基质金属蛋白酶-9和血管内皮生长因子在子痫前期患者胎盘组织中的表达

目的 检测子痫前期患者胎盘组织中RECK、基质金属蛋白酶-9（MMP-9）、血管内皮生长因子（VEGF）的基因表达,探讨它们与胎盘滋养细胞浸润过程的调控关系。 方法 采用RT-PCR、Western blotting、免疫组织化学检测120例妊娠足月剖宫产（正常妊娠、轻度子痫前期、中度子痫前期、重度子痫前期各30例）胎盘组织中RECK、MMP-9、VEGF的基因表达。结果 3组子痫前期患者胎盘组织中MMP-9及VEGF的mRNA表达水平均显著低于正常妊娠组（P<0.05）;重度子痫前期组中RECK mRNA的表达显著高于正常妊娠组（P<0.05）;3组子痫前期患者胎盘组织中MMP-9及VEGF蛋白表达均显著低于正常妊娠组（P<0.05）,中度和重度子痫前期组中RECK蛋白表达显著高于正常妊娠组（P<0.05）。结论 子痫前期患者胎盘中RECK与MMP-9、VEGF之间存在负相关性,它们可能参与了胎盘滋养细胞浅浸润过程的调控。     

Examination of soluble cell adhesion molecules in pregnancy induced hypertension]

This study was performed to determine whether or not the soluble-intercellular adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (sVCAM-1) and endothelial leukocyte adhesion molecule-1 (sELAM-1) are sensitive markers of pregnancy induced hypertension (PIH). sICAM-1 concentrations were significantly higher (p < 0.05) in the mild PIH compared to non-pregnant women and normal pregnant groups. sVCAM-1 concentrations in the mild PIH group and the severe PIH group were significantly higher than the non-pregnant women group (p < 0.0001, p < 0.01, respectively) and the normal pregnant group (p < 0.0001, p < 0.0005, respectively). The concentrations of sELAM-1 in the mild PIH group were also significantly higher compared to normal pregnant group (p < 0.01). Our results suggest that soluble cell adhesion molecules may be useful markers detecting endothelial damage and dysfunction in patients with PIH.     

妊娠期高血压疾病胎盘组织中CASR和EGFR的相关研究

目的探讨在妊娠期高血压疾病患者胎盘组织中细胞外钙受体（CASR）和表皮生长因子受体（EGFR）的表达情况及其相互关系。方法通过免疫组织化学方法检测妊娠期高血压疾病患者64例（妊娠期高血压组21例,子痫前期轻度组23例,重度组20例）及健康足月孕妇20例（对照组）胎盘组织中CASR和EGFR蛋白的表达情况。结果 （1）妊娠期高血压疾病患者胎盘组织中CASR在妊娠期高血压组表达水平为59.0532±8.039,子痫前期轻度组患者中为64.3623±3.7278,两组比较,差异有统计学意义（P〈0.0001）;CASR在子痫前期重度组患者中表达为112.2831±6.2060,与妊娠期高血压组比较,差异有统计学意义（P〈0.0001）,与子痫前期轻度组比较,差异有统计学意义（P〈0.0001）。CASR的蛋白在妊娠期高血压组患者胎盘组织中表达水平为59.0532±8.039,对照组为54.8585±4.3035,两组比较,差异无显著性（t=0.08,P=0.7759）。（2）妊娠期高血压疾病患者胎盘组织中表皮生长因子受体（EGFR）在妊娠期高血压组表达水平为56.174±3.1020,子痫前期轻度组患者中为78.6844±2.6713,两组比较,差异有统计学意义（t=18.73,P=0.0001）;EGFR在子痫前期重度组患者中表达为94.2090±6.8352,与子痫前期轻度组比较,差异有统计学意义（t=11.37,P〈0.0001）。（3）胎盘组织中CASR和表皮生长因子受体（EGFR）表达量呈正相关关系（r=0.352,P〈0.05）。结论妊娠期高血压疾病患者胎盘组织中CASR的蛋白表达升高和EGFR激活及过度增高,可能在妊娠期高血压疾病发生发展中起重要作用。     

