正常孕妇及子痫前期患者血清抑制素A水平的研究

目的 检测正常孕妇在各孕周血清抑制素A(Inhibin-A)的浓度,并探讨其与子痫前期发病的关系.方法 采用酶联免疫吸附法(ELISA)检测691例正常孕妇及33例子痫前期孕妇外周血清中Inhibin-A的水平,统计分析子痫前期孕妇与正常孕妇血清Inhibin-A中位数的差异.结果 正常孕妇Inhibin-A水平随孕周增加而逐渐升高,子痫前期孕妇血清Inhibin-A水平显著高于相同孕周正常孕妇的中位数.结论 正常孕妇血清Inhibin-A浓度随妊娠进展逐渐增加,Inhibin-A浓度在子痫前期患者中明显升高.Inhibin-A升高对子痫前期发病有一定的指示作用.     

妊娠相关蛋白A作为子痫前期预测标志物的研究进展

子痫前期是妊娠期特有疾病,其发病率为2％～8％,是导致妊娠不良结局的主要原因之一,也是导致孕产妇及围产儿死亡的主要原因之一。子痫前期发病机制尚未完全明了。目前用于子痫前期的预测因子不胜枚举,如PAPP-A、PP-13、PlGF、sFlt-1、PP-13、sEng、抑制素-A、激活素-A、PTX3、P-选择素以及UtA-PI等。本文探索以PAPP-A作为子痫前期预测标记物的价值。PAPP-A是由合体滋养层细胞分泌的胎盘源性蛋白,是反映胎盘功能的指标之一,子痫前期患者胎盘功能异常,导致胎盘的分泌功能出现异常,病变的胎盘分泌的PAPP-A浓度减少。     

激活素A和抑制素A在子痫前期和子痫患者中的表达及意义

目的:探讨子痫前期和子痫患者胎盘、血清和羊水中激活素A(activin A)和抑制素A(inhibin A)的表达变化及其和该病发病的关系。方法:采用免疫组织化学SABC法检测子痫前期和子痫患者(研究组)及正常晚孕妇女(对照组)胎盘组织中激活素A和抑制素A的表达;采用酶联免疫吸附实验(ELISA)检测羊水中两者水平变化和分娩前、后两者血清水平。结果:①两组胎盘激活素A和抑制素A均在合体滋养细胞胞浆表达,染色随病情加重逐渐加深,与该病存在线性相关关系;②研究组产前血清激活素A和抑制素A水平异常升高,和对照组相比差异有统计学意义;③研究组羊水激活素A和抑制素A水平异常升高,和对照组相比差异有统计学意义;④研究组产前、产后血清激活素A、抑制素A与产后血压均呈正相关,研究组血清激活素A、抑制素A下降幅度与血压下降幅度均呈正相关。结论:激活素A和抑制素A在子痫前期和子痫患者胎盘、血清及羊水中均呈高表达,参与子痫前期和子痫的发病;血清激活素A和抑制素A水平可能作为评估疾病预后的指标。     

D-二聚体和血小板检测在妊娠子痫前期中的价值

目的 探讨妊娠子痫前期患者的Pt、D-二聚体（D—dimer）的变化及其对妊娠子痫前期凝血功能的诊断价值。方法 采用激光加阻抗法测定血常规和D—dimer，采用ELISA测定正常晚期孕妇45例（对照组）和轻度子痫前期65例（研究Ⅰ组）及重度子痫前期48例（研究Ⅱ组）患者的Pt和D—dimer指标。结果 研究Ⅰ组与对照组Pt比较，差异无统计学意义（P〉0．05），而两组D—dimer比较，差异有统计学意义（P〈0．01）；研究Ⅱ组与对照组Pt、D—dimer比较，差异均有统计学意义（P〈0．01）。结论 妊娠子痫前期患者存在明显血栓前状态，Pt、D—dimer随病情加重而呈明显的变化趋势。故产前测定Pt、D—dimer，对妊娠子痫前期的防治和血栓前状态的诊断具有重要价值，并与疾病严重程度相一致。     

