正常及妊高征孕妇尿中各种蛋白的变化

应用酶联免疫方法对正常未孕妇女２８例、不同孕周的正常孕妇１０１例（包括产后）及妊高征患者２５例尿中各种蛋白进行检测。结果：孕妇在妊娠早期尿中白蛋白及ＩｇＭ排出较非孕妇女明显增多（Ｐ＜０．０５－０．０１），ＩｇＧ亦有增多趋势。妊高征患者与正常不同孕周的孕妇相比，ＩｇＧ，ＩｇＡ、白蛋白的排出均明显增加（Ｐ＜０．０５－０．０１），而ＩｇＭ无差异、产后与孕晚期妇女相比，ＩｇＭ明显减少（Ｐ＜０．０５）；正常     

正常妊娠妇女外周血可溶性白细胞介素－2受体及淋巴细胞亚群的变化

测定了８７例妊娠晚期及２９例正常非孕妇女外周血可溶性白细胞介素－２受体（ｓＩＬ－２Ｒ）水平，同时对其中３６例孕妇及１０９例正常非孕妇女（正常对照）进行外周血淋巴细胞亚群检测。结果：妊娠晚期妇女ｓＩＬ－２Ｒ水平及Ｔｓ细胞（ＣＤ＿８）明显高于正常对照，分别为：２１４６００±７０４００Ｕ／Ｌ比１６２１００±８４１Ｄ０Ｕ／Ｌ，　Ｐ＜０．０１及３７．６％±５．３％比３１．３％±７．０％，Ｐ＜０．０１。妊娠妇女Ｔｈ细胞／Ｔｓ细胞（ＣＤ＿４／ＣＤ＿８）比例明显低于正常对照（１．２±０．２比１．５±０．５，Ｐ＜０．０１）。但总Ｔ淋巴细胞（ＣＤ＿３），ＣＤ＿４，细胞与正常对照相比，差异无显著性，分别为：６４．１％±７．３％比６６．０％±９．９％，Ｐ＞０．０５及４４．１％±５．８％比４３．８％±９．Ｏ％，Ｐ＞０．０５。相关分析表明孕妇ｓＩＬ－２Ｒ水平与ＣＤ＿３、ＣＤ＿４、ＣＤ＿８细胞及ＣＤ＿４／ＣＤ＿８均无显著相关性（ｒ分别为０．２０３２，０．２０７７，０．１０３７及０．１２１４，Ｐ均＞０．０５）。提示：孕妇外周血Ｔ淋巴细胞亚群及血清ｓＩＬ－２Ｒ的变化对维持正常妊娠有重要作用，ｓＩＬ－２Ｒ可能是促进胎儿正常生长的重要介质之一。     

正常妊娠妇女外周血可溶性白细胞介素—2受体及淋巴细胞亚群…

测定了８７例妊娠晚期及２９例正常非孕妇女外周血可溶性白细胞介素－２受体（ｓＩＬ－２Ｒ）水平，同时对其中３６例孕妇及１０９例正常非孕妇女（正常对照）进行外周血淋巴细胞亚群检测。结果：妊娠晚期妇女ｓＩＬ－２Ｒ水平及Ｔｓ细胞（ＣＤ８）明显高于正常对照，分别为：２１４６００±７０４００Ｕ／Ｌ比１６２１００±８４１００Ｕ／Ｌ，Ｐ＜０．０１及３７６．６％±５．３％比３１．３±７．０％，Ｐ＜０．０１。妊娠妇女Ｔ     

妊高征患者外周血清及单核细胞内镁,钙含量测定

目的：探讨镁、钙代谢在妊高征病理生理变化中的作用。方法：采用原子吸收分光光度测定法（火焰原子化法），测定了２６例妊高征患者（妊高征组）产前外周血清及单核细胞内镁、钙含量，以２７例同期住院的正常晚期妊娠妇女作对照（对照组）。结果：妊高征组与对照组比较：（１）妊高征组外周血清镁、钙含量显著降低（Ｐ＜０．０１及Ｐ＜０．０５）；（２）中、重度妊高征患者外周血单核细胞内镁含量显著降低（Ｐ＜０．００１及Ｐ＜０．０１）；（３）中、重度妊高征患者外周血中单核细胞内的钙含量显著降低（Ｐ＜０．０１及Ｐ＜０．０５）。结论：镁、钙含量降低可能在妊高征病理生理变化中起重要作用。     

