高龄初产妇妊高征孕妇脐血清中过氧化脂质及超氧化物歧化酶水平的变化

总结１９９４年５月～１９９６年４月高龄初产妇妊高征患者４０例，并以正常高龄初产妇５５例作为对照组，测定孕晚期孕妇及脐血清中ＬＰＯ及ＳＯＤ含量的变化。高龄初产妇妊高征孕妇血清ＬＰＯ水平比对照组明显升高（Ｐ＜０．００１），血清ＳＯＤ水平明显降低（Ｐ＜０．００１），并随病情的加重，血清ＬＰＯ水平升高及血清ＳＯＤ水平降低更为显著，但两组脐血清ＬＰＯ及ＳＯＤ水平比较，则无明显统计学差别（Ｐ＞０．１及＞０．０５）。妊高征组ＩＵＧＲ明显高于对照组（Ｐ＜０．００５）。提示妊高征的发病与ＩＵＧＲ的发生与孕妇血中高水平的ＬＰＯ有关。     

大鼠精索静脉曲张对睾丸氧自由基和LPO浓度的影响

应用成年Ｗｉｓｔａｒ大鼠制作精索静脉曲张动物模型，术后３月，处死动物取出睾丸。以电子自旋共振（ＥＳＲ）法测试睾丸组织的氧自由基相对自旋浓度，ＴＢＡ法和化学发光法分别检测过氧化脂质（ＬＰＯ）含量、超氧化物歧化酶（ＳＯＤ）水平。实验结果表明，精索静脉曲张组（ＶＧ）左、右睾丸氧自由基自旋浓度明显高于假手术对照组（ＣＧ）（Ｐ＜Ｏ．０５）；ＶＧ双睾ＬＰＯ含量显著高于ＣＧ（Ｐ＜０．０１）；睾丸氧自由基相对自旋浓度和ＬＰＯ含量呈明显正相关（ｒ＝０．５４，Ｐ＜０．０５）；．ＶＧ双睾ＳＯＤ水平均显著低于ＣＧ（Ｐ＜０．０１）；睾丸ＳＯＤ水平与氧自由基自旋浓度呈显著负相关（ｒ＝－０．９１，Ｐ＜０．０１）。上述结果提示：精索静脉曲张大鼠睾丸组织中含有大量的氧自由基和ＬＰＯ，损伤睾丸细胞及其各级生物膜，会导致睾丸生精功能紊乱造成不育，而睾丸氧自由基清除障碍可能是氧自由基浓度增高继之ＬＰＯ含量增多的重要机制之一。     

妊娠期糖尿病患者母血及脐血中过氧化脂质、超氧化物歧化酶水平变化的研究

为探讨妊娠期糖尿病患者母血及脐血清中ＬＰＯ和ＳＯＤ的关系；测定正常孕妇和妊娠期糖尿病孕妇及其脐血中ＬＰＯ与ＳＯＤ含量。结果：妊娠期糖尿病组与正常孕妇血中ＬＰＯ水平比较，随孕周增加ＬＰＯ升高，而孕晚期明显升高，有统计学差异，Ｐ＜０．００５，ＳＯＤ水平随孕周增加而降低，而孕晚期明显下降，有统计学差异，Ｐ＜０．０５。结论：本研究提示妊娠期糖尿病的发生与母血中高水平的ＬＰＯ和ＳＯＤ降低有关。     

