子痫前期患者血脂代谢调节的探讨

目的:探讨子痫前期患者脂代谢调节水平及其异常调节情况。方法:采取前瞻性研究方法,随机抽取317例正常孕妇,分别测定不同妊娠周数的血脂和游离脂肪酸(FFA)水平;选取产前规律检查的正常孕妇54例,分别于孕10~14周,20~24周及30~34周测定血脂代谢水平。并随机抽取孕周相同、年龄相同或相近的正常孕妇77例与重度子痫前期77例进行1:1配对研究,比较血脂代谢变化。结果:正常妊娠妇女血清中TG、TCHO和LDL水平随妊娠周数增加而增加,但FFA和HDL水平并未随妊娠的周数的增加而发生明显变化。重度子痫前期TG和FFA水平较对照组明显升高(P<0.05),而HDL水平下降(P<0.05);FFA/HDL和LDL/HDL比值较对照组明显升高(P<0.05),而FFA/TG、FFA/LDL及FFA/TCHO比值无明显变化(P>0.05)。早发型重度子痫前期患者中肝功损害组的TCHO和LDL水平较对照组明显增高(P<0.05)。结论:重度子痫前期患者存在脂质代谢调节异常,具有损伤作用的FFA增加,而具有保护作用的HDL下降,FFA/HDL比值升高,重度子痫前期正常的血脂代谢平衡发生变化,FFA增加可能在重度子痫前期脂质代谢异常调节方面起到一定作用。     

子(癎)前期患者血清对氧磷酶基因多态性及其活力检测

目的研究对氧磷酶1(paraoxonase1,PON1)基因R192Q位点多态性及PON1活力和血脂脂蛋白水平在子前期(preeclampsia,PE)发病中的相关性。方法共139例孕妇,其中PE组73例,包括轻度子前期(mildpreeclampsia,MPE)34例,重度子前期(severepreeclampsia,SPE)39例,对照组为66例健康孕妇。应用全自动生化分析仪测定血脂脂蛋白,乙酸苯酯法测定PON1活力,聚合酶链反应(polymerasechainreaction,PCR)、限制性片段长度多态性(restrictionfragmentlengthpolymorphism,RFLP)方法分析PON1R192Q位点多态性。结果(1)SPE组胆固醇(cholesterol,CHOL)、甘油三脂(triglyeride,TG)、低密度脂蛋白(lowdensitylipoprotein,LDL)和载脂蛋白B(apolipoproteinB,apoB)均比对照组高(P<0·05),而高密度脂蛋白(highdensitylipo-protein,HDL)和载脂蛋白A(apolipoproteinA,apoA)比对照组低(P<0·05)。MPE组TG、HDL、apoA和apoB与对照组差异显著(P<0·05),CHOL和LDL与对照组差异无显著性(P>0·05),与SPE组差异显著(P<0·05)。(2)PE组PON1活力明显低于对照组(P<0·05)。MPE组与SPE组比较差异无显著性(P>0·05)。(3)PE组和对照组间的基因型变异频率和R、Q等位基因频率均有统计学差异(P均<0·05)。(4)PON1活力比较,QQ基因型分别高于RR和RQ基因型(P均<0·05),RQ基因型比RR基因型高(P<0·05)。结论PE患者PON1活性下降。PON1基因R192Q位点多态性与PON1活力有关,QQ基因型PON1活力最高,其次是RQ和RR基因型。PON1R192Q位点多态性与PE发病有关,R等位基因可能是其易感基因。     