早期流产与肿瘤坏死因子α关系的初步研究

采用放射免疫竞争法检测５０例早期流产患者，３５例正常早孕妇女及２０例非孕妇女血清肿瘤坏死因子α（ＴＮＦα）水平。结果表明：早期流产患者血清ＴＮＦα水平明显高于正常早孕妇女（２．２８７±２．１１８μｇ／Ｌ、０．３１１±０．２８３μｇ／Ｌ，Ｐ＜０．００１），其中难免流产后者血清ＴＮＦα水平较先兆流产患者高（２．９９９±２．５２６μｇ／Ｌ、１．２８１±０．７５２μｇ／Ｌ，Ｐ＜０．００５），提示ＴＮＦα与早期流产关系密切。正常早孕妇女血清ＴＮＦα水平明显低于健康非孕妇女（０．３１１±０．２８３μｇ／Ｌ、０．７２９±０．１２４μｇ／Ｌ，Ｐ＜０．００１），ＴＮＦα在正常妊娠中亦可能起重要的调节作用，值得进一步研究。     

孕妇营养下小于胎龄儿的关系

对６０例小于胎龄儿孕妇及６０例正常孕妇进行了营养调查，结果ＩＵＧＲ组孕妇的体重、妊娠中期、晚期热量摄入、血清白蛋白、前白蛋白及血糖水平均低于正常孕妇组，而两组血中微量元素铜、锌差异无显著性。热量摄入低者以妊娠剧吐持续时间长（４４．８３％）及偏食（３１．０３％）为主要原因。母血与脐血血糖水平（ｒ＝０．８５）、前白蛋白水平（ｒ＝０．５２）均具有显著相关性（Ｐ＜０．０１）。出生体重与孕妇孕期热量摄入、母     

妊高征患者血清尿酸含量与围产期结局的分析

通过测定３０例正常孕产妇和６４例妊高征患者的血清尿酸（ＵＡ）、肌酐（Ｃｒ）和尿素氮（ＢＵＮ）的水平，以探讨尿酸对妊高征围产期结局的影响。结果表明：妊高征患者血清尿酸含量明显高于正常妊娠（Ｐ＜００１），而妊高征的围产儿病死率明显高于正常妊娠对照组（Ｐ＜００１），且重度妊高征患者较轻度妊高征产妇增加显著（Ｐ＜００１～００５）。认为妊高征患者血清尿酸的变化不仅可作为临床监测指标，而且对妊高征的诊断和治疗均具有参考价值     

晚期正常妊娠及妊高征患者血清一氧化氮水平及其意义

应用Ｇｒｅｉｓｓ反应测定３５例育龄非孕妇女、３２例正常晚期妊娠妇女及３２例妊高征患者的务清 氧化氮含量，以探讨一氧化氮在正常妊娠及妊高征发病机理中的作用。结果：正常晚期妊娠妇女血清 氧化氮含量明显高于育龄非孕妇女（Ｐ〈０．００１），而妊高征患者的血清一氧化氮含量明显低于正常孕妇（Ｐ〈０．００１）。表明：妊娠期一氧化氮合成增加对维持正常妊娠具有意义；妊高征的发生可能与妊娠期一氧化氮合成减少腾。     

正常孕妇及妊高征患者血浆中5-羟色胺和5-羟吲哚乙酸含量的测定

目的　探讨血浆中５羟色胺（５ＨＴ） 和５羟吲哚乙酸（５ＨＩＡＡ） 与妊高征发病的关系。　方法　采用高效液相色谱—电化学检测法测定正常妊娠各期孕妇组及妊高征组血浆中５ＨＴ和５ＨＩＡＡ含量。　结果　正常妊娠各期孕妇组血浆中５ＨＴ含量无显著差异;妊高征组血浆中５ＨＴ含量（７０－４４ ±２８－６９ μｇ／Ｌ）明显高于正常晚孕组（２４－９６±６－５７ μｇ／Ｌ）（ Ｐ＜ ０．０１） ;妊高征组血浆中５ＨＩＡＡ 含量（４－１１±２．３０ μｇ／Ｌ） 较正常晚孕组（７－８７ ±１．７５ μｇ／Ｌ） 明显降低,Ｐ＜ ０．０１。　结论　孕妇血浆中５ＨＴ含量变化可能与妊高征血管收缩的病理过程有关。     