输精管结扎家兔血清总胆固醇、酯质过氧化物及一些酶系的变化

应用日本大耳白兔复制输精管结扎模型，分为输精管结扎２５月组（ＶＧ２５）和６月组（ＶＧ６），并设同龄假手术对照组（ＳＯＧ２５和ＳＯＧ６）．实验结果表明，１．增龄可使血清总胆固醇（Ｃｈ）和甘油三脂（ＴＧ）含量增高，肌酸磷酸激酶（ＣＰＫ）、乳酸脱氢酶（ＬＤＨ）、谷草转氨酶（ＧＯＴ）、ａ－羟丁酸脱氢酶（ＨＢＤＨ）的血清水平略增高，但ＶＧ与ＳＯＧ比较无差异；２．血清酸性磷酸酶（ＡＣＰ）水平，２５月组明显高于６月组（Ｐ＜０．０５），ＶＧ与ＳＯＧ比较无差异（Ｐ＞０．０５）；３．血清脂质过氧化物（ＬＰＯ）含量，２５月组明显地高于６月组（Ｐ＜０．０５），而输精管结扎对其无影响；４．相关检验表明，血清ＬＰＯ含量与血清ＣＰＫ和ＡＣＰ水平均呈明显正相关关系，ｒ值分别为０．４７２（Ｐ＜０．０５），０．６８０（Ｐ＜０．００１）。提示血清酶水平的增高与膜的脂质过氧化有关。输精管结扎对老化过程、细胞及亚细胞膜结构无不良影响。     

高龄初产妇妊高征孕妇脐血清中过氧化脂质及超氧化物…

总结１９９４年５月－１９９６年４月高龄初产妇妊高征患者４０例，并以正常高龄发产妇５５例作为对照组，测定孕晚期孕妇及脐血清中ＬＰＯ及ＳＯＤ含量的变化。高龄初产妇妊高征发血清ＬＰＯ水平比对照组明显升高（Ｐ〈０．００１），血清ＳＯＤ水平明显降低（Ｐ〈０．００１），并随病情的加重，血清ＬＰＯ水平升高及血清ＳＯＤ水平降低更为显著，但两组脐血清ＬＰＯ及ＳＯＤ水平比较，则无明显统计学差别（Ｐ〉０．１及〉０．５）     

胎儿宫内发育迟缓时胎盘病理改变与孕妇血及脐血中一氧化氮水平的关系

目的了解胎儿宫内发育迟缓（ＩＵＧＲ）时胎盘病理改变与母血及脐血中一氧化氮（ＮＯ）水平的关系。方法对１９９７年１１月～１９９８年１０月３８例妊娠合并胎儿宫内发育迟缓（ＩＵＧＲ组）及３０例正常孕妇（对照组）分娩后的胎盘及胎儿附属物进行分析。用隔还原显色法测定母血及脐血ＮＯ水平。结果ＩＵＧＲ组中２６例有胎盘、脐带病理改变（６８．４２％）。主要表现为绒毛发育迟缓及绒毛炎;对照组中５例有胎盘病理改变（１６．６７％）,两组比较差异有极显著性（Ｐ＜０．０１）;ＩＵＧＲ组中母血及脐血ＮＯ水平均低于对照组（Ｐ＜０．０５,Ｐ＜０．０１）;ＩＵＧＲ组中２６例胎盘病理改变明显,其母血及脐血ＮＯ水平低于胎盘无明显病理改变者（Ｐ＜０．０５,Ｐ＜０．０５）;两组脐血ＮＯ水平均高于母血ＮＯ水平（Ｐ＜０．０１,Ｐ＜０．０５）,两组脐血与母血ＮＯ水平均有相关性（ｒ＝０．５４７５,ｒ＝０．８５０６）;脐血ＮＯ水平与新生儿体重在ＩＵＧＲ组未发现明显相关性（ｒ＝０．２８３８）。结论ＩＵＧＲ时,胎盘发生明显病理变化,导致母血及脐血中ＮＯ的水平降低。     