T-bet mRNA和GATA3 mRNA在子痫前期蜕膜组织中的表达

目的探讨T-bet mRNA和GATA3 mRNA在正常妊娠产妇及子痫前期患者蜕膜组织中的表达差异。方法选取子痫前期和正常妊娠产妇作为实验组和对照组,采用RT-PCR方法,检测各组产妇蜕膜组织中T-bet mRNA和GA-TA3 mRNA表达水平。结果①子痫前期重度组与轻度组相比,子痫前期重度组与正常组相比T-bet mRNA表达量的差异有统计学意义（P〈0.01,P〈0.01）。子痫前期轻度组与正常组T-bet mRNA表达量相比较差异无统计学意义（P=0.089）。②子痫前期重度组与轻度组相比,子痫前期重度与正常组相比,GATA3 mRNA表达量的差异有统计学意义（P〈0.01,P〈0.01）,子痫前期轻度组与正常组相比GATA3 mRNA表达量的差异无统计学意义（P=0.127）。③T-bet mRNA/GATA3 mRNA比值在正常组与子痫前期重度组间、子痫前期轻度组与重度组间差异有统计学意义（P〈0.01,P〈0.01）。二者比值在正常组与子痫前期轻度组间差异无统计学意义（P=0.522）。结论子痫前期Th1漂移可能与T-bet高表达和GATA3低表达有关。     

妊娠期高血压疾病患者孕中期血管内皮功能变化

目的探讨妊娠期高血压疾病患者在孕中期临床发病前的血管内皮功能的变化。方法对340例孕中期孕妇用超声行肱动脉血流介导的舒张功能（FMD）,血清内皮素（ET）、一氧化氮（NO）测定,并根据其随访的妊娠结局分为妊娠期高血压疾病组（妊高征组）和正常组,比较两组的FMD,ET,NO结果。结果 340例中有41例孕晚期发生妊娠期高血压疾病（妊高征组）,而其余299例未发生妊娠期高血压疾病（正常组）。孕中期妊高征组FMD、血清NO显著低于正常组,而血清ET显著高于正常组,差异均有显著性（P〈0.05）。在妊高征组内,重度子痫前期组FMD、血清NO显著低于轻度子痫前期组,而血清ET显著高于轻度子痫前期,差异有显著性（P〈0.05）。结论孕中期妊娠期高血压疾病潜在患者虽然血压正常,但已存在血管内皮损伤,可被超声、实验室等检出。     

Homocysteine,endothelin-1 and nitric oxide in patients with hypertensive disorders complicating pregnancy

Objective: To investigate the change of level of serum homocysteine (Hcy), endothelin-1 (ET-1) and nitric oxide (NO) and clinical significance in patients with HDCP. Methods: Two hundred and thirty nine patients with HDCP (137 patients with mild preeclampsia, 102 patients with severe preeclampsia) who were hospitalized between June 2012 and June 2015 and 200 normal pregnancy women in outpatient department were enrolled in our study were divided into HDCP group and control group. Serum Hcy concentration was measured by enzymatic cycling assay. ET-1 concentration was measured by enzyme linked immunosorbent assay. And no concentration was measured by nitrate reductase assay. Results: Serum Hcy and ET-1 in HDCP group were significantly higher as compared to control group (P<0.05). Level of serum NO in HDCP group was significantly lower than in the control group (P<0.05). Level of serum Hcy and ET-1 in mild and severe preeclampsia group were significantly higher as compared to control group, respectively (P<0.05). Level of serum NO in mild and severe preeclampsia group were significantly lower than in the control group’ respectively (P<0.05). Level of serum Hcy and ET-1 in severe preeclampsia group were significantly higher as compared to mild preclampsia group (P<0.05). Level of serum NO in severe preeclampsia group were significantly lower than in mild preeclampsia group (P<0.05). Spearman rank correlation analysis showed that level of serum Hcy and ET-1 was positively correlated with severity of diseases (r=0.689, 0.718, P<0.05). Level of serum NO was negatively correlated with severity of diseases (r=-0.702, P<0.05). Conclusion: Serum Hcy, ET-1 and NO were associated with pathogenesis of HDCP. Comprehensively measurement of them could effectively evaluate the incidence and progress of HDCP.     

