血清孕酮水平与早期先兆流产预后的关系

流产病因复杂,其中内分泌异常是近年来的研究热点,有资料表明,约20%的先兆流产为孕酮不足导致。本文通过对110例早期先兆流产病例的研究,探讨血清孕酮值与早期先兆流产预后的关系。1资料与方法110例早期先兆流产患者,来自2003年10月至2004年10月我院门诊确诊的病例。所有患者治疗前均抽血,采用放射免疫法测定血清孕酮值,根据血清孕酮水平将病人分为3组。第一组15例,血清孕酮值大于78 nmol/L,为正常值[1],提示黄体功能正常,B超见孕囊发育正常,仅给予卧床休息等一般处理。第二组28例,血清孕酮值小于31.8 nmol/L,B超提示孕囊发育异常,放弃安…     

早期先兆流产孕妇HCMV感染与血清PAPP-A水平的相关性研究

目的探讨早孕妇女妊娠相关血浆蛋白A(PAPP-A)水平与人巨细胞病毒(HCMV)活动性感染的相关性以及二者在早期自然流产发病机制中的作用。方法应用酶联免疫吸附试验(ELISA)和逆转录PCR(RT-PCR)筛选HCMV活动性感染早孕先兆流产妇女,定量检测其外周血血清PAPP-A水平,并与相同孕周的非HCMV活动性感染的先兆流产孕妇及健康孕妇进行比较分析。结果早期先兆流产妇女中HCMV活动性感染者、非活动性感染者、健康孕妇血清PAPP-A分别为:(0.4924±0.088)m lU/m l,(0.805±0.213)m lU/m l和(2.479±1.020)m IU/m l(F=93.98,P<0.01)。结论早孕妇女HCMV活动性感染和PAPP-A水平密切相关,并可能在早期自然流产的发病机制中占据相当重要的地位。     

孕妇并发症与孕早期血清锌关系探讨

为探讨孕早期测定血清锌对预测孕妇和胎儿并发症的意义，作者对６７例正常孕妇在妊娠１４─１８周时取肘静脉血测定血清锌、铜含量，并追踪观察孕产期经过。结果６７例孕妇中正常妊娠分娩４８例，有不同并发症１９例（２５例次）。二组相比较，并发症组血清锌含量显著低（Ｐ＜０．００１）。提示孕早期血清锌低对孕妇和胎儿有潜在危险，在孕早期应检查血清锌量，必要时补锌治疗。     

先兆流产与异位妊娠孕妇血清孕酮检测及其临床意义

先兆流产与异位妊娠是孕妇中常见的两种情形.近年来, 异位妊娠发生率上升趋势明显, 异位妊娠与正常妊娠之比, 国外(以美国为例)由1970年的1:222上升至1989年的1:51,国内由1:167-322上升到1:56-93[1].导致先兆流产与异位妊娠的因素很多.本文对上述孕妇血清孕酮进行了检测, 现报道如下.     

血清检测联合阴道超声评估早期先兆流产的诊断价值分析

目的 探讨孕5～7周孕妇血清检测联合阴道超声评估早期先兆流产的诊断价值,以指导优生优育.方法 选取200例孕5～7周早期先兆流产患者(先兆流产组)与100例早孕正常妊娠者(正常妊娠组)作为研究对象,研究时间为2019年6月-2020年3月,其中先兆流产组按照妊娠结局分为继续妊娠组(n=100)与难免流产组(n=100)...     

秦巴山区孕妇巨细胞病毒活动性感染与血清锌水平的关系

目的探讨秦巴山区孕妇巨细胞病毒(human cytomegalovirus,HCMV)活动性感染与血清锌含量的关系.方法采用ELISA和PCR相结合的方法检测秦巴山区HCMV活动性感染的妊娠妇女52例作为病例组,同期检测的52例未感染孕妇作为对照组,用原子吸收光谱法测定两组孕妇血清锌含量,随访妊娠结局并检测其分娩的新生儿尿液中的HCMV-DNA.结果①新生儿尿液HCMV-DNA阳性者共21例,宫内传播率40.38%(21/52).②HCMV活动性感染孕妇血清锌平均值为46.29±13.81μg/dl明显低于未感染孕妇组82.73±23.98μg/dl(P＜0.05).结论该地区HCMV活动性感染孕妇体内明显缺锌,可能与该地区智力低下(MR)发病率高有一定关系.     