正常晚期妊娠胎儿脐动脉、大脑中动脉及腹主动脉血流速度波形与胎儿血气相关性探讨

目的探讨正常妊娠胎儿血流速度波形与胎儿血气的相关性。方法应用彩色多普勒超声对４５例正常晚期妊娠初孕妇女于剖宫产术前２４小时内进行胎儿脐动脉（ＵＡ）、大脑中动脉（ＭＣＡ）及腹主动脉（ＡｂＡｏ）的血流速度波形（ＦＶＷｓ）检查，计算搏动指数（ＰＩ）、阻力指数（ＲＩ）及收缩期最大血流速度（Ｓ）与舒张末期血流速度（Ｄ）的比值（Ｓ／Ｄ），同时对剖宫产分娩的新生儿立即进行脐动脉血气ｐＨ、二氧化碳分压（ＰＣＯ２）、氧分压（ＰＯ２）测定。结果ＵＡＲＩ与血ｐＨ、ＰＯ２呈明显负相关（Ｐ＜０．０１，Ｐ＜０．０５），与ＰＣＯ２呈正相关（Ｐ＜０．０５），ＭＣＡＲＩ与血ｐＨ、ＰＯ２呈明显正相关（Ｐ＜０．０１，Ｐ＜０．０５），与ＰＣＯ２呈负相关（Ｐ＜０．０５）。结论产前监测ＵＡ及ＭＣＡ的血流速度波形，可间接了解胎儿血气情况，及时判断胎儿宫内安危的状况。     

一氧化氮在妊高征发病及子宫-胎盘-胎儿循环中的调节作用

目的：探讨一氧化氮（ＮＯ）在妊高征发病及在子宫－胎盘－胎儿循环阻力中的调节作用和对胎儿生长发育的影响。方法：采用Ｇｒｅｉｓｓ法测定了４３例妊高征患者（妊高征组）分娩前后外周血及脐血血清ＮＯ的含量，以２５例正常晚孕妇（正常晚孕组）及１８例健康未孕妇（未孕组）作对照。应用彩色多普勒超声检测了部分病例子宫动脉及脐动脉血流阻力指标Ｓ／Ｄ值，并观察了部分病例胎盘绒毛血管的超微结构变化。结果：妊高征组产前外周血及脐血ＮＯ含量均低于正常晚孕组（Ｐ＜０．０１）。脐血ＮＯ含量高于母血（Ｐ＜０．０１）。妊高征组外周血及脐血血清ＮＯ含量均与脐动脉Ｓ／Ｄ值呈负相关（ｒ分别为－０．５２，Ｐ＜０．０５及－０．５８，Ｐ＜０．０１）。中、重度患者的胎盘绒毛血管均有不同程度的病变。结论：ＮＯ的合成减少可能是妊高征发病中的一个重要环节，妊高征患者ＮＯ合成减少与胎盘循环阻力增高及绒毛血管的超微结构改变可能互相影响、互为因果。     

过期妊娠孕妇机体过氧化与胎盘功能关系的研究

测定足月妊娠及过期妊娠红细胞超氧化物歧化酶（ＳＯＤ）和全血谷胱甘肽过氧化物酶（ＧＳＨ－Ｐｘ）活力，血清脂质过氧化物（ＬＰＯ）及血清Ｅ３，ｈＰＬ及血浆ＴＸＢ２和６－ｋｅｔｏ－ＰＧＦ１α（６ＫＰ）水平。结果显示过期妊娠者ＳＯＤ，ＧＳＨ－Ｐｘ活力明显低于正常足月妊娠，Ｐ〈０．００１，ＬＰＯ明显高于正常足月妊娠，Ｐ〈０．０５，同时Ｅ３，ｈＰＬ下降，Ｐ〈０．００１，６ＫＰ亦降低，Ｐ〈０．０５。在过期妊娠期中     