孕妇血清妊娠相关蛋白-A及超敏C反应蛋白水平变化与子痫前期的关系研究

目的:探讨妊娠相关蛋白-A( PAPP-A)及超敏C反应蛋白(hsCRP)在子痫前期发病中的作用.方法:选择年龄、孕产次相匹配的轻度子病前期(MPE组)、重度子病前期(SPE组)及正常妊娠孕妇(对照组)各30例.检测其血清PAPP-A和hsCRP水平,分析二者与相关临床资料的相关性.结果:①SPE组的新生儿出生时平均体重、Apgar评分、胎盘重量均显著低于对照组,差异有统计学意义(P＜0.05),小于胎龄儿发生率、新生儿窒息率明显高于对照组,差异有统计学意义(P＜0.05).②对照组、MPE组及SPE组血清PAPP-A和hsCRP水平依次增高,两两比较,差异均有统计学意义(P＜0.05).③3组血清PAPP-A与hsCRP水平均呈明显正相关(P＜0.05);3组孕妇血清hsCRP水平与HCT均无明显相关性(P ＞0.05);MPE及SPE组血清PAPP-A和hsCRP水平与舒张压及24小时尿蛋白定量均呈明显正相关(P＜0.05).结论:PAPP-A及hsCRP水平升高可能是子病前期发病的重要因素,二者可能共同参与子痛前期发病.     

子痫前期血清脂联素水平变化与胰岛素抵抗的关系

目的 探讨子痫前期患者血清脂联素水平变化及其与胰岛素抵抗的关系.方法 选取2006年1月至2008年10月于解放军第202医院妇产科住院分娩的子痫前期患者110例为研究时象,其中轻度子痫前期患者58例,重度子痫前期患者52例,另取68例正常孕妇作为对照组.采用酶联免疫吸附法(ELIsA)测定各组孕妇血清脂联素水平,同时测定各组孕妇空腹血糖、空腹胰岛素水平,并计算胰岛素抵抗指数,以评价胰岛素抵抗程度.结果 轻度子痫前期患者脂联素水平(15.59±2.42)mg/L明显高于对照组(11.52±1.27)mg/L(P<0.05),重度子痫前期患者脂联素水平(20.47±3.09mg/L)明显高于对照组及轻度子痫前期组(P<0.01).空腹血糖、空腹胰岛素水平及胰岛素抵抗指数在各组之间无统计学意义(P>0.05).在子痫前期患者中血清脂联素水平与空腹胰岛素水平及胰岛素抵抗指数显著负相关(r值分别为-0.628,-0.389,P值分别为0.002,0.009).结论 脂联素可能参与了子痫前期的发生、发展过程,脂联素可能成为反映胰岛素抵抗严重程度的指标.     

子痫前期患者血浆中可溶性内皮细胞蛋白C受体及凝血酶激活的纤溶抑制物的变化及临床意义

目的:探讨子痫前期(PE)患者血浆中可溶性内皮细胞蛋白C受体(sEPCR)和凝血酶激活的纤溶抑制物(TAFI)水平的变化及临床意义。方法:收集年龄、孕周相匹配的重度PE患者48例(SPE组)、轻度PE患者39例(MPE组)、正常孕妇63例(对照组)为研究对象。测定所有研究对象血浆中sEPCR、TAFI、D二聚体(D-Dimer)、凝血酶原时间(PT)及活化部分凝血活酶时间(APTT),并进行相关性分析。观察胎盘中血栓形成的情况。结果:PE患者血浆中sEPCR、TAFI及D-Dimer水平均显著高于对照组(P<0.05),SPE组显著高于MPE组(P<0.05)。对照组、SPE组及MPE组患者血浆中PT、APTT水平则无显著差异(P>0.05)。PE患者血浆中sEPCR与TAFI水平呈正相关(P<0.05);sEPCR、TAFI水平分别与D-Dimer水平呈正相关(P<0.05)。PE患者胎盘组织中有血栓形成,而对照组无血栓形成。结论:血浆中高水平sEPCR及TAFI能促进胎盘微血栓的形成,与PE的发生密切相关。     

