自然流产408例危险因素分析

目的:研究自然流产发生原因及影响因素,为制定防治对策,指导优生优育及妇幼卫生保健提供依据。方法:采用病例对照研究方法,选择408例自然流产者作为病例组,同期选择正常妊娠分娩的产妇461名作对照组,调查可能的危险因素,并进行统计学分析。结果:单因素分析显示,年龄、职业、孕期阴道流血及保胎史、早孕家装史、妊娠期合并症、孕期服叶酸史、孕次、不良妊娠史是自然流产的影响因素（P<0.01）。多因素logistic回归分析显示,年龄、服装职业、化工职业、美容美发业、建筑装潢职业、孕期阴道流血、早孕家装史、早孕服叶酸、生殖道感染、病毒性感冒、其他内外科疾患、孕次、流产次数和不良妊娠史均是自然流产的独立影响因素。结论:高龄、服装职业、化工职业、美容美发职业、建筑装潢职业、孕期阴道流血、早孕家装史、孕期感染、孕次、流产次数和不良妊娠史均是自然流产的独立危险因素,孕期服叶酸是保护因素。     

血清中胰岛素样生长因子-2水平与早期自然流产的关系

目的:探讨血清中胰岛素样生长因子-2表达水平与早期自然流产的关系.方法:采用放射免疫法检测23例正常早孕妇女(对照组)和25例早期自然流产患者(流产组)血清中胰岛素样生长因子-2水平.结果:流产组中血清胰岛素样生长因子-2水平为(97.88±10.50) ng/mL,对照组为(140.52±12.8) ng/mL,两组比较,流产组明显低于对照组,有显著性差异(P＜0.05).结论:胰岛素样生长因子-2低水平表达与胚胎发育不良及流产发生密切相关.     

早期自然流产胚胎染色体异常的危险因素分析

目的 分析早期自然流产胚胎染色体异常患者临床资料、生化指标及其分布特征,探讨可能导致胚胎染色体异常的危险因素.方法 选择315例早期自然流产并进行绒毛染色体检测的患者.根据其绒毛组织染色体微阵列分析(CMA)结果分为异常组(165例)与正常组(150例),回顾性分析及比较两组临床资料、生化指标水平的差异.将筛选出的差异...     

同型半胱氨酸与复发自然流产的关系

目的了解孕妇血清同型半胱氨酸水平与不明原因复发性流产的关系。方法将检测对象分为3组:复发性流产组40例(A组),其中早孕流产组25例(A1组)),中孕流产组15例(A2组);正常妊娠组B组,其中正常早早孕组30例(B1组),正常中孕组30例(B2组);正常育龄妇女组30例(C组),采用循环酶法检测各组血清同型半胱氨酸水平。结果 A组与B组及C组血清同型半胱氨酸水平比较,差异有显著性(P0.01);A1组血清同型半胱氨酸水平与A2组比较,差异有显著性(P0.01);而B1与B2组血清同型半胱氨酸水平比较,差异无显著性(P0.05);A1组与B1组比较,差异有显著性(P0.01);A2组与B2组比较,差异有显著性(P0.01)。结论同型半胱氨酸与复发性流产发病存在密切相关,高同型半胱氨酸水平可以作为不明原因复发性流产的一个危险因素。     

Association between folate intake, serum folate levels and the risk of lung cancer: a systematic review and meta-analysis

Background Folate plays a critical role in nucleotide synthesis and DNA methylation,and was considered to be associated with anti-carcinogenesis.Results from studies that concern the relationship between the folate intake or serum folate levels and lung cancer risk showed no consistency,which requires our further comprehensive metaanalysis.Methods Systematic literature search was conducted to identify the relevant studies (published prior to February 2013)according to standard protocol.Estimated effects were calculated under both random-effects and fixed-effects models.Heterogeneity between studies and publication bias were also evaluated.Results A total of 4390 cases and 6138 controls from 6 case-control studies revealed a significant overall inverse association between folate intake and lung cancer risk (OR =0.74,95％ Cl =0.65-0.84,P＜ 0.001).Summary of 1438 cases and 2582 controls from 4 case-control studies and 44 cases out of a cohort of 1988 participants suggested a marginal association without significance (OR =0.78,95％ Cl =0.60-1.02,P =0.075) between high serum folate levels and less lung cancer susceptibility; however,subgroup analysis about population-based case-control studies showed that high serum folate levels significantly associated with the reduced lung cancer risk (OR =0.76,95％ Cl =0.58-1.00,P =0.048).Conclusion Higher folate intake can be a protective factor against lung cancer risk,and higher serum folate level is probably associated with reduced lung cancer risk in marginal manner,though more studies are warranted to confirm these associations.     