NT—proBNP在妊娠高血压心功能评估中的价值

目的探讨N-端脑利钠肽前体（NT—proBNP）在妊娠高血压疾病（PIH）心功能评估中的价值。方法将102例PIH孕妇分为妊娠高血压组37例,轻度子痫前期组33例,重度子痫前期组32例,另外选取正常妊娠组32例及正常未孕育龄妇女32例作为对照组,采用电化学发光法测定患者血清NT—proBNP浓度。结果PIH组、正常妊娠组和对照组的NT—proBNP水平分别为（300．52±134．44）、（83．42±26．26）和（59-83±12．89）pg／ml,三者间比较差异均有统计学意义（P〈0．01）。重度子痫前期组、轻度子痫前期组、妊娠高血压组的NT-proBNP水平分别为（488．56±155．54）、（323．39±148．90）和（185．73±43．78）pg／ml,三者间比较差异均有统计学意义（P〈0．01）。NT—proBNP与孕妇体重指数（BMI）呈正相关（r=0．602）,与新生儿体重呈负相关（r=-0．279）。结论孕后NT-proBNP有所升高,而且是能够用于评估PIH孕妇心功能的敏感指标之一。     

子痫前期患者血清内脂素、肿瘤坏死因子α水平与胰岛素抵抗的相关性

目的:探讨子痫前期患者血清内脂素及肿瘤坏死因子-α(TNF-α)与胰岛素抵抗(IR)的关系。方法:根据子痫前期分类标准选取重度子痫前期患者30例、轻度子痫前期患者30例及正常孕妇40例。采用酶联免疫吸附试验(ELISA)法检测孕妇血清内脂素和TNF-α浓度,血浆葡萄糖氧化酶法测定空腹血糖(FBG),放射免疫法测定空腹胰岛素(FIns),全自动生化分析仪测定血浆甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平。通过计算平均动脉压(MAP)、体质量指数(BMI)和胰岛素抵抗指数(HOMA-IR),分析子痫前期患者血清内脂素、TNF-α水平与IR的关系。结果:重度、轻度子痫前期患者的血清内脂素和TNF-α浓度低于正常孕妇(P0.05),且重度子痫前期患者的血清内脂素和TNF-α浓度低于轻度子痫前期患者(P0.05);血清内脂素与TNF-α、HDL-C呈正相关(P0.05),与MAP、FIns呈负相关(P0.05);血清TNF-α与HDL-C呈正相关(P0.05),与BMI、TG、MAP、FIns呈负相关(P0.05)。多元逐步线性回归分析显示,FBG、FIns和HOMA-IR是影响血清内脂素及TNF-α水平的相关因素。结论:子痫前期患者血清内脂素、TNF-α水平与IR密切相关。     

妊娠期高血压疾病中血清可溶性Endoglin水平变化的研究

目的检测正常妊娠和妊娠期高血压疾病患者血清中Endoglin的水平,探究其与妊娠期高血压疾病的发病关系及意义。方法采用酶联免疫吸附双抗体夹心法（ELISA）检测44例妊娠期高血压疾病患者（妊娠期高血压疾病组,其中妊娠期高血压15例、轻度子痫前期14例、重度子痫前期15例）及16例正常晚期妊娠妇女（对照组）,22例正常中期妊娠妇女血清中Endoglin水平。结果妊娠期高血压疾病组血清Endoglin浓度为（2.86±2.15）ng/ml,正常晚期妊娠组为（1.14＋0.46）ng/ml,两组比较差异有统计学意义（P〈0.05）。妊娠期高血压、轻度子痫前期、重度子痫前期患者血清中可溶性Endoglin水平逐渐升高[分别为（1.68±0.78）ng/ml,（2.49±1.10）ng/ml,（4.44±2.94）ng/ml],各组间差异有统计学意义（P〈0.05）,且有随孕周增加而逐渐增加的趋势。正常中期妊娠组血清中Endoglin浓度为（0.83±0.32）ng/ml,与正常晚期妊娠组比较差异有统计学意义。结论血清Endoglin水平升高可能与妊娠期高血压疾病的发病及病情发展有关,并有可能成为疾病的预测指标。     