细菌性阴道病感染与先兆流产关系的研究

目的确探讨细菌性阴道病感染情况与先兆流产的关系.方法分别对128例先兆流产孕妇和117例正常孕妇进行细菌性阴道病检查鉴定.结果先兆流产孕妇细菌性阴道病感染率为32.81%,正常孕妇细菌性阴道病感染率为23.08%,两组相比,有显著性差异(P＜0.01).结论为提高妊娠成功率,预防细菌性阴道病的发生,及时诊断和治疗细菌性阴道病十分必要.     

地中海贫血与先兆流产的关系

目的　对我院 3644例普通病人进行地贫筛选。方法　采用中山医大“一管脆性法” ,基因诊断选择gapPCR技术。结果　阳性 433例 ,发病率 1 1 88%;对先兆流产 1 363例住院病人进行地贫筛选 ,阳性率 1 9 66 %明显高于普通人群组 ;对先兆流产组 66对夫妇同时检测 ,阳性 1 9对 ,阳性率 2 8 78%,远远高于先兆流产一方受检组     

血清CA125检测在早期先兆流产妊娠预后的价值

目的探讨血清CA125检测在预测早期先兆流产妊娠预后的价值。方法采用电化学发光法对120例早期先兆流产及50例正常早孕妇女血清CA125进行测定。结果先兆流产继续妊娠组、妊娠失败组及对照组血清CA125含量分别为(22.32±9.59)U/ml、(81.69±30.65)U/ml、(10.68±4.96)U/ml,先兆流产妊娠失败组血清CA125含量明显高于正常对照组和先兆流产继续妊娠组(P0.01)。结论单次测定血清CA125水平对预测早期先兆流产的妊娠预后有一定的参考价值。     

先兆流产与儿童智力发展水平的关系

目的：检验孕妇先兆流产与儿童智力发展之间的关系。方法：采用测验与调查的方法，分别对170名先兆组儿童和182名正常儿童的智商分数进行了研究分析。结果：孕妇先兆流产病史，虽未导致典型的智力落后，但更易引起低体重新生儿的出现，并影响其智力的正常发展；尤其是高龄孕妇的先兆流产病史，会对儿童智力发展产生更大的负面影响。结论：先兆流产可能会是影响儿童智力发展的一个潜在因素。     

Maternal serum levels of pro-inflammatory cytokines in missed and threatened abortion

PROBLEM: A study of association between pro-inflammatory cytokines, and missed and threatened abortions with good outcome has been performed. METHOD OF STUDY: The presence of pro-inflammatory cytokines, namely interleukin (IL)-8 and IL-12 and the soluble interleukin-2 receptor (SIL-2R) was investigated in maternal serum of 12 patients with threatened abortion twice (at admission and discharge), 14 patients with missed abortion, 14 women with healthy first-trimester pregnancy, and 14 normal non-pregnant women, using specific enzyme-linked immunosorbent assays. RESULTS: SIL-2R and, in particular, IL-12 was detected with significantly higher levels in missed abortion group compared with all other groups. IL-8 was detected with no significant difference among all the groups studied. CONCLUSIONS: In spite of caution due to the small sizes of the subject samples, these results support a role of the immune system in the first trimester pregnancy and hypothesize that missed abortion may be associated with an enhanced Th1 reactivity, whereas threatened abortion with good outcome resembles the normal pregnancy with a non-enhanced Th1 reactivity.     

阿托西班与盐酸利托君联合使用在晚期先兆流产及先兆早产治疗中的意义

目的观察阿托西班与盐酸利托君联合使用在晚期先兆流产及先兆早产治疗中的意义。方法对本院157例先兆流产或先兆早产且需要长期或大剂量使用宫缩抑制剂的患者进行回顾性研究。其中盐酸利托君单药使用者有108例（利托君单药组）,盐酸利托君与阿托西班联合使用者49例（联合用药组）。比较利托君单药组与联合用药组利托君使用的平均剂量及药物总量,以及两组患者妊娠延长天数及新生儿预后。另外对两组患者用药时相关的生命体征（包括心率、呼吸频率）及不良反应（包括心悸、胸闷、头痛）发生率进行对比。结果利托君单药组及联合用药组在延长妊娠天数、胎儿丢失率、新生儿出生体重及新生儿出生1min Apgar评分方面差异无统计学意义（P〉0.05）,但联合用药组的平均利托君用量及药物总量明显低于利托君单药组,孕妇平均心率及临床副作用均低于利托君单药组,差异有统计学意义（P〈0.05）。结论对需要长期或大量使用盐酸利托君抑制宫缩的先兆流产或先兆早产患者,如联合阿托西班一同使用,可降低利托君的药物用量,明显降低临床副作用。     