重度子痫前期产妇血清和胎盘组织中脂蛋白脂酶的表达及意义

目的:探讨脂蛋白脂酶(LPL)在重度子痫前期产妇血清和胎盘组织中的表达及意义。方法:收集2008年9月至2009年5月在上海市第六人民医院产科住院并分娩的重度子痫前期产妇26例为子痫前期组,选择同期分娩的正常产妇30例为对照组。用酶法检测血脂浓度,ELISA法检测血清LPL浓度,RT-PCR法和Western blot法检测胎盘组织LPL基因和蛋白的表达。结果:①子痫前期组血脂浓度明显高于对照组(P<0.05)。②子痫前期组血清LPL浓度及胎盘组织LPL基因和蛋白表达水平均明显低于对照组(P<0.05)。③子痫前期组血清LPL浓度与胎盘组织LPL蛋白表达水平呈正相关(r=0.421,P<0.05),与甘油三酯(TG)呈负相关(r=-0.668,P<0.01),与高密度脂蛋白(HDL)呈正相关(r=0.876,P<0.01)。结论:子痫前期患者机体脂蛋白脂酶表达降低,脂蛋白脂酶可能通过参与高血脂代谢在子痫前期发病过程中起着重要作用。     

子痫前期患者血清脂联素表达水平与血脂代谢及胰岛素抵抗的相关性

目的:探讨脂联素、血脂代谢及胰岛素抵抗与子痫前期发病的关系。方法:选择2007年9月—2008年7月住院分娩的妊娠妇女120例及妊娠前健康体检妇女30例,其中60例子痫前期妊娠妇女按发病时妊娠周不同分为早发型组(29例,发病时妊娠周≤34周)和晚发型组(31例,发病时妊娠周>34周)。60例正常晚期妊娠妇女分为妊娠≤34周组和妊娠>34周组,各30例;采用酶联免疫吸附法(ELISA)检测各组血清脂联素与胰岛素水平;应用全自动生化分析仪测定血脂、血糖水平。检测临床相关指标,包括血压、妊娠前体质量等,并进行相关性分析。结果:①早发型子痫前期组血清脂联素低于同期对照组,晚发型子痫前期组血清脂联素低于同期对照组,差异均有统计学意义(P<0.05);且早发型组低于晚发型组,差异有统计学意义(P<0.05),校正红细胞压积(HCT)后,仍有统计学意义。②早发型、晚发型子痫前期组血清三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、载脂蛋白B(ApoB)、空腹胰岛素(FINS)水平及胰岛素抵抗指数(IRI)均高于同期对照组,而高密度脂蛋白(HDL)、载脂蛋白A1(ApoA1)低于同期对照组(均P<0.05)。③早发型、晚发型子痫前期组血清脂联素与TG、收缩压(SP)、舒张压(DP)、平均动脉压(MAP)及IRI均呈负相关;与HDL呈正相关。结论:子痫前期妊娠妇女血清脂联素表达降低可能与子痫前期发病有关;血脂代谢异常及胰岛素抵抗与子痫前期患者脂联素表达降低有关,可能参与低脂联素促发子痫前期的病理生理机制。     