妊高征患者血浆D—二聚体的检测及临床意义

目的：探讨妊高征患者和正常妊娠妇女血浆Ｄ－二聚体的变化及临床意义。方法：用酶联免疫吸附试验，定量检测１０６例正常妊娠妇女（正常妊娠组）和５４例妊高征患者（妊高征组，其中轻、中度妊高征２５例，先兆子痫１８例，子痫１１例）血浆Ｄ－二聚体。结果：轻、中度妊高征患者血浆Ｄ－二聚体水平为２．２７±０．９２ｍｇ／Ｌ，显著高于正常妊娠组晚孕期（１．４５±０．３８ｍｇ／Ｌ，Ｐ＜０．０１）；先兆子痫患者血浆Ｄ－二聚体水平为３．０９±１．６５ｍｇ／Ｌ，显著高于轻、中度妊高征患者（Ｐ＜０．０１）；子痫患者血浆Ｄ－二聚体水平为５．６２±１．３４ｍｇ／Ｌ，显著高于先兆子痫患者（Ｐ＜０．０１）。结论：临床上动态检测中、晚孕期妊娠妇女血浆Ｄ－二聚体水平对妊高征的早期诊断有重要意义；监测妊高征患者血浆Ｄ－二聚体水平可预测疾病的预后。     

Serum estradiol as an aid in the diagnosis of ectopic pregnancy.

The value of serum beta-hCG measurement in the diagnosis of ectopic pregnancy is well established, and there have been recent studies on the use of serum progesterone levels. However, we have been unable to find any reports on the potential application of serum estradiol (E2) assays in the diagnosis of ectopic pregnancy. We therefore concurrently measured serum E2, progesterone, and beta-hCG in 100 women with ectopic pregnancies, as well as in 69 controls with normal intrauterine pregnancies and 36 women with threatened abortion. The mean (+/- standard deviation) E2 levels for ectopic-pregnancy patients, the normal controls, and the women with threatened abortion were 281.1 +/- 115.6, 788.2 +/- 45.5, and 788.8 +/- 40.6 pg/mL, respectively; the mean levels in the ectopic group were significantly different (P less than .0001) from those of the other two groups. All but one of the ectopic pregnancies had values below 650 pg/mL for E2 and 23 ng/mL for progesterone, and all but one of the normal intrauterine pregnancies had values above these levels. Our data suggest that the addition of the estradiol assay, with or without progesterone, to the early evaluation of patients suspected of having an ectopic pregnancy may be helpful in diagnosis.     

妊娠期肝内胆汁淤积症患者血清及新生儿脐血中可溶性细胞间粘附分子-1的检测及临床意义

目的 :检测妊娠期肝内胆汁淤积症 (ICP)患者血清及新生儿脐血中可溶性细胞间粘附分子 - 1(SICAM - 1)及其临床意义。方法 :采用酶联免疫吸附法 (ELISA)检测各项指标。结果 :(1)ICP患者血清、新生儿脐血中SICAM - 1的浓度明显高于正常孕妇组 (P<0 .0 1) ,随着ICP程度的增加 ,SICAM - 1的浓度逐渐增高 (P <0 .0 5 ) ;两组孕妇产后 1周母血中SICAM - 1逐渐降至正常 (P >0 .0 5 ) ;(2 )ICP患者血清中SICAM - 1的升高与胆汁酸 (BA)、ALT、AST呈正相关 (P <0 .0 0 1,P <0 .0 0 5 )。结论 :ICP患者血清、新生儿脐血中SICAM - 1含量的升高在ICP的发病中可能有一定的作用     

南昌地区正常孕产妇血清免疫球蛋白与补体3水平的观察

目的 了解正常妊娠孕产妇血清ＩｇＧ、ＩｇＡ、ＩｇＭ及Ｃ３水平。方法 采用单相免疫扩散法对２７３例正常孕产妇三种血清免疫球蛋白（Ｉｇ）和补体３（Ｃ３）水平进行了测定,并与２１例非妊娠妇女作比较。结果 正常妊娠组与非妊娠组比较,血清ＩｇＧ水平降低明显,差异有显著性（Ｐ〈０．０１）。早、中、晚孕及产后分别下降４４．０３％、１８．４６％、３５．４５％和３５．７７％。除中孕组外,其它各组差异均有显著性（Ｐ〈     

Prediction of fetal outcome in threatened abortion by maternal serum placental lactogen and alpha fetoprotein.

Abnormally low human placental lactogen (HPL) or high alpha fetoprotein (AFP) levels in maternal serum are unfavorable prognostic signs in women with threatened abortion but normal levels cannot be used to discriminate between viable and nonviable pregnancies. Out of 112 women with threatened abortion, 69 aborted; of these, 36 had a low HPL level and they all aborted. Five women had an increased AFP concentration. Four of these aborted and the remaining case was a twin pregnancy in which one fetus died and the other survived. HPL and AFP levels provide complementary information as to the fetal outcome in threatened abortion. This was indicated by a normal HPL level in all of the five cases with raised maternal AFP, and by a normal AFP level in 35 of the 36 women with low maternal HPL.     