D-二聚体和血小板检测在妊娠子痫前期中的价值

目的 探讨妊娠子痫前期患者的Pt、D-二聚体(D-dimer)的变化及其对妊娠子痫前期凝血功能的诊断价值.方法 采用激光加阻抗法测定血常规和D-dimer,采用ELISA测定正常晚期孕妇45例(对照组)和轻度子痫前期65例(研究Ⅰ组)及重度子痫前期48例(研究Ⅱ组)患者的Pt和D-dimer指标.结果 研究Ⅰ组与对照组Pt比较,差异无统计学意义(P＞0.05),而两组D-dimer比较,差异有统计学意义(P＜0.01);研究Ⅱ组与对照组Pt、D-dimer比较,差异均有统计学意义(P＜0.01).结论 妊娠子痫前期患者存在明显血栓前状态,Pt、D-dimer随病情加重而呈明显的变化趋势.故产前测定Pt、D-dimer,对妊娠子痫前期的防治和血栓前状态的诊断具有重要价值,并与疾病严重程度相一致.     

孕妇妊娠前体质指数与子痫前期发生的临床分析

目的 为查找严重影响孕产妇的妊娠结局和母婴安全危险因素,探讨妊娠前体质指数(BMI)与子痫前期(PE)发生及临床特征的关系.方法 选择2018年7月—2019年7月济宁医学院附属医院产科收治的1 000例孕产妇为调查对象,根据孕妇怀孕前的BMI将孕产妇分为四组,体重过低组200例,体重正常组200例,体重超重组300例...     

NF-kB在子痫前期中的表达及意义

目的:探讨NF-kB在子痫前期胎盘中的表达及意义.方法:选取2008年1月～2010年1月在海南省人民医院住院患者90例,其中对照组30例,子痫前期患者60例(轻度30例,重度30例).采用免疫组化法检测胎盘NF-kB p65、IkB-α的表达.结果:1对照组与子痫前期患者的胎盘NF-kBp65和IkB-α表达比较,子痫前期组较对照组的胎盘NF-kBp65表达明显升高,IkB-α表达明显降低(P<0.01).2轻度与重度子痫前期患者胎盘NF-kBp65和IkB-α表达变化,子痫前期组重度组较子痫前期轻度组胎盘NF-kBp65表达明显升高,IkB-α表达明显降低(P<0.01).结论:子痫前期患者胎盘NF-kB活化增强,参与免疫炎症反应及胎盘细胞损伤,从而参与子痫前期的发病过程.     

胎盘蛋白13检测在子痫前期患者妊娠中晚期血清中的变化分析

目的：研究探讨妊娠子痫前期患者血清中的胎盘蛋白13（PP13）含量与孕妇妊娠孕周长短的变化关系。方法：回顾性分析本院收治的44例子痫前期患者的临床资料。将其分为轻度子痫前期组16例和重度子痫前期组28例;另外选择30例正常健康孕妇设为对照组。采用ELISA检测方法测定孕妇在不同孕周时血清中的PP13的含量。结果：轻、重度子痫前期组血清中PP13的含量均显著高于正常孕妇组（P〈0.05）;且重度子痫前期组显著高于轻度子痫前期组（P〈0.05）;各组妊娠晚期血清中PP13的含量显著高于妊娠中期（P〈0.05）;相对于妊娠中期,子痫前期组妊娠晚期孕妇血清中PP13含量的增加值显著高于正常孕妇组（P〈0.05）。结论：重度子痫前期孕妇血清中的PP13的含量高于轻度子痫前期孕妇,子痫前期患者血清中的PP13的含量高于正常孕妇,随着妊娠时间的延长,孕妇血清内PP13的含量有所增高。     

血栓弹力图和血清淀粉样蛋白A检测在子痫前期中的应用价值分析

目的 探讨血栓弹力图(TEG)、血清淀粉样蛋白A(SAA)检测在子痫前期中的应用价值.方法 纳入50例子痫前期患者为实验组,50例正常妊娠晚期孕妇为对照组,实验组按病情严重程度分为轻度子痫前期组(26例)与重度子痫前期组(24例).各组均采集血样进行TEG、SAA检测,对比各组检测结果.结果 轻度子痫前期组与重度子痫前...     