孕妇血清及其新生儿脐血、胎盘组织中脂肪型脂肪酸结合蛋白表达变化与子痫前期发病的关系

目的 探讨孕妇血清及其新生儿脐血中脂肪型脂肪酸结合蛋白(FABP4)水平、胎盘组织中FABP4 mRNA的表达变化在子痫前期发病中的作用.方法 选择2008年12月-2009年10月在福建省妇幼保健院产科住院分娩的60例重度子痫前期孕妇,按发病时孕周不同分为早发型子痫前期组(发病时孕周≤34周)和晚发型子痫前期组(发病时孕周>34周)各30例;另选同期正常晚期孕妇60例,根据孕周不同分为早发型对照组(孕周≤34周)和晚发型对照组(孕周>34周)各30例.采用酶联免疫吸附试验(ELISA)检测孕妇血清FABP4、空腹血糖(FPG)、空腹胰岛素(FINS)及新生儿脐血FABP4水平;采用稳态模型评估法计算胰岛素抵抗指数(HOMA-IR);采用逆转录(RT)PCR技术检测胎盘组织中FABP4 mRNA的表达;记录临床相关指标,包括孕妇入院时体质指数(BMI)、收缩压(SP)、舒张压(DP)及平均动脉压(MAP)、血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、肌酐(Cr)、尿酸(UA)、肾小球滤过率(GFR)、24 h尿蛋白定量和新生儿出生体质量.结果 (1)早发型及晚发型子痫前期组孕妇血清中FABP4水平分别为(176±9)及(170±9)ng/L,早发型及晚发型对照组分别为(81±13)及(94±15)ng/L,分别比较,差异均有统计学意义(P<0.05).(2)早发型及晚发型子痫前期组孕妇血清FINS、HOMA-IR水平分别为(21.9±4.3)mU/L、5.1±1.7及(22.6±4.0)mU/L、4.9±1.5,分别比较,差异均有统计学意义(P<0.05).(3)早发型及晚发型子痫前期组孕妇胎盘组织中FABP4 mRNA的表达水平分别为3.17±0.89及2.97±0.72,均高于晚发型对照组的1.00±0.28,分别比较,差异均有统计学意义(P<0.05);但早发型子痫前期组与晚发型子痫前期组比较,差异无统计学意义(P>0.05).(4)早发型及晚发型子痫前期组新生儿脐血中FABP4水平分别为(92±10)及(100±8)ng/L,均低于晚发型对照组的(141±18)ng/L,分别比较,差异均有统计学意义(P<0.05).早发型子痫前期组、晚发型子痫前期组及晚发型对照组新生儿出生体质量两两比较,差异均有统计学意义(P<0.05).相关性分析结果显示,脐血FABP4水平与孕妇血清FABP4及胎盘组织中FABP4 mRNA表达水平均呈明显负相关(r分别为-0.882、-0.678,P<0.05),与新生儿出生体质量呈明显正相关(r=0.728,P<0.05).(5)早发型及晚发型子痫前期组孕妇血清中FABP4水平与胎盘组织中FABP4 mRNA表达水平均呈明显正相关(r分别为0.609、0.403,P<0.05),与血TG(r分别为0.702、0.562),FINS(r分别为0.528、0.423),HOMA-IR(r分别为0.566、0.519),Cr(r分别为0.443、0.523),UA(r分别为0.438、0.413)均呈明显正相关(P<0.05),而与血HDL(r分别为-0.539、-0.498),GFR(r分别为-0.717、-0.778)均呈明显负相关(P<0.05).结论 子痫前期孕妇血清FABP4水平及胎盘组织中FABP4 mRNA表达水平均明显升高,且两者呈明显正相关.提示FABP4水平升高可能是子痫的期发病的重要因素之一,而胎盘组织中FABP4 mRNA表达水平升高可能是导致子痫的期孕妇血清FABP4水平升高的主要原因.     

FGF21在PCOS患者血清中的表达及意义

目的:评价多囊卵巢综合征(PCOS)患者血清中成纤维细胞因子21(FGF21)的表达,初步探讨FGF21在PCOS发病中的作用。方法:研究对象分为PCOS组和正常对照组。PCOS组分为肥胖患者和非肥胖患者。分别用酶联免疫法(ELISA)测定血清FGF21水平;采取磁酶免法测定黄体生成素(LH)、睾酮(T);应用化学发光法检测空腹血糖(FBG)、空腹胰岛素(Ins)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)水平。结果:PCOS组FGF21表达明显高于对照组(P<0.01),并且与体重指数(BMI)、Ins(r=0.423,P<0.01;r=0.341,P<0.05)成正相关;在PCOS组中,肥胖患者血清中的FGF21水平高于非肥胖患者(P<0.05),与IR、LH(r=0.440,P=0.046;r=0.44,P=0.044)成正相关。结论:PCOS患者血清中FGF21水平明显高于对照组,在PCOS组中肥胖患者血清中FGF21水平明显高于非肥胖患者。FGF21有望成为PCOS治疗中的新突破。     

Circulating oxidized low-density lipoprotein and paraoxonase activity in preeclampsia