The impact of dydrogesterone supplementation on serum cytokine profile in women with threatened abortion

PROBLEM: The role of increased Th1 cytokine expression in pregnancy failure has been questioned recently. The therapeutic value of progestogens in threatened abortion (TA) is still debated. The aim of this prospective study was to compare serum cytokine [tumor necrosis factor (TNF)-alpha, interleukin (IL)-12 and IL-10] concentrations in women with TA to those in women with normal pregnancy and to evaluate the impact of dydrogesterone supplementation in the former group on cytokine concentration. METHODS OF STUDY: Twenty-seven threatened aborters were treated for 10 days with dydrogesterone (30-40 mg/day). Sixteen healthy pregnant controls received no treatment. Serum cytokine concentrations were measured twice in both groups by enzyme-linked immunosorbent assay. RESULTS: Mean serum concentrations of Th1- and Th2-type cytokines in women with TA did not differ from those in women with normal pregnancy at first and second sampling. After dydrogesterone supplementation, mean TNF-alpha/IL-10 ratio changed from 1.08 to 1.75 while IL-12/IL-10 ratio remained almost the same (0.56-0.61) in the threatened aborters group and did not differ from those in healthy women. CONCLUSIONS: The results of this study indicate that peripheral cytokine production in threatened aborters does not differ from that observed among healthy pregnant women. The protective effect of dydrogesterone supplementation in threatened aborters is manifested via restoring progesterone-induced blocking factor concentration rather than controlling cytokine production.     

微量元素锌含量与难免流产的关系

目的探讨体内微量元素锌含量与难免流产的关系。方法对62例难免流产孕妇进行了血清元素Zn含量检测,并与66例正常孕妇比较。结果难免流产孕妇血清Zn含量显著降低,与正常孕妇比较差异均有统计学意义(P0.01)。结论血清元素Zn含量降低可能是孕妇难免流产发生的原因之一,及时纠正有望降低孕妇难免流产的发生率。     

先兆流产患者保胎治疗过程中血清HCG、PROG、E2和CA125的动态监测

目的研究先兆流产患者保胎治疗过程中血清人绒毛膜促性腺激素（HCG）、孕酮（PROG）、雌二醇（E2）和糖链多肽抗原125（CA125）的变化情况,探讨其动态监测在疗效预测及预后判断中的临床价值。方法选取2011年6月至2012年5月于四川省绵阳市中心医院就诊的先兆流产患者61例及正常妊娠23例,以黄体酮/绒毛膜促性腺激素肌肉注射为保胎治疗,动态监测其保胎治疗过程中体内HCG、PROG、E2和CA125水平,并对检测结果进行统计学分析。结果治疗前先兆流产患者HCG、PROG、E2和CA125水平分别为（6542.4±3769.5）mIU/ml、（19.1±6.7）ng/ml、（484.6±318.2）pg/ml和（36.8±19.3）U/ml,与正常妊娠比较差异均有统计学意义（P〈0.05）;保胎治疗后以不同妊娠结局分组,继续妊娠组（n=48）同难免流产组（n=13）两组相同时间点的监测结果比较,HCG、E2和CA125水平在治疗后第3天即出现显著变化,差异有统计学意义,PROG在第6天出现差异有统计学意义（P〈0.05）。结论治疗过程中动态监测先兆流产患者血清HCG、PROG、E2和CA125的变化情况,有助于疾病诊断、疗效预测及预后判断。     

血清CA-125水平与妊娠先兆流产预后的关联分析

目的探讨早期正常妊娠及先兆流产孕妇血清糖类抗原125（CA-125）水平的变化,讨论其对妊娠预后的预测价值。方法对97例单胎早孕孕妇的临床资料进行回顾性分析。孕妇均为正常妊娠,无先兆流产病史。其中,正常妊娠32例,先兆流产继续妊娠38例,先兆流产妊娠失败27例。动态监测CA-125水平,比较分析监测指标的意义。结果先兆流产妊娠失败组孕妇的CA-125水平显著高于正常妊娠组和先兆流产继续妊娠组（P〈0．05）。结论血清CA-125的水平检测对妊娠的预后判断有较高的临床应用价值。     

