达细胞内CTLA-4在母-胎免疫耐受中起重要作用。     

人工授精后血小板计数变化在早孕诊断中应用价值的研究

目的：为探讨血小板计数法用于超早孕诊断的可行性和可靠性,方法：对行AID术的健康妇女58例和处于正常排卵期的未婚妇女对照组28例,采用库尔特血细胞计数仪测量血小板数,结果：58例AID妇女血小板下降者34例,占64％,。12例化学妊娠者只有1例血小板未下降,28例对照组未孕妇女中血小板下降者3例,诊断敏感性为91．7％,特异性89．3％,阳性预期率78．5％,阴性预期率96％,诊断效率90．0％,诊断指数181％,结论：测定授精后血小板计数变化,可简单快守判断体内有无受精卵。     

HbA1c水平对2型糖尿病患者红细胞及胞内血红蛋白的影响

 目的: 探讨不同糖化血红蛋白(HbA1c)水平对2型糖尿病(T2DM)患者红细胞及胞内血红蛋白(Hb)的影响。方法: 选取健康人30名为对照组(H组),T2DM患者102例,按HbA1c水平分为3组:血糖控制良好组(A组)30例(HbA1c<7.0%);血糖控制较差组(B组)36例(7.0%≤HbA1c<9.0%);持续高血糖组(C组)36例(HbA1c≥9.0%)。利用新型静态显微图像分析技术和紫外-可见光谱技术,对各组红细胞及胞内Hb进行检测。结果: 与H组比较,A、B、C组红细胞的圆度因子明显增大(P<0.05)且与HbA1c水平呈正相关;B组红细胞的截面积和C组红细胞的全部形态参数均较H组明显增大(P<0.05);A、B、C组,除A、B组间红细胞长短轴参数无显著差异,其它组间参数比较差异有统计学显著性。与H组比较,A、B、C组Hb的紫外-可见光谱的谱型和谱峰未出现明显差异,但B、C组Hb的吸光度较H组明显下降(P<0.01),且C组Hb的吸光度也明显低于A组(P<0.05),随HbA1c水平的升高呈逐渐下降趋势。结论: 随HbA1c水平的升高,T2DM患者红细胞的形态发生改变,变形功能逐渐减弱,胞内Hb的结构可能发生改变。     

Effect of maternal weight during pregnancy on offspring muscle strength response to resistance training in late adulthood

Purpose

Maternal obesity can unfavorably influence offspring body composition, muscle strength, and possibly muscle’s adaptability to training, but the human studies are scarce. Therefore, we aimed to investigate the effect of maternal obesity on offspring muscle strength responses to resistance training intervention in elderly frail women.