子痫前期孕妇妊娠结局的影响因素分析

目的 分析子痫前期孕妇妊娠结局的影响因素.方法 随机选取2017年6月-2019年1月梅州市人民医院收治的133例子痫前期孕妇为研究对象,均经影像学、病理学检查确诊为子痫前期,按围生儿结局分成A组(围生儿结局较好,80例)和B组(围生儿结局较差,53例).比较两组的日间平均收缩压(dSBP)、夜间平均收缩压(nSBP)...     

Seminal Plasma Levels of PAPP-A in Normospermic and Oligospermic Men and Tissue Localization of PAPP-A in the Male Genital Tract

Radioimmunoassay, gel filtration, isoelectric focusing, and immunoperoxidase methods were used to study the levels, properties, and localization of pregnancy-associated plasma protein A (PAPP-A) in the human seminal plasma and male genital tract. Seminal plasma specimens from 20 normospermic and 20 oligospermic men were studied. PAPP-A was found in 30 of 40 samples, the levels ranging from undetectable to 135 μg/liter (median 35 μg/liter) in the normospermic group and from undetectable to 111 μg/liter (median 21 μg/liter) in the oligospermic group. There was no significant difference in the PAPP-A levels between the two groups, and no correlation was observed between the seminal plasma PAPP-A levels and the volume of seminal plasma or the sperm count or the viability of spermatozoa. Serial dilutions of seminal plasma and PAPP-A standard yielded parallel dose-response curves, and incubation with seminal plasma did not result in any change in the elution pattern of [¹²⁵I] PAPP-A in gel filtration. PAPP-A-immunoreactive material from seminal plasma eluted as two peaks, the major one corresponding to the elution volume of purified PAPP-A and the minor eluting more slowly. The isoelectric point of seminal plasma PAPP-A was 4.3-4.7 and that of term pregnancy serum was 4.2-4.6. In the immunoperoxidase staining, PAPP-A was seen in the epithelium of the prostate, seminal vesicle, and the ampullar part of the vas deferens but not in the testis, epididymis, proximal parts of vas deferens or urethra. The results confirm the occurrence of PAPP-A in the seminal plasma but do not suggest any clinical utility for seminal plasma PAPP-A measurements. Distal glandular parts of the genital tract are the site of PAPP-A localization in tissue, indicating either synthesis or uptake.     

妊娠相关血浆蛋白-A预测妊娠期高血压疾病的价值

目的研究早期预测妊娠期高血压疾病(hypertensive disorder complication pregnancy)的方法,旨在加强妊娠期高血压疾病的临床监控和管理。方法回顾性分析3005例产前筛查Down′s综合征孕妇中的妊娠相关血浆蛋白-A(pregnancy-associated plasma protein-A,PAPP-A)水平与妊娠期高血压疾病发病的相关性。结果3005例产前进行Down′s综合征筛查的孕妇中,40例孕28～孕38周时,发生妊娠期高血压疾病。这40例患者孕早、中期的血清PAPP-A的中位数的倍数(multiples of the median,MOM)值均明显升高,病例组与对照组比较,差异有显著意义(P<0.01)。结论PAPP-A可作为孕早、中妊娠期高血压疾病筛查的指标,可能是早、中期产前筛查附带得到预测妊娠期高血压疾病发病风险的血清标记物。     

子痫前期患者子宫螺旋动脉血流动力学、胎盘微血管密度及HSP-70、PAPP-A变化研究

目的:探讨子痫前期患者子宫螺旋动脉血流动力学、胎盘微血管密度及HSP-70、PAPP-A的变化规律。方法:选取32例子痫前期患者为观察组,同期进行产检的32例健康孕妇为对照组,将两组孕妇的子宫螺旋动脉改变情况及血流动力学指标、胎盘微血管密度、血清HSP-70、PAPP-A水平进行统计及比较。结果:观察组的子宫螺旋动脉无变化者比例高于对照组,PI、RI及S/D水平均高于对照组,随孕周增加呈现降低的趋势,胎盘微血管密度低于对照组,血清HSP-70及PAPP-A均高于对照组,且重度患者变化幅度均大于轻度患者,差异有统计学意义(P均<0.05)。结论:子痫前期患者存在子宫螺旋动脉血流动力学、胎盘微血管密度及HSP-70、PAPP-A的异常,且轻度与重度患者也存在明显的差异。     