辅助生殖技术助孕妊娠后患者晚期自然流产危险因素分析

目的：探讨辅助生殖技术（ART）助孕妊娠后患者发生晚期自然流产的相关因素,阐明引起晚期自然流产的危险因素。方法：采用回顾性分析研究方法,收集310例行ART助孕后妊娠患者的临床资料,根据患者妊娠结局不同分为足月产组（248例）和晚期流产组（62例）。记录2组患者一般情况、不孕症发病主要原因及相关因素、临床情况和妊娠结局情况,并将单因素回归分析中P<0.05的因素纳入多因素Logistic回归方程,进一步分析患者晚期流产的危险因素。结果：2组患者既往晚期流产或早产次数、既往宫颈LEEP或锥切史、既往宫腔镜下电切史、多囊卵巢综合征（PCOS）病史、体质量指数（BMI）、周期类型、内膜厚度、是否双胎妊娠和排卵障碍比较差异有统计学意义（P<0.05）。将P<0.05的因素纳入多因素Logistic回归方程,BMI (OR=1.194, 95%CI:1.088-1.311,P<0.01)、既往有晚期流产或早产史（OR=5.673,95%CI:1.189-27.069,P=0.029）、宫颈LEEP或锥切史（OR=5.113, 95%CI:1.025-25.496, P=0...     

反复流产的病因探讨

反复流产的原因较复杂，由多种病因所造成，包括解剖、内分泌、遗传、感染、免疫功能异常等，有必要对其进行深入探讨，以作针对性治疗。     

Plasma adiponectin levels and risk of myocardial infarction in men

Context  Adiponectin, a recently discovered adipocyte-derived peptide, is involved in the regulation of insulin sensitivity and lipid oxidation and, purportedly, in the development of atherosclerosis and coronary heart disease in humans. Objective  To assess prospectively whether plasma adiponectin concentrations are associated with risk of myocardial infarction (MI). Design, Setting, and Participants  Nested case-control study among 18 225 male participants of the Health Professionals Follow-up Study aged 40 to 75 years who were free of diagnosed cardiovascular disease at the time of blood draw (1993-1995). During 6 years of follow-up through January 31, 2000, 266 men subsequently developed nonfatal MI or fatal coronary heart disease. Using risk set sampling, controls were selected in a 2:1 ratio matched for age, date of blood draw, and smoking status (n = 532). Main Outcome Measure  Incidence of nonfatal MI and fatal coronary heart disease by adiponectin level. Results  After adjustment for matched variables, participants in the highest compared with the lowest quintile of adiponectin levels had a significantly decreased risk of MI (relative risk [RR], 0.39; 95% confidence interval [CI], 0.23-0.64; P for trend <.001). Additional adjustment for family history of MI, body mass index, alcohol consumption, physical activity, and history of diabetes and hypertension did not substantively affect this relationship (RR, 0.41; 95% CI, 0.24-0.70; P for trend <.001). Further adjustment for hemoglobin A_1c or C-reactive protein levels also had little impact, but additional adjustment for low- and high-density lipoprotein cholesterol levels modestly attenuated this association (RR, 0.56; 95% CI, 0.32-0.99; P for trend = .02). Conclusions  High plasma adiponectin concentrations are associated with lower risk of MI in men. This relationship can be only partly explained by differences in blood lipids and is independent of inflammation and glycemic status.      

血清中sHLA-G水平与自然流产的关系

目的:通过定量测定正常妊娠妇女与自然流产患者血清中sHLA-G,探讨sHLA-G的水平与自然流产的关系。方法:采用ELISA法定量检测16例正常妊娠妇女和16例自然流产患者血清中的sHLA-G水平。结果:正常妊娠组血清中sHLA-G的浓度为(1.37±1.44)IU/ml;自然流产组为(0.57±0.27)IU/ml。自然流产组sHLA-G水平明显低于正常妊娠组,差异有统计学意义,P<0.05。结论:血清中sHLA-G水平在维持妊娠的过程中有重要作用,低水平的sHLA-G与自然流产具有一定的关联性。     

反复自然流产与生殖道感染

反复自然流产是早期妊娠常见的并发症之一,其发生率为0．4％～1％左右。80％以上原因不明,少数患者因染色体异常、生殖器畸形以及感染等因素引起。感染因素在反复自然流产病因中的作用逐渐被人们所重视。本文通过对反复自然流产病因与生殖道感染的关系作一概述,为预防和治疗反复自然流产提供依据。     

血清sHLA-G水平和绒毛中HO-1蛋白的表达与早期流产的相关性研究

目的：探讨血清可溶性人类白细胞抗原- G（sHLA- G）水平及绒毛中血红素氧合酶-1（HO-1）蛋白的表达与早期流产的相关性。方法选择非自愿正常早期妊娠的患者60例作为对照组,自然流产患者80例,分为先兆流产组40例,稽留流产组40例,分别用ELISA法和免疫组化二步法分别检测血清sHLA- G水平和绒毛中HO-1蛋白的表达。结果相应的sHLA- G水平和HO-1蛋白表达由高到低依次排序为对照组、先兆流产组、稽留流产组,差异均有统计学意义（P＜0.05或0.01）。结论血清sHLA- G水平和绒毛中HO-1蛋白的表达与早期流产的发生、发展密切相关。     