妊高征患者血浆内皮素、过氧化脂质和红细胞超氧化物歧化酶活性的变化

目的：探讨内皮素－１（ＥＴ－１）和过氧化脂质（ＬＰＯ）在妊高征发病中的作用。方法：分别用放射免疫法、硫代巴比妥酸荧光微量法和邻苯二酚自氧化法，测定９５例妇女血浆ＥＴ－１、ＬＰＯ和红细胞超氧化物歧化酶（ＲＢＣ－ＳＯＤ）的活性。其中正常非妊娠妇女１５例（对照组），正常晚期妊娠妇女２０例（正常妊娠组），妊高征患者６０例（妊高征组）。结果：（１）正常妊娠组血浆ＥＴ－１、ＬＰＯ和ＲＢＣ－ＳＯＤ活性均高于对照组（Ｐ＜０．０１），但ＬＰＯ／ＲＢＣ－ＳＯＤ比值差异无显著性；（２）妊高征组的ＥＴ－１和ＬＰＯ／ＲＢＣ－ＳＯＤ比值显著高于正常妊娠组，且随病情的加重而升高，产后３～７天迅速下降；（３）妊高征组的ＥＴ－１和ＬＰＯ／ＲＢＣ－ＳＯＤ比值呈正相关（ｒ＝０．８４６，Ｐ＜０．００１）。结论：提示机体内氧化和抗氧化平衡失调与内皮细胞损伤，在妊高征发病过程中起重要作用。     

应用硫酸镁治疗胎儿生长迟缓

目的　探讨胎儿生长迟缓 (intrauterinegrowthretardation ,IUGR)孕妇的静脉血与新生儿脐静脉血中镁离子含量的变化及其与新生儿体重的关系。方法　将 39例IUGR孕妇随机分为治疗 1组 14例 ,治疗 2组 14例 ,未治疗组 11例。治疗 1组用 10 %葡萄糖 5 0 0ml 复方丹参液 14ml 低分子右旋糖酐 5 0 0ml静脉滴注 ;治疗 2组除有与治疗 1组相同的处方外 ,再加用 5 %葡萄糖 5 0 0ml 2 5 %硫酸镁 2 0ml静脉滴注 ,并以同期分娩的 12例正常孕妇为对照组。采用全自动生化分析仪 ,测定 4组孕妇的肘静脉血和新生儿脐静脉血中的镁离子含量。结果　治疗 1组孕妇静脉血中镁离子含量[(0 6 9± 0 0 5 )mmol/L]和未治疗组 [(0 6 8± 0 0 2 )mmol/L]比较 ,差异无显著性 (P >0 0 5 ) ,和治疗 2组 [(1 0 6± 0 0 9)mmol/L]比较 ,差异有显著性 (P <0 0 5 ) ,各组新生儿脐血镁离子含量比较 ,差异有极显著性 (P <0 0 1) ,对照组和治疗 2组、未治疗组和治疗 1组比较 ,差异无显著性 (P >0 0 5 ) ,其余各组间比较 ,差异有极显著性 (P <0 0 1) ,各组胎盘重量比较 ,差异有极显著性 (P <0 0 1) ,各组新生儿体重比较 ,差异有显著性 (P <0 0 5 )。结论　镁缺乏是IUGR发生的原因之一 ,中晚期孕妇适量补充镁有预防和治疗IUGR的作用     