Preeclampsia is one of the most frequent complications of pregnancy, however, little is known about its etiology. The objective of this study was to investigate the association of oxidized low-density lipoprotein (oxLDL) and paraoxonase (PON1) activity in women with either preeclampsia or normotensive (NT) pregnancy. The study groups included 41 pregnant women with preeclampsia and 33 normotensive pregnant women. In all patients maternal serum total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides (TGs) were measured using enzymatic methods. Serum PON1 activities and malondialdehyde (MDA) concentrations were measured by spectrophotometric methods, and oxLDL was measured by enzyme-linked immunoassay (ELISA). Serum concentrations of lipid parameters (TC, LDL, VLDL, and TGs) were significantly higher in preeclampsia compared with NT controls (p < 0.001, p < 0.05, p < 0.05, and p < 0.001, respectively). Serum concentrations of MDA and oxLDL were significantly higher, while PON1 activity was significantly lower in preeclampsia compared with NT controls (p < 0.001, p < 0.001, and p < 0.001, respectively). A positive correlation was detected between oxLDL and MDA (r = 0.876), and a negative correlation was detected between both MDA and oxLDL and PON1 (r = -0.837 and r = -0.759, respectively). Our data demonstrate that preeclampsia is associated with increased oxLDL and decreased PON1 activity. Elevated oxidative stress, oxLDL, dyslipidemia and decreased PON1 activities may cause vascular endothelial damage and contribute to the pathophysiology of preeclampsia.     

Fibrinogen concentration and factor VIII activity in women with preeclampsia.

OBJECTIVE: To compare fibrinogen concentration and factor VIII activity obtained from pregnant women with preeclampsia with those obtained from women with either normal pregnancies or with complications unrelated to preeclampsia. MATERIALS AND METHODS: Fibrinogen concentration and factor VIII activity were measured in the following groups: normal pregnancy, consisting of women at routine 16- to 28-week antenatal visits or after admission at term for elective cesarean section; women with non-preeclampsia (non-PE) related conditions, including women with threatened abortion, cholestasis, systemic lupus erythematosus (SLE), and previous deep venous thrombosis (DVT); and women with preeclampsia as defined by the Australasion Society for the Study of Hypertension in Pregnancy (ASSHP) criteria. Blood was collected from 44 women in each group. Fibrinogen concentration and factor VIII activity were measured. RESULTS: Fibrinogen concentrations and factor VIII activities were higher in women with preeclampsia compared with those from women with either normal or complicated pregnancies (p < 0.05). It was twice as likely that a woman with preeclampsia would have a raised fibrinogen and factor VIII levels. The ranges for each analyte did, however, show overlap. Women with preeclampsia were more likely to have both a raised fibrinogen concentration and increased factor VIII activity than other pregnant women (p < 0.001). CONCLUSION: This study has shown a novel increase in both fibrinogen concentration and factor VIII activity in pregnant women with preeclampsia compared with values obtained from women with normal or non-preeclampsia complicated pregnancies, with women with preeclampsia twice as likely to have a raised fibrinogen concentration and increased factor VIII activity. These changes may contribute to the hypercoagulability seen in preeclampsia.     

Urinary N-acetyl-beta-D-glucosaminidase (NAG) activity in women with preeclampsia

OBJECTIVES: Preeclampsia is the pregnancy specific disorder in which reduced organ perfusion and ischemia of the kidney, liver and brain can be detected. In the kidney, the most typical anatomopathological lesion is glomerular endotheliosis but renal tubular damage was also demonstrated. The NAG is an enzyme which is released into urine from the lysosomes of the proximal renal tubules epithelium and therefore increased urinary NAG activity is a marker of tubular damage or dysfunction. DESIGN: The aim of the study was to assess the renal tubular damage in women with preeclampsia by measuring of urinary NAG activity. MATERIALS AND METHODS: The study group consisted of 46 pregnant women in third trimester with preeclampsia. 36 normal pregnant women in third trimester and 26 healthy nonpregnant women served as two control groups. Urinary activity of NAG was measured in the second morning urine sample by colorimetric method and the results were expressed as NAG/creatinine ratio (U/mmol). RESULTS: Urinary NAG/creatinine ratio was increased in normal pregnant women in third trimester (0.77 +/- 0.44 U/mmol) exceeding that of nonpregnant women (0.23 +/- 0.16). In women with preeclampsia, the urinary NAG/creatinine ratio was significantly higher when compared to the normal pregnant women in third trimester (1.46 +/- 1.63 U/mmol). There were no correlation between urinary NAG excretion and blood pressure results in women with preeclampsia. CONCLUSIONS: The increased urinary NAG activity in women with preeclampsia seems to be a sign of proximal tubular damage. The renal function follow up study in such women is indicated.     