妊娠子痫前期血栓前状态的探讨

目的 探索凝血酶原时间、部分凝血活酶时间、纤维蛋白原、血小板、D-二聚体在妊娠子痫前期凝血功能障碍发生的诊断价值.方法 检测113例妊娠子痫前期患者凝血酶原时间、部分凝血活酶时间、血小板、纤维蛋白原,用磁珠法测凝血三项,用激光加阻抗法测定血常规,D-二聚体采用酶联免疫吸附双抗体夹心法测定,与45例正常妊娠孕妇相比,.结果 轻度子痫前期凝血酶原时间、部分凝血活酶时间、血小板、纤维蛋白原值与正常妊娠组比较,差异无统计学意义(P＞0.05),D-二聚体差异有统计学意义(P＜0.01);重度子痫前期与正常妊娠组比较,差异无统计学意义(P＞0.05),D-二聚体、血小板差异有统计学意义(P＜0.01).结论 妊娠子痫前期血液存在血栓前状态,凝血酶原时间、部分凝血活酶时间、纤维蛋白原不能灵敏反映高凝状态,不能作为早期诊断价值;不能作为亚临床弥漫性血管内凝血时监测的首选指标.D-二聚体、血小板对妊娠子痫前期凝血功能障碍监测有重要临床意义,可作为临床实验室诊断的首选指标,有利于早期诊断、预防.     

子痫前期患者血清和胎盘β-hCG水平测定

目的 探讨子痫前期患者血清和胎盘组织中人绒毛膜促性腺激素水平改变与发病的相关性.方法 选择轻度、重度子痫前期患者及对照组(正常妊娠孕妇)各24例,随机选择三组产妇的胎盘各16例,利用酶联免疫分析法测定三组血清及胎盘中人绒毛膜促性腺激素水平.结果 轻度子痫前期患者组血清和胎盘中人绒毛膜促性腺激素水平分别为60.7±18.2ng/mL、5.13±1.6ng/mg,均高于对照组的27.9±16.4ng/mL、2.98±1.2ng/mg(P＜0.01);重度子痫前期患者组血清和胎盘中人绒毛膜促性腺激素水平分别为93.5±29.6ng/mL、7.82±1.5ng/mg,明显高于轻度子痫前期组的60.7±18.2ng/mL、5.13±1.6ng/mg(P＜0.01).结论 子痫前期患者血清和胎盘中人绒毛膜促性腺激素水平升高,可能通过调节细胞滋养细胞和血管内皮细胞的功能而参与了子痫前期的发病.     

The effects of zinc supplementation on serum zinc and cholesterol concentrations in hemodialysis patients.