硫酸镁对胎儿生长受限孕鼠胎盘组织半胱氨酸天冬氨酸蛋白酶3表达的影响

目的探讨硫酸镁对胎儿生长受限(FGR)孕鼠胎盘组织半胱氨酸天冬氨酸蛋白酶3(caspase-3)表达的影响,及硫酸镁治疗FGR的机理。方法烟熏法构建FGR模型。实验对象分为对照组(10只)、治疗组(18只)、FGR组(10只)。治疗组中低剂量(硫酸镁300 mg／kg)治疗10只、高剂量(硫酸镁600 mg／kg)治疗8只,皮下注射给药。络合指示剂方法测孕鼠血清Mg2+(血镁)浓度。物理测量胎鼠的各项生理指标。链霉菌抗生物素蛋白-过氧化物酶连接(SP)法及RT-PCR法检测胎盘组织caspase-3的表达情况。结果(1)FGR组孕鼠血镁浓度为(0．55±0．03)mmol／L,高、低剂量治疗组孕鼠血镁浓度分别为(0．72±0．13)、(0．61±0．03)mmol／L,高、低剂量治疗组分别与FGR组比较,差异均有统计学意义(P<0．01)。(2)FGR组孕鼠胎盘重量为(0．63±0．05)g,其胎鼠体重为(2．95±0．46)g,高剂量治疗组分别为(0．80±0．16)、(3．58±0．10)g,两组分别比较,差异均有统计学意义(P<0．05、P<0．01)。(3)FGR组胎盘组织caspase-3 mRNA表达量为0．626±0．036,其蛋白表达量为199．5±4．7,高剂量治疗组分别为0．361±0．030、183．0±3．3,差异均有统计学意义(P< 0．05),低剂量治疗组caspase-3 mRNA表达量为0．525±0．029,与高剂量治疗组比较,差异也有统计学意义(P<0．05)。(4)孕鼠血镁浓度与胎鼠重量、胎盘组织caspase-3 mRNA及蛋白表达量有显著相关性(r=0．899,P=0．038;r=-0．747,P=0．033;r=-0．915,P=0．001)。结论硫酸镁能降低胎盘组织caspase-3 mRNA及蛋白表达,硫酸镁可能通过抑制胎盘caspase-3的表达,减少胎盘滋养细胞、血管内皮细胞等功能细胞的凋亡,从而改善FGR胎鼠的低体重现象。     

Placental growth hormone is increased in the maternal and fetal serum of patients with preeclampsia.

OBJECTIVES: Placental growth hormone (PGH) is a pregnancy-specific protein produced by syncytiotrophoblast and extravillous cytotrophoblast. No other cells have been reported to synthesize PGH Maternal. PGH Serum concentration increases with advancing gestational age, while quickly decreasing after delivery of the placenta. The biological properties of PGH include somatogenic, lactogenic, and lipolytic functions. The purpose of this study was to determine whether the maternal serum concentrations of PGH change in women with preeclampsia (PE), women with PE who deliver a small for gestational age neonate (PE + SGA), and those with SGA alone. STUDY DESIGN: This cross-sectional study included maternal serum from normal pregnant women (n = 61), patients with severe PE (n = 48), PE + SGA (n = 30), and SGA alone (n = 41). Fetal cord blood from uncomplicated pregnancies (n = 16) and PE (n = 16) was also analyzed. PGH concentrations were measured by ELISA. Non-parametric statistics were used for analysis. RESULTS: (1) Women with severe PE had a median serum concentration of PGH higher than normal pregnant women (PE: median 23,076 pg/mL (3473-94 256) vs. normal pregnancy: median 12 157 pg/mL (2617-34 016); p < 0.05), pregnant women who delivered an SGA neonate (SGA: median 10 206 pg/mL (1816-34 705); p < 0.05), as well as pregnant patients with PE and SGA (PE + SGA: median 11 027 pg/mL (1232-61 702); p < 0.05). (2) No significant differences were observed in the median maternal serum concentration of PGH among pregnant women with PE and SGA, SGA alone, and normal pregnancy (p > 0.05). (3) Compared to those of the control group, the median umbilical serum concentration of PGH was significantly higher in newborns of preeclamptic women (PE: median 356.1 pg/mL (72.6-20 946), normal pregnancy: median 128.5 pg/mL (21.6-255.9); p < 0.01). (4) PGH was detected in all samples of cord blood. CONCLUSIONS: (1) PE is associated with higher median concentrations of PGH in both the maternal and fetal circulation compared to normal pregnancy. (2) Patients with PE + SGA had lower maternal serum concentrations of PGH than preeclamptic patients without SGA. (3) Contrary to previous findings, PGH was detectable in the fetal circulation. The observations reported herein are novel and suggest that PGH may play a role in the mechanisms of disease in preeclampsia and fetal growth restriction.     