血清胱抑素C水平与早发型子痫前期发生和不良妊娠结局关系探讨

目的:研究孕妇发生早发型子痫前期及其出现不良妊娠结局与血清胱抑素C(CC)水平变化趋势关系。方法:选取2009年7月至2011年7月在南方医科大学南方医院妇产科住院治疗并分娩的早发型子痫前期患者69例,其中轻度15例(早发轻度组),重度54例(早发重度组),分析血清CC水平和子痫前期发生及母儿结局的关系。并同期选择产前检查正常的妊娠孕妇100例,检测其孕中期和孕晚期血清CC水平作为对照。结果:①正常妊娠孕妇孕中期和孕晚期时血清CC分别为0.81±0.12mmol/L和1.01±0.18mmol/L。早发轻度组血清CC(1.15±0.39mmol/L)和早发重度组血清CC(1.69±0.68mmol/L),分别与正常妊娠孕妇的孕中期和孕晚期比较,差异均有统计学意义(P<0.05)。②早发重度组的血清CC水平高于早发轻度组(P<0.05);早发重度组收缩压、舒张压、尿酸、肌酐和24小时尿蛋白水平均明显高于早发轻度组(P<0.05);早发重度组的羊水过少、胎儿生长受限、胎死宫内、低蛋白血症、胎盘早剥和HEELP综合征等不良妊娠的发生率高于早发轻度组。③早发重度组中出现不良妊娠结局患者中的CC水平高于未出现不良妊娠结局患者(P<0.05)。结论:子痫前期患者在妊娠中期血清CC水平已高于正常妊娠妇女,可能与子痫前期的发生和不良妊娠结局的出现相关。     

Placental and serum levels of carotenoids in preeclampsia

OBJECTIVE: We compared placental tissue, maternal serum, and umbilical cord venous blood levels of four dietary carotenoids (alpha-carotene, beta-carotene, lycopene, and canthaxanthin) in normal pregnant women and those with preeclampsia. METHODS: Levels of alpha-carotene, beta-carotene, lycopene, and canthaxanthin were measured in placental tissue, maternal serum, and umbilical cord venous blood from 22 normal pregnant women and 19 women with preeclampsia. The criteria for recruitment included gestational age of 30-42 weeks, singleton pregnancy, intact membranes, absence of labor contractions, and absence of any other medical complication concurrent with preeclampsia. Carotenoids were measured using high-pressure liquid chromatography. RESULTS: All four carotenoids were detectable in human placental tissue, maternal serum, and umbilical cord venous blood samples. The levels of beta-carotene, lycopene, and canthaxanthin in placentas from preeclamptic women were significantly lower (P =.032, .009, and .013, respectively, by Mann-Whitney test) than those from normal pregnant women. Maternal serum levels of beta-carotene and lycopene were significantly lower (P =.004 and .008, respectively, by Mann-Whitney test) in women with preeclampsia. However, umbilical cord venous blood levels of these carotenoids were not significantly different between the two groups. CONCLUSION: Lower placental tissue and maternal serum carotenoid levels in women with preeclampsia suggest that oxidative stress or a dietary antioxidant influence might have an effect on the pathophysiology of preeclampsia.     