全血微量元素含量与妊娠期高血压相关性研究

目的探讨妊娠高血压的发生发展与全血微量元素含量的关系,为妊娠期高血压的预防及治疗提供理论依据。方法按妊娠期高血压疾病诊断标准将入选的78例晚孕孕妇分为妊娠期高血压、子痫前期轻度、子痫前期重度3个组,40例正常健康晚孕孕妇为对照组;采用火焰原子吸收光谱法分别测定患病组和对照组孕妇全血微量元素（铜、锌、钙、镁、铁）浓度水平,对数据统计处理并进行对照研究。结果患病各组与对照组比较微量元素铜、钙、镁含量无显著性差异（P〉0．05）;微量元素锌含量在正常对照组、妊娠高血压组、子痫前期轻度组、子痫前期重度组之间依次递减,妊娠高血压组与对照组比较无显著性差异（P〉0．05）,子痫前期轻、重度组锌元素含量显著低于对照组,差异有统计学意义（P〈0．05）,子痫前期轻、重度组锌元素含量显著低于妊娠高血压组,差异有统计学意义（P〈0．05）,子痫前期重度组锌元素含量显著低于子痫前期轻度组,差异有统计学意义（P〈0．05）;微量元素铁含量在正常对照组、妊娠高血压组、子痫前期轻度组、子痫前期重度组之间依次递增,妊娠高血压组与对照组比较无显著性差异（P〉0．05）,子痫前期轻、重度组铁元素含量显著高于对照组,差异有统计学意义（P〈0．05）,子痫前期轻、重度组铁元素含量显著高于妊娠高血压组,差异有统计学意义（P〈0．05）,子痫前期重度组铁元素含量显著高于子痫前期轻度组,差异有统计学意义（P〈0．05）。结论妊娠高血压是孕期常见合并症,要加强妊高征孕妇微量元素的均衡摄入,确保母婴健康。     

Circulating Levels of Immunoreactive Cytokines in Women with Preeclampsia

PROBLEM: Circulating inflammatory cytokines have been implicated in the pathogenesis of preeclampsia. To test this hypothesis, we measured plasma levels of immunoreactive tumor necrosis factor (TNF)-α and -β, interleukin (IL)?1α and -β, and IL-6 and ?10 in women with preeclampsia, in women with transient gestational hypertension, and throughout normal pregnancy. METHOD OF STUDY: Enzyme-linked immunosorbent assays were used and subjected to extensive validation studies. RESULTS: The median concentration of plasma TNF-α was increased by twofold in women with preeclampsia compared with that in normal third-trimester pregnancy (P < 0.001) and in women with gestational hypertension (P < 0.04). The median concentration of plasma IL-6 was increased by threefold in women with preeclampsia compared with that in normal third-trimester pregnancy (P < 0.001) and increased twofold compared with that in women with gestational hypertension (P < 0.1). There were no significant differences observed in the levels of plasma IL-1β and IL-10 between the preeclamptic and other subject groups. The level of IL-1β, but not the levels of IL-10, TNF-α, or IL-6, was significantly changed during normal pregnancy compared with the nonpregnant condition manifesting an overall decline (P < 0.04). TNF-β and IL-1α were not detected in any samples, possibly because of the low sensitivity of these particular immunoassays. CONCLUSION: Elevated levels of TNF-α and IL-6 may contribute to the putative endothelial dysfunction of preeclampsia.     

妊娠期高血压疾病患者血浆Pro BNP水平及其临床意义

目的 观察妊娠期高血压疾病患者Pro BNP水平及临床意义。方法 选择在我院行剖宫产术的妊娠期高血压疾病患者89例为HDCP组,包括妊娠高血压24例,轻度子痫前期21例,重度子痫前期44例;同期在我院行剖宫产术的妊娠晚期健康妇女88例为对照组,采用电化学发光法检测各组Pro BNP并对比。结果 HDCP组Pro BNP为（844.02±788.74）pg/ml,显著高于对照组的（142.90±187.20）pg/ml,差异有统计学意义（P＜0.05）。与对照组相比,轻度子痫前期组和重度子痫前期组Pro BNP均显著增高,差异有统计学意义（P＜0.05）。与妊娠高血压组相比,轻度子痫前期组和重度子痫前期组Pro BNP显著增高,差异有统计学意义（P＜0.05）。重度子痫前期组Pro BNP显著高于轻度子痫前期组,差异有统计学意义（P＜0.05）。结论 妊娠期高血压疾病患者血浆Pro BNP水平高于妊娠晚期健康妇女,检测妊娠期高血压疾病患者血浆Pro BNP水平可及时了解早期心肌细胞损害及心脏功能情况,对了解病情、观察疗效和预后判断具有重要价值。     