反复自然流产的免疫流行病学研究

目的分析反复自然流产（ＲＳＡ）的免疫病因组成。方法用间接血凝法检测ＡＢＯ血型抗体,用ＢＡ－ＥＬＩＳＡ法检测透明带抗体,用ＥＬＩＳＡ法检测磷脂抗体,以单向混合淋巴细胞反应封闭试验检测封闭效率,通过补体依赖性细胞毒试验测定细胞毒指数,通过单向混合淋巴细胞反应封闭抑制试验分析封闭抗体的抗独特型抗体,利用流式细胞仪分析封闭抗体对ＣＤ抗原的作用。以正常生育组为对照,回顾性分析了１２９例原发性ＲＳＡ及１６例继发性ＲＳＡ的免疫病因构成。结果在ＲＳＡ病因组成中,封闭抗体缺乏占３１．７％,透明带自身抗体占２０．４％,磷脂抗体占１２．５％,ＡＢＯ血型抗体占１１．５％;在原发性流产病因组成中,封闭抗体缺乏占３１．４％,透明带自身抗体占２０．４％,磷脂抗体占８．５％,ＡＢＯ血型抗体占８．４％;在继发性流产中,封闭抗体独特型－抗独特型网络失调占３９．４％,磷脂抗体占３１．４％,ＡＢＯ血型抗体占２２．４％。结论根据ＲＳＡ免疫流行病学分析,ＲＳＡ的病因可以分类为：母－胎免疫识别低下型、母－胎免疫识别过度型及母－胎免疫识别紊乱型。     

反复自然流产夫妇的细胞遗传学分析

目的：分析反复自然流产染色体异常的关系。方法：检测200对反复自然流产史夫妇外周血淋巴细胞核型。结果：反复自然流产夫妇中异常核型检出率为8％，其中易位检出率为2．5％，倒位检出率为1．5％，大Y检出率为2％，缺失检出率为3．5％，异常核型中女性高于男性，为1：0．6。结论：反复自然流产夫妇不但与染体色畸变有关，还与染色体多态性有关。对反复自然流产夫妇进行染色体检查，为优生优育提供依据。     

自体抗体与反复流产的关系

[目的]探讨反复流产(RSA)与自身抗体,包括抗心磷脂抗体(aCL)、抗子宫内膜抗体(EmAb)和抗精子抗体(AsAb)的关系。[方法]对116例原因不明RSA患者(研究组)和40例正常非孕妇女(对照组),采用酶联免疫吸附法检测血清aCL和EmAb;采用凝集试验法检测AsAb。其中,研究组又按不同人流次数分为4组。[结果]整个研究组中aCL、EmAb和AsAb的阳性百分比均高于对照组,差异均有显著性(P<0.05),且人工流产次数与血清EmAb阳性率呈正直线关系(r=0.996)。[结论]体内aCL、EmAb和AsAb的存在可能是原因不明RSA的病因之一,且EmAb可能与人工流产导致后来反复自然流产有关。     

叶酸干预对复发性流产患者同型半胱氨酸及叶酸水平的影响探讨

目的：探讨叶酸干预对复发性流产患者同型半胱氨酸（HCY）及叶酸水平的影响。方法以42例复发性流产患者为研究对象,45例正常孕前检查者为对照,检测2组血清HCY水平、叶酸水平,根据检查结果给予叶酸干预,比较干预后2组HCY、叶酸水平。结果入组时复发性流产组血清HCY、血浆叶酸及红细胞叶酸水平与对照组比较差异均有统计学意义（P<0.05）。用药3个月后,复发性流产组血清HCY水平仍然显著高于对照组（P<0.05）,红细胞叶酸水平显著低于对照组（P<0.05）,但是血浆叶酸水平接近对照组,差异无统计学意义（P>0.05）。结论复发性流产患者血清同型半胱氨酸水平高于正常女性,叶酸水平偏低,叶酸干预可改善患者叶酸代谢紊乱、降低同型半胱氨酸水平。     

The moral significance of spontaneous abortion.

Spontaneous abortion is rarely addressed in moral evaluations of abortion. Indeed, 'abortion' is virtually always taken to mean only induced abortion. After a brief review of medical aspects of spontaneous abortion, I attempt to articulate the moral implications of spontaneous abortion for the two poles of the abortion debate, the strong pro-abortion and the strong anti-abortion positions. I claim that spontaneous abortion has no moral relevance for strict pro-abortion positions but that the high incidence of spontaneous abortion is not (as some claim) eo ipso any sort of justification for voluntarily induced abortion. Secondly, I show that if the strict anti-abortionist position is to be taken seriously in its insistence that prenatal life has a right to be protected by virtue of its being conceived, then it seems necessary to take measures to prevent spontaneous abortion and its presumptive causes, and this as a matter of moral obligation.     

自发流产夫妇细胞遗传学分析

对２３０对自发流产夫妇的染色体进行了检查与分析，发现染色体异常２６例，占受检夫妇的１１．３％。染色体平衡易位１７例，倒位４例，数目异常４例，进一步证实了染色体异常是引起自发流产的重要遗传因素之一。通过检出携带者，实施产前宫内诊断，可杜绝有染色体异常的胎儿出生。