Changes of serum paraoxonase (an HDL-cholesterol-associated lipophilic antioxidant) and arylesterase activities in severe preeclamptic women

OBJECTIVE: To determine the serum lipid profile, the activity of paraoxonase (PON, the lipophilic antioxidant component of HDL-cholesterol), and alterations of the arylesterase activity in preeclamptic women. STUDY DESIGN: This cross-sectional study included 28 severe preeclamptic, and 24 healthy pregnant women. Fasting venous blood samples were collected during the antepartum period for spectrophotometric determination of the PON and arylesterase activities. RESULTS: In the severe preeclamptic group, the mean levels of total cholesterol, triglycerides, and LDL-cholesterol were 4, 5 and 9.8% higher, respectively, and HDL-cholesterol 9% lower than in the healthy controls. The PON and arylesterase activities were significantly lower in the severe preeclamptic women than in the controls, P<0.001 and P=0.000, respectively. A moderately positive correlation was detected between the serum levels of HDL-cholesterol and PON (r=0.49, P<0.02, n=52) and between HDL-cholesterol and arylesterase (r=0.42, P<0.05, n=52). CONCLUSIONS: Our results suggest that an abnormal lipid profile and decreased PON and arylesterase activities may have a role in pathogenesis of preeclampsia.     

Neurokinin B peptide serum levels are higher in normotensive pregnant women than in preeclamptic pregnant women

OBJECTIVES: The purpose of this study was to examine neurokinin B levels in serum from preeclamptic and normotensive and to investigate the role of neurokinin B in preeclampsia. STUDY DESIGN: Peripheral and uterine venous blood neurokinin B levels were measured in 14 normotensive and 8 preeclamptic pregnant women by radioimmunoassay. RESULTS: Neurokinin B levels in normotensive women were 4.91 +/- 2.67 nmol/L in peripheral and 5.59 +/- 2.06 nmol/L in uterine blood. In pregnant women with preeclampsia, neurokinin B levels were 2.79 +/- 1.68 nmol/L and 3.20 +/- 1.55 nmol/L, respectively. Neurokinin B levels were significantly higher in normotensive women (P=.032 in peripheral and P=.006 in uterine blood). CONCLUSIONS: Neurokinin B serum levels were higher in normotensive women. Higher neurokinin B concentrations in normotensive pregnant women may be due to the advanced gestational age and/or the result of a negative interaction of other vasoactive substances. The role of neurokinin B in preeclampsia remains to be determined.     

Fibrinogen Concentration and Factor VIII Activity in Women with Preeclampsia

Objective: To compare fibrinogen concentration and factor VIII activity obtained from pregnant women with preeclampsia with those obtained from women with either normal pregnancies or with complications unrelated to preeclampsia. Materials and Methods: Fibrinogen concentration and factor VIII activity were measured in the following groups: normal pregnancy, consisting of women at routine 16- to 28-week antenatal visits or after admission at term for elective cesarean section; women with non-preeclampsia (non-PE) related conditions, including women with threatened abortion, cholestasis, systemic lupus erythematosus (SLE), and previous deep venous thrombosis (DVT); and women with preeclampsia as defined by the Australasion Society for the Study of Hypertension in Pregnancy (ASSHP) criteria. Blood was collected from 44 women in each group. Fibrinogen concentration and factor VIII activity were measured. Results: Fibrinogen concentrations and factor VIII activities were higher in women with preeclampsia compared with those from women with either normal or complicated pregnancies (p < 0.05). It was twice as likely that a woman with preeclampsia would have a raised fibrinogen and factor VIII levels. The ranges for each analyte did, however, show overlap. Women with preeclampsia were more likely to have both a raised fibrinogen concentration and increased factor VIII activity than other pregnant women (p < 0.001). Conclusion: This study has shown a novel increase in both fibrinogen concentration and factor VIII activity in pregnant women with preeclampsia compared with values obtained from women with normal or non-preeclampsia complicated pregnancies, with women with preeclampsia twice as likely to have a raised fibrinogen concentration and increased factor VIII activity. These changes may contribute to the hypercoagulability seen in preeclampsia.     