凝血指标、免疫因子和妊娠高血压综合征病情的关系观察

目的 探讨凝血指标、免疫炎症因子和妊娠高血压综合征病情的关系.方法 收集2015年1月至2016年10月在本院就诊的妊娠高血压综合征孕妇150例,其中轻中度子痫前期50例,重度子痫前期50例,子痫50例;另外选取30例健康非孕妇女和30例正常晚期妊娠妇女作为对照,采用免疫比浊法检测各组受检者的免疫指标、血浆凝血指标,包括C3、C4、IgA、IgG、IgM、D-D水平、凝血酶时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib).结果 ①健康非孕对照组、正常晚期妊娠组、轻中度子痫前期组三组C3、C4、IgA、IgG、IgM无明显差异,P＞0.05.和健康非孕对照组、正常晚期妊娠组对比,重度子痫前期C3、IgG、IgM显著减低,子痫组C3、C4、IgA、IgG、IgM更低,P＜0.05.②和健康非孕组对比,正常妊娠晚期组和妊娠高血压各组PT和APTT值显著减小,Fib和D-D水平显著增高,差异具有统计学意义(P＜0.05).和正常晚期妊娠组对比,妊娠高血压各组PT和APTT值显著减小,Fib和D-D水平显著增高,差异具有统计学意义(P＜0.05).妊娠高血压各组内对比,和轻中度子痫前期对比,重度子痫前期组、子痫组PT和APTT值显著减小,Fib和D-D水平显著增高,差异具有统计学意义,P＜0.05.和重度子痫前期组对比,子痫组PT和APTT值显著减小,Fib和D-D水平显著增高,差异具有统计学意义,P＜0.05.结论 凝血指标、免疫炎症因子和妊娠高血压综合征病情的关系密切,对妊娠高血压综合征患者进行C3、C4、IgA、IgG、IgM、D-D水平、凝血指标的检测,有利于尽早发现和监测患者的病情发展情况.     

Peripheral blood galectin-1-expressing T and natural killer cells in normal pregnancy and preeclampsia

The purpose of this study was to determine whether the proportion of galectin-1-expressing peripheral blood T and NK cells is altered in normal pregnancy and preeclampsia (PE). We also examined whether circulating levels of galectin-1 and anti-galectin-1 autoantibodies are affected in PE. Seventy preeclamptic patients, 75 healthy pregnant and 21 healthy non-pregnant women were involved in this study. Serum galectin-1 and anti-galectin-1 autoantibody levels were measured by ELISA. Intracellular galectin-1 expression of lymphocytes was determined with flow cytometry. Serum galectin-1 and anti-galectin-1 IgG levels did not differ significantly between the healthy pregnant and the PE group. In healthy pregnant women, significantly higher percentage of T and NK cells expressed gal-1 in their cytoplasma than in healthy non-pregnant women. However, the proportion of galectin-1-expressing peripheral blood T and NK cells was markedly decreased in PE compared to normal pregnancy, which might contribute to the activation of innate and acquired immune cells.     

Maternal serum levels of VCAM-1, ICAM-1 and E-selectin in preeclampsia

Endothelial dysfunction is thought to be a central pathogenic feature in preeclampsia on the basis of elevated adhesion molecules. The aim of the present study was to compare the levels of soluble vascular cell adhesion molecule-1 (sVCAM-1), intercellular adhesion molecule-1 (sICAM-1) and E-selectin (sE-selectin) in sera of normal and preeclamptic pregnancies. We studied the serum levels of sVCAM-1, sICAM-1 and sE-selectin in normal pregnant women (n=63), mild preeclampsia (n=33) and severe preeclampsia (n=82). Concentrations of soluble adhesion molecules were determined with enzyme-linked immunoassay (ELISA). Serum concentrations of sVCAM-1 were significantly higher in both mild (p=0.004) and severe preeclampsia (p=0.000) than normal pregnancy. There were also significant differences in sVCAM- 1 levels between mild and severe preeclampsia (p=0.002). sICAM-1 levels of severe preeclampsia were statistically different from those of normal pregnancy (p=0.038). Levels of sE-selectin were elevated in both mild (p=0.011) and severe preeclampsia (p=0.000) compared to normal pregnancy, but no statistical difference between the mild and severe preeclampsia (p=0.345). These results suggest that all three soluble adhesion molecules are increased in severe preeclampsia, and sVCAM-1 among them may be useful in predicting the severity of preeclampsia.     