OBJECTIVE: To examine the effect of zinc sulfate supplementation on the concentrations of serum zinc and serum cholesterol in hemodialysis (HD) patients. SETTING: Outpatient dialysis center in a large metropolitan city. DESIGN: Randomized, double-blind, before-after trial. PATIENTS: Twenty-eight maintenance HD patients were selected. Twenty (15 women and 5 men) completed the study. Subjects were identified for inclusion in the study by the following criteria: HD treatment for a minimum of 6 months, no signs of gastrointestinal disorders, and no record of hospitalizations for reasons other than vascular access complications within the last 3 months. INTERVENTIONS: Patients were given a daily supplement of 7.7 micromol zinc sulfate (50 mg elemental zinc) or a cornstarch placebo capsule for 90 days. Patients completed 2-day food records, at day 0 and day 90 of the study, which included 1 dialysis day and 1 nondialysis day. MAIN OUTCOME MEASURE: Fasting, predialysis serum samples were collected on days 0, 40, and 90 to determine serum zinc and total cholesterol (TCHOL) concentrations. Dietary parameters, including zinc, protein, and energy intake, were also analyzed on days 0 and 90. RESULTS: Initial concentrations of serum zinc indicated subjects were below the normal range for serum zinc standards (12 micromol/L [80 microg/dL]). After supplementation, subjects in the zinc-supplemented group showed significant increases in serum zinc concentrations from 0.79 microg/mL at day 0 to 0.96 microg/mL at day 90. Serum TCHOL concentrations were initially low among subjects in the control (2.914 +/- 0.158 mmol/L [112.7 +/- 6.1 mg/dL]) and zinc-supplemented (3.155 +/- 0.354 mmol/L [122.0 +/- 13.7 mg/dL]) groups. Serum TCHOL concentrations in the control group increased slightly throughout the study period but did not reach statistical significance. A progressive increase in serum TCHOL concentration was observed in the zinc-supplemented group from the beginning (3.155 +/- 0.354 mmol/L [122.0 +/- 13.7 mg/dL]) to the end (4.445 +/- 0.478 mmol/L [171.9 +/- 18.5 mg/dL]) of the study (r =.63, P <.05). Mean serum high-density lipoprotein (HDL) cholesterol concentrations for the zinc-supplemented group were 0.959 mmol/L +/- 0.11 (37.1 mg/dL +/- 4.3), 0.825 mmol/L +/- 0.08 (31.9 mg/dL +/- 3.2), and 0.908 mmol/L +/- 0.10 (35.1 mg/dL +/- 3.9) from the beginning to the end of the experimental period. The mean serum HDL cholesterol concentrations for the control group were 0.760 mmol/L +/- 0.075 (29.4 mg/dL +/- 2.9), 0.760 +/- 0.08 (29.4 mg/dL +/- 3.0), and 0.799 mmol/L +/- 0.13 (30.9 mg/dL +/- 4.9) from the beginning to the end of the experimental period. A progressive increase in low-density lipoprotein (LDL) cholesterol concentration was observed for the zinc-supplemented group throughout the study. Mean LDL cholesterol concentrations for the zinc-supplemented group were 2.19 mmol/L +/- 0.39 (85 mg/dL +/- 15.0), 3.30 mmol/L +/- 0.36 (127.8 mg/dL +/- 14.1), and 3.53 mmol/L +/- 0.53 (136.7 mg/dL +/- 20.6) from the beginning to the end of the study period. When serum zinc concentration was correlated with serum LDL cholesterol concentration, a significant correlation was found (r =.62, P <.03) for the zinc-supplemented group and no significant difference was found for the control group. No significant differences in LDL cholesterol concentrations were found within the control group from the beginning to the end of the study. Dietary intake of zinc, cholesterol, total fat, and saturated fat remained constant and did not statistically influence serum values. Reported energy intake increased significantly in the zinc-supplemented group from 5,799 kJ/24 h (1,385 kcal/d) at day 0 to 7,042 kJ/24 h (1,682 kcal/d) at day 90. CONCLUSION: Zinc supplementation is an effective means of improving serum levels of zinc and cholesterol in the HD patient.     

子痫前期的病因研究进展

子痫前期是围产期母婴死亡的主要原因之一,通常发生在孕中晚期,病情变化复杂很难预知,一般以终止妊娠来控制病情发展.其病因和发病机理目前尚不清楚,可能与妊娠期间胎盘缺血缺氧、脂代谢异常、免疫失衡、基因调节失控、线粒体缺陷和细胞滋养层细胞侵入子宫内膜有关.子痫前期和子痫是多因素疾病,可能是环境的危险因素与体内一个或多个易感基因协同作用的结果 .胎盘肾素血管紧张素系统和人类组织相溶性抗原的表达起了明显作用.     

测定血清抑制素A对异位妊娠监测的价值

目的 探讨血清抑制素A在监测、诊断异位妊娠及腹腔镜保守性手术治疗疗效方面的价值.方法 采用酶联双位点免疫检测252例异位妊娠患者的外周血清抑制素A,其中持续性异位妊娠组23例、非持续性异位妊娠组229例;采用放射免疫法测定术前1天及术后人绒毛膜促性腺激素水平及其变化.结果 ①持续性异位妊娠组术前1天血清抑制素A水平明显高于非持续性异位妊娠组(t=5.651,P<0.01);②以术前1天血清抑制素A水平≥178ng/L为阈值,预测持续性异位妊娠发生的敏感度和特异度分别为84.56%和96.55%.结论 联合监测血清抑制素A及人绒毛膜促性腺激素可作为早期持续性异位妊娠的筛查试验.