安宝、硫酸镁与间苯三酚治疗孕20周后先兆流产的临床效果比较

目的探讨安宝、硫酸镁和间苯三酚在治疗孕20周后先兆流产方面的临床疗效和临床安全性。方法选取绵阳市第三人民医院2012年12月到2013年5月妇产科收治的单胎孕妇共188例,随机分为硫酸镁治疗组（A组,n=58）,安宝治疗组（B组,n=68）和间苯三酚治疗组（C组,n=62）。观察三组孕妇用药后临床症状消失的时间,治疗过程中出现的不良反应。结果A、B、C三组使用药物后的起效时间分别为（2．84±0．29）、（1．32±0．28）和（2．28±0．22）d,B组明显比A组和c组短,差异有统计学意义（P〈0．05）。治疗有效率分别为74．14％、91．18％和93．55％,A组明显比B组和C组低,差异有统计学意义（P〈0．0167）。头晕头痛、面色潮红、乏力的发生率均为A组明显高于B组和C组（P〈0．0167）;恶心呕吐等胃肠道不适的发生率C组明显低于A组和B组（P〈0．0167）;心悸发生率B组明显高于A组和c组（P〈0．0167）。结论安宝治疗孕20周后先兆流产起效快、疗效高,宜作为首选;不能耐受安宝者可首选间苯三酚,保胎成功率与安宝相当而不良反应率低,值得临床推广。     

Gender differences in the relationship between serum zinc concentration and metabolic syndrome

Background: Zinc, a co-factor of antioxidant enzymes, may be involved in the pathophysiology of metabolic syndrome (MetS).

Aim: To determine the association between serum zinc concentration and MetS in a population-based study.

Subjects and methods: In the Tehran Lipid and Glucose Study, serum zinc concentration was measured by flame atomic absorption spectrometry in 2626 adult participants. After removal of outliers, usable data was available for 2401 participants. Dietary zinc was assessed by a validated semi-quantitative food frequency questionnaire.

Results: Compared to those without the MetS, serum zinc concentration was significantly higher in men with syndrome (17.1?±?4.9 vs 16.5?±?4.6?μmol/L, p?=?0.035); however, values were comparable in females (16.1?±?4.8 vs 15.8?±?4.4, p?=?0.460). Men in tertile 3 of serum zinc had significantly higher chances of having MetS, even after multivariate adjustment (OR?=?1.48, 95% confidence interval (CI)?=?1.07–2.06, p?=?0.020). Women in tertile 2 of serum zinc had significantly lower chances of having MetS, which remained significant after multivariate adjustment (OR?=?0.68, 95% CI?=?0.47–0.99, p?=?0.046).

Conclusion: This study observed a gender difference between serum zinc and MetS, with higher levels being positively associated with MetS in men and having a protective effect in women. Further studies are needed to elucidate the role of zinc status in the development of MetS.     

The impact of dydrogesterone supplementation on hormonal profile and progesterone-induced blocking factor concentrations in women with threatened abortion

PROBLEM: The therapeutic value of progestogens in threatened abortion is still under debate. In the presence of sufficient progesterone levels during pregnancy, lymphocytes synthesize a mediator [progesterone-induced blocking factor (PIBF)] that is anti-abortive in mice. The aim of this study was to evaluate the effect of dydrogesterone on pregnancy outcome of threatened aborters. METHOD OF STUDY: Twenty-seven threatened aborters were treated for 10 days with dydrogesterone (30-40 mg/day). Sixteen healthy pregnant controls received no treatment. Serum progesterone and estradiol concentrations as well as urine PIBF concentrations were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: Pregnancy outcomes in dydrogesterone-treated threatened aborters did not statistically differ from those in healthy controls. Serum progesterone concentrations in control patients, but not those in threatened aborters increased as pregnancy progressed. Following dydrogesterone treatment, initially low PIBF concentrations of threatened aborters significantly increased (P = 0.001) to reach the PIBF level found in healthy controls. CONCLUSIONS: These data suggest that by inducing PIBF production, dydrogesterone might improve pregnancy success rates in threatened aborters.     

早期自然流产与环境因素的相关性分析

目的探讨与早期自然流产相关的环境危险因素,为降低自然流产率、减少不良妊娠结局的发生提供参考。方法采用问卷调查的方式,分析比较了97例在厦门市妇幼保健院诊断为早期自然流产的妇女和76例同期正常分娩的妇女的个人史资料和早孕期环境接触情况。结果单因素分析显示,自然流产组妇女的妊娠次数、既往自然流产次数、早孕期被动吸烟、每日手机通话次数以及使用染发剂的比例显著高于对照组(P均<0.05)。多因素分析显示,以上提到的三个环境接触因素均可增加早期自然流产的危险。结论早孕期被动吸烟、每日手机通话次数以及使用染发剂均与自然流产有一定关联,因此孕妇在怀孕期间应尽量避免被动吸烟、长时间使用电磁辐射大的设备以及接触染发剂等化学物质。