Maternal plasma corticotrophin-releasing hormone—elevated in preterm labour but unaffected by indomethacin or nylidrin

Summary. The role of corticotrophin-releasing hormone (CRH) in preterm labour was studied in 23 women in preterm labour at between 26 and 33 weeks gestation who were randomly allocated to receive treatment with indomethacin (  n=11  ) or with nylidrin a beta-sympathomi-metic agent (  n=12  ). Maternal plasma CRH in the preterm group (median 70, range 9–597 pmol/1) before therapy was higher (   P < 0.05  ) than that in 23 control pregnancies, without uterine contractions, matched for gestational age (median 51, range 4–127 pmol/1). CHR levels determined after 3 and 24 h of treatment showed a 10% decrease in the indomethacin group and 10–20% decrease in the nylidrin group, but these changes were not statistically significant. After cessation of uterine contractions during tocolysis, 12 women proceeded to give birth preterm (<37 weeks) and their pretreatment CRH levels (median 195, range 9–597 pmol/1) were higher (   P < 0.05  ) than those in women whose pregnancy proceeded to term (median 52, range 16–207 pmol/1). In another group of women, full-term labour was not accompanied by any changes in maternal CRH levels. Umbilical plasma CRH levels were 1.1–9.8% of the paired maternal levels and did not rise with advancing gestational age. Nor had the type of delivery (elective caesarean section before labour, or preterm or term vaginal delivery) any effect on fetal CRH levels. Neither maternal nor fetal CRH was related to maternal or fetal cortisol levels. We conclude that: (i) maternal CRH is elevated in preterm labour, (ii) maternal CRH is not affected by treatment with indomethacin or nylidrin and (iii) fetal CRH is of no significance in the initiation of preterm or term labour.     

胰岛素样生长因子—I与胎儿出生体重的关系

目的 了解胰岛素生长因子－Ｉ（ＩＧＦ－Ｉ）在胎儿生长发育中所起的作用,方法 选择１７１例产妇及其所分娩的新生儿１６４例,根据出生体重将新生儿分为大于胎龄儿（ＬＧＡ）组,产妇７７例,新生儿６４例,适于胎龄儿（ＡＧＡ）组：产妇５９例,新生儿５９例;小儿胎龄儿（ＳＧＡ）组：产妇３５例,新生儿４３例,用放射免疫法测定血清中ＩＧＦ－Ｉ的浓度。结果 母血中ＩＧＦ－Ｉ浓度均高于脐血,两者间存在浓度梯度（Ｐ〈０．     

Unexplained intrauterine fetal death is accompanied by activation of complement

OBJECTIVE: Activation of the complement system has recently been implicated in the mechanisms of fetal loss in the antiphospholipid syndrome. It is, however, possible that complement activation is also involved in other causes of fetal death in the second and third trimesters of pregnancy. We therefore conducted a study to determine whether fetal death is associated with changes in the maternal plasma concentrations of complement split products or anaphylatoxins (C3a, C4a and C5a). STUDY DESIGN: A cross-sectional study was designed to include normal pregnant women (n=60) and patients with fetal death (n=60). Patients with fetal death were classified according to the cause of fetal demise into: a) unexplained (n=44); b) associated with preeclampsia (n=8); and c) associated with chromosomal abnormalities or major congenital fetal anomalies (n=8). The plasma concentrations of C3a, C4a and C5a were measured using sensitive and specific ELISAs. Non-parametric statistics were used for analysis. A P value of <0.05 was considered significant. RESULTS: 1) The median plasma concentration of C5a was higher in patients with fetal death than in normal pregnant women [median 16 ng/mL (range 4.5-402.5) vs. median 11.6 ng/mL (range 1.2-87.1), respectively; P<0.001]; 2) patients with an unexplained fetal death and those associated with preeclampsia had a higher median plasma C5a concentration than normal pregnant women (P=0.002 and P<0.001, respectively); 3) no differences were observed in the maternal plasma concentrations of C3a and C4a among the study groups. CONCLUSIONS: Unexplained fetal death is associated with evidence of complement activation.     