Serum paraoxonase-1 activity in women with endometriosis and its relationship with the stage of the disease

BACKGROUND: There is increasing evidence that oxidative stress may play a role in the pathophysiology of endometriosis. Serum paraoxonase-1 (PON-1) is a high-density lipoprotein (HDL) associated enzyme that prevents oxidative modification of low-density lipoprotein (LDL). The aims of the study were to (i) compare the serum PON-1 activity in women with endometriosis versus controls and (ii) assess whether PON-1 activity can be used as a diagnostic test for endometriosis. METHODS: A total of 87 women who underwent laparoscopy or laparotomy were divided into groups by visual diagnosis at surgery: control patients (n = 40) with no pathologic findings; endometriosis sufferers with minimal to mild (n = 24) and moderate to severe (n = 23) stage. Serum PON-1 activity was measured spectrophotometrically. Lipid hydroperoxide (LOOH) levels were measured by iodometric assay. Serum triglyceride (TG), total cholesterol (TC), HDL and LDL levels were also determined. RESULTS: PON-1 activity was significantly lower whereas LOOH levels were significantly higher in women with moderate to severe endometriosis than in women with minimal to mild endometriosis and controls, and in women with minimal to mild endometriosis compared with control groups (P < 0.0001, for all). A significant negative correlation was found between PON-1 activity and stage of the disease (r=-0.74, P < 0.0001). PON-1 activity and HDL levels were decreased whereas LOOH, TG, TC and LDL levels increased in all women with endometriosis versus controls (all P < 0.0001). CONCLUSIONS: Reduced serum PON-1 activity and increased LOOH might contribute to the increased susceptibility for the development of atherosclerosis. PON-1 activity can be used as a diagnostic test to detect endometriosis.     

Angiogenic imbalance and plasma lipid alterations in women with preeclampsia from a developing country

Background: An imbalance between anti-angiogenic factors (e.g. soluble vascular endothelial growth factor receptor-1 (s-FLT1) and soluble endoglin (s-Eng)) and pro-angiogenic factors (e.g. placental growth factor (PlGF)) as well as increased oxidized low-density lipoprotein (ox-LDL) concentrations have been associated with preeclampsia (PE). Risk factors associated with the development of PE, however, are known to be different between developed and developing countries. The aim of the study was to determine the levels of s-FLT1, s-Eng, PIGF, and ox-LDL in women with PE from a developing country. Methods: A multi-center case–control study was conducted. One hundred and forty three women with PE were matched by age and parity with 143 healthy pregnant women without cardiovascular or endocrine diseases. Before delivery, blood samples were taken and serum was stored until analysis. Results: Women with PE had lower concentrations of PIGF (p < 0.0001) and higher concentrations of s-Eng (p = 0.001) than healthy pregnant women. There were no differences between the groups regarding ox-LDL or s-FLT1. Women with early onset PE had higher s-FLT1 concentrations (p = 0.0004) and lower PIGF concentrations (p < 0.0001) than their healthy pregnant controls. Women with late onset PE had higher concentrations of s-Eng (p = 0.005). Women with severe PE had higher concentrations of s-Eng (p = 0.0008) and ox-LDL (p = 0.01), and lower concentrations of PIGF (p < 0.0001). Conclusions: Women with PE from a developing country demonstrated an angiogenic imbalance and an increased rate of LDL oxidation. Findings from this study support the theory that PE is a multifactorial disease, and understanding differences in these subpopulations may provide a better target to approach future therapies.     

Plasma concentrations of Lp(a) lipoprotein and TGF-β1 are altered in preeclampsia

This study was performed to investigate the possible association between preeclampsia and the plasma concentrations of Lp(a) lipoprotein and TGF-β₁ in a large series of patients. Additionally, correlation between the concentrations of these molecules and the severity of preeclampsia or fetal growth retardation was evaluated. Following clinical examination and biochemical analyses, both electroimmunoassay and RIA technique were used for quantitative determinations of plasma Lp(a) lipoprotein. ELISA technique was used to measure the active form of TGF-β₁ in plasma of pregnant normotensive and preeclamptic women. We examined 154 women with preeclampsia (preeclampsia group) and 76 healthy, pregnant normotensive women (control group). The preeclampsia group was further divided into the following subgroups: mild preeclampsia, severe preeclampsia and preeclampsia with fetal growth retardation. Plasma levels of Lp(a) lipoprotein were lower in the total preeclampsia group as well as in all preeclampsia subgroups (5.45 ± 7.41, 5.58 ± 8.02, 5.08 ± 5.38, and 4.32 ± 5.28 mg/dl in the total preeclampsia group, and in subgroups with mild preeclampsia, severe preeclampsia, and preeclampsia with fetal growth retardation, respectively) than in the control group (7.84 ± 9.26 mg/dl) as determined by quantitative electroimmunoassay. Corresponding results were obtained with a radioimmunoassay (166.03 ± 200.2 U/l in the total preeclampsia group vs. 229.18 ± 257.7 U/l in controls). There was good correlation between the two methods used for Lp(a) lipoprotein measurement. The differences between controls and the total preeclampsia group as well as each preeclampsia subgroup were statistically significant by a non-parametric test (one-way Kruskal-Wallis test). Plasma concentrations of the active form of TGF-β₁ were increased in all preeclampsia subgroups as well as in the total group (5.63 ± 1.68 ng/ml) compared to controls (4.67 ± 1.33 ng/ml). This increase in TGF-β₁ was statistically highly significant. Plasma concentrations of Lp(a) lipoprotein and the active form of TGF-β₁ did not differ significantly between the preeclampsia subgroups. The outcome of this study may suggest involvement of both parameters in the pathophysiology of preeclampsia and may substantiate the notion of a multifactorial etiology of the disease.     