Significance of changes in lipid peroxides and antioxidant enzyme activities in pregnant women with preeclampsia and eclampsia

This review addresses the general hypothesis that the pathogenesis of preeclampsia and eclampsia are related to an imbalance of increased oxidative stress and lipid peroxidation coupled with a deficiency of antioxidant protection. Accordingly, this study was initiated to assess total antioxidant status and free-radical activity in preeclampsia and eclampsia. The patients studied were 44 healthy pregnant women and 45 women with hypertension classified as having preeclampsia (n=27), and eclampsia (n=18). The serum levels of lipid peroxide were significantly increased (p<0.0001) and antioxidant enzyme activities (superoxide dismutase and glutathione levels) in erythrocytes were significantly decreased (p<0.0001) in women with preeclampsia and eclampsia compared with the controls. The groups of preeclampsia and eclampsia had similar values of catalase activities as the controls (p>0.05). There were no correlations between serum levels of lipid peroxide and antioxidant enzyme activities or systolic-diastolic blood pressure of pregnant women with preeclampsia and eclampsia. The mean systolic and diastolic blood pressure, the serum lactate dehydrogenase (LDH) and aspartate transaminase (AST) levels of preeclamptic and eclamptic women were high, whereas haemoglobin (Hb), Hematocrit (Htc) and platelet levels were lower than those of the control subjects (p<0.0001). There were no differences in mean gestational week, whereas the mean age of eclamptic women was lower than that of the other two groups (p<0.001). The serum levels of Alanine-transaminase (ALT) and urea in eclamptic women were significantly higher compared with the other two groups (p<0.0001), whereas creatinine levels were lower than those of the other two groups (p<0.05). Our findings give support to those few studies considering lipid peroxidation as an important factor in the pathogenesis of preeclampsia and eclampsia. Further studies are needed to clarify the relations between lipid peroxidation and antioxidative function and their pathophysiological significance in preeclampsia and eclampsia.     

Maternal circulating nitrite levels are decreased in both normal normotensive pregnancies and pregnancies with preeclampsia.

OBJECTIVE: To evaluate whether maternal nitric oxide synthesis in pregnancies with preeclampsia is different from that in normal normotensive pregnancies. MATERIALS: Maternal circulating combined nitrate and nitrite levels or nitrite level were compared between 10 normotensive nonpregnant women, 30 normotensive pregnant women (10 first-trimester, 10 second-trimester, and 10 third-trimester pregnancies), 20 normotensive postpartum women (10 at 1 week after delivery, and 10 at 4 weeks after delivery), and 13 preeclamptic women (32 to 40 weeks' gestation). End-products of nitric oxide synthesis were measured from maternal venous blood samples using a fluorometric assay. RESULTS: Maternal circulating nitrite levels in nonpregnant women (1.13 +/- 0.22 microM) were significantly higher than those in the first-trimester pregnant women (0.68 +/- 0.13 microM), second-trimester pregnant women (0.65 +/- 0.13 microM), third-trimester pregnant women (0.48 +/- 0.17 microM), first puerperal week women (0.36 +/- 0.16 microM), and fourth puerperal week women (0.67 +/- 0.17 microM), respectively (p < 0.05). Maternal circulating nitrite level was decreased with advancing gestation, still remained low just after delivery, and was increased 4 weeks later. There was no significant difference in maternal circulating nitrite level between preeclamptic women (0.40 +/- 0.17 microM) and third-trimester pregnant women (0.48 +/- 0.17 microM). However, there were no significant differences in maternal circulating combined nitrate and nitrite levels among the groups. CONCLUSION: These results suggest that the maternal nitric oxide synthesis is not changed in normal normotensive pregnancies and pregnancies with preeclampsia. However, plasma nitrite level, which has stronger spasmolytic activity than the activity of the nitrate, was decreased in both normal normotensive pregnancies and pregnancies with preeclampsia.