表皮生长因子与胎儿宫内发育迟缓关系的研究

探讨表皮生长因子与胎儿宫内发育迟缓的关系。方法用放射免疫分析,测定８６例妊娠晚期妇女血清,羊水和脐静脉血ＥＧＦ浓度;根据新生儿出生体重,将研究对象分成对照组５４例,大于胎龄儿组１８例和ＩＵＧＲ组１４例。对照组中有１１例同时测定脐动脉血清ＥＧＦ浓度,比较各组间羊水和孕妇,脐血清ＥＧＦ水平及脐动,静脉血清间ＥＧＦ水平的差异。     

可行走式无痛分娩的镇痛效果及其对母儿的影响

目的：分析可行走式无痛分娩的镇痛效果及其对母儿的影响。方法：回顾性分析2012年9月-2013年9月收治的177例孕产妇,按其分娩方式分为无痛分娩组（n=83）和常规分娩组（n=94）,比较2组产妇各产程疼痛评分、产程及新生儿情况。结果：无痛分娩组剖宫产率低于常规分娩组（P＜0.05）;无痛分娩组第一产程较常规分娩组缩短,其第二产程较常规分娩组延长（P＜0.05）,2组产妇第三产程差异无统计学意义（P＞0.05）;无痛分娩组产妇各产程视觉模拟评分法（VAS）评分均低于常规分娩组（P＜0.05）;2组胎儿窘迫发生率及Apgar评分差异均无统计学意义（P＞0.05）;2组产妇产后3 h出血发生率及出血量差异均无统计学意义（P＞0.05）;常规分娩组未见产后不良反应,无痛分娩组4例（5.6%）出现体位性低血压,3例（4.2%）下肢肌力减弱,均经对症治疗后于3 h内缓解。结论：可行走式无痛分娩具有良好的镇痛效果,可显著降低产妇各产程的疼痛感觉,且不会发生严重产后并发症,对胎儿无害,是一种有效、安全的分娩镇痛方式,值得临床推广应用。     

胎儿宫内发育迟缓时胎盘病理改变与孕妇血及脐血中一氧化氮 …

目的 了解胎儿宫内发育迟缓（ＩＵＧＲ）时胎病理改变与母血及脐血中一氧化氮（ＮＯ）水平的关系。方法 对１９９７年１１月￣１９９８年１０月３８例妊娠合并胎儿宫内发育迟缓（ＩＵＧＲ组）及３０例正常３０例正常孕妇（对照组）分娩后的胎盘及胎儿附属物进行分析。     

Preeclampsia is associated with low concentrations of protein Z.

OBJECTIVE: Protein Z, a vitamin K-dependent plasma protein, has an important role in the regulation of the coagulation cascade. Protein Z deficiency has been associated with unexplained pregnancy loss and adverse pregnancy outcome in patients with thrombophilia. This study was conducted to determine if preeclampsia (PE), small for gestational age (SGA), and fetal demise are associated with changes in maternal plasma concentrations of protein Z. STUDY DESIGN: This cross-sectional study included normal pregnant women (N = 71), patients with PE (N = 130), patients who delivered an SGA neonate (N = 58), and patients with fetal demise (N = 58). Maternal plasma protein Z concentrations were measured by a sensitive and specific immunoassay. Protein Z deficiency was defined as maternal plasma concentrations 0.05); and (3) women in the PE and fetal demise groups had significantly higher rates of protein Z deficiency than those with normal pregnancy outcome. CONCLUSIONS: (1) PE, but not SGA or fetal demise, is associated with a significantly lower maternal median plasma concentration of protein Z than normal pregnancy, and (2) a high rate of protein Z deficiency is observed in patients with PE and fetal demise.