妊娠高血压患者NT-proBNP、sRAGE与心功能的关系

目的 探讨妊娠高血压患者血清N末端脑钠肽前体（NT-proBNP）、可溶性晚期糖基化终末产物受体（sRAGE）的变化及其意义。方法 选取2015年4月~2019年8月我院确诊的妊娠高血压患者95例（病例组）及正常妊娠者95例（对照组）,检测两组的血清NT-proBNP、sRAGE水平、左室舒张末期内径（LVDd）、左室射血分数（LVEF%）、心肌收缩峰值速度（Vs）、二尖瓣舒张早期运动速度/二尖瓣舒张晚期运动速度（E/A）,分析血清NT-proBNP、sRAGE与LVEF及E/A的关系。结果 病例组血清NT-proBNP、sRAGE水平高于对照组,差异有统计学意义（P＜0.05）;病例组LVEF%、Vs、E/A低于对照组,差异有统计学意义（P＜0.05）;病例组的LVDd高于对照组,差异有统计学意义（P＜0.05）;妊娠高血压、轻度子痫前期、重度子痫前期孕妇血清NT-proBNP、sRAGE水平呈逐渐升高趋势,两两比较,差异均有统计学意义（P＜0.05）;妊娠高血压患者血清NT-proBNP、sRAGE水平与LVEF%、E/A值均呈负相关,差异均有统计学意义（P＜0.05）。结论 妊娠高血压患者血清NT-proBNP、sRAGE水平较正常妊娠妇女升高,并且与病情严重程度及发生心功能损害有关。     

ADMA/NOS/NO/cGMP通路系统在子痫前期患者母胎界面的表达及意义

目的：探讨ADMA/NOS/NO/cGMP通路系统在子痫前期患者母胎界面的表达及意义。方法：分别选取重度子痫前期、轻度子痫前期、妊娠期高血压患者各20例,另选同期行剖宫产的单胎初产健康妊娠妇女20例作为对照。检测并比较各组胎盘组织NO和cGMP水平、总NOS活性,免疫组化SP法检测胎盘组织eNOS和iNOS表达。高效液相色谱法检测各组脐静脉内皮细胞（Human umbilical vein endothelial cells,HUVECs）内ADMA水平。结果：重度、轻度子痫前期组胎盘组织NO水平分别为（7.6±3.6） μmol/g、（11.4±4.3） μmol/g,均显著低于对照组（均P＜0.05）;重度、轻度子痫前期组胎盘组织cGMP水平分别为（3.26±0.31）pmol/g、（4.53±0.42）pmol/g,均显著低于对照组（均P＜0.05）,且4组胎盘组织cGMP水平与NO水平呈正相关关系（r=0.672）;重度、轻度子痫前期组胎盘组织总NOS活性分别为（10.4±3.0）、（14.8±1.6 ）U/mg蛋白质,显著低于对照组（均P＜0.05）,4组胎盘组织总NOS活性与NO水平呈正相关关系（r=0.785）;重度、轻度子痫前期组胎盘组织eNOS表达显著低于对照组（均P＜0.05）,重度子痫前期组iNOS表达显著高于对照组（P＜0.05）;重度子痫前期、轻度子痫前期及妊娠期高血压3组HUVECs内ADMA水平均显著高于对照组（均P＜0.05）,且4组患者HUVECs内ADMA水平与胎盘组织NO水平呈负相关关系（r=-0.582）。结论：ADMA/NOS/NO/cGMP通路系统可能在子痫前期的发病中起重要作用。