First trimester serum inhibin A in normal pregnant women

Objectives To establish reference ranges for maternal serum inhibin A in normal first trimester pregnant women. Materials and methods This was a cross-sectional study. We measured maternal serum inhibin A in normal pregnant women gestation age between 6⁺⁰ and 14⁺⁶ weeks using the enzyme-linked immunosorbent assay (ELISA) method. Maternal serum inhibin A was analyzed according to gestational ages (GA). Results Serum of 300 pregnancies was analyzed and the outcome demonstrated the median of maternal serum inhibin A according to gestational age. The levels of maternal serum inhibin A during the 6⁰–6⁺⁶ week of gestations are lowest when compared with other gestational age. The levels of maternal serum inhibin A during 9⁰–9⁺⁶ week of gestations are maximal. Maternal serum inhibin A then declined until 14 weeks of gestation. Conclusion Serum inhibin A can be measured during the first trimester of pregnancy by using the recent ELISA technique. Our reference ranges might be useful for further studies, such as prediction of adverse pregnancy outcome in threatened abortion.     

Study of serum SP1 levels in early normal and abnormal pregnancies

The pregnancy-specific beta 1 glycoprotein (SP1) levels in the serum of normal and abnormal pregnancies were determined by radioimmunoassay in the first trimester. The results indicated that serum SP1 levels of normal pregnancies increased with the advancing gestational week; 67% of threatened abortions with low SP1 levels would finally abort and only 7% of those with normal SP1 levels would abort. Serum SP1 levels were of lower values in ectopic pregnancy and hydatidiform mole. Serum SP1 might be taken as a better index for estimating the fetal prognosis in threatened abortion and an auxiliary diagnostic means for ectopic pregnancy and hydatidiform mole.     

Evaluation of threatened abortion by human chorionic gonadotropin levels and ultrasonography

To determine the prognostic value of human chorionic gonadotropin (HCG) concentrations in maternal plasma and urine, we studied 104 women with threatened abortion (cases) and 108 women with normal pregnancies and normal serum levels of HCG (controls). Of the 104 cases, 48 were also examined ultrasonically. We concluded that measurements of serum levels of HCG are of more accurate prognostic value than those of urine levels. Low serum levels of HCG indicate a poor prognosis for the pregnancy, as do steady decreases, in repeated measurements, of initially high HCG level. The combination of normal serum levels of HCG and signs of fetal life during ultrasonic examination indicates a very good prognosis for the pregnancy.     

妊娠中、晚期血清瘦素、β-hCG及ADAM12水平的变化及其与子痫前期发生的关系

目的：探讨妊娠中、晚期妇女血清瘦素、人绒毛膜促性腺激素β亚单位（β-hCG）及解整合素-金属蛋白酶12（ADAM12）的水平变化及这些指标对子痫前期（PE）发生的预测价值.方法：选择2007年6月-2008年5月在福建省妇幼保健院定期产检和住院分娩的189例妊娠妇女,分别测定妊娠中期（20～24周）和妊娠晚期（30～34周）血清瘦素、β-hCG、ADAM12的浓度,其中25例发展为PE者为病例组,164例正常妊娠者为正常组.根据受试者工作特征（ROC）曲线确定预测界限值.结果：①妊娠中期病例组血清β-hCG、ADAM12浓度显著高于正常组（P＜0.001）.②妊娠晚期病例组血清瘦素、β-hCG、ADAM12浓度明显高于正常组（P＜0.001）.③病例组妊娠晚期血清瘦素、β-hCG及ADAM12水平均较妊娠中期升高（P＜0.05）,正常组妊娠晚期血清瘦素水平较妊娠中期升高（P＜0.001）,而血清β-hCG与ADAM12水平2组间差异无统计学意义（P＞0.05）.④妊娠中期以血清β-hCG≥32 μg/L、血清ADAM12≥818 μg/L为预测界值,两者联合阳性预测值为82.61%,高于单项阳性预测值（P＜0.05）.两者联合ROC曲线下面积与单项ROC曲线下面积比较差异无统计学意义（P＞0.05）.⑤妊娠晚期以血清瘦素≥23 μg/L、血清β-hCG≥37 μg/L及血清ADAM12≥900 μg/L为预测界值,三者联合阳性预测值达92.31%,高于单项阳性预测值（P＜0.05）.三者联合ROC曲线下面积大于单项β-hCG及瘦素ROC曲线下面积（P＜0.05）,但与单项ADAM12曲线下面积差异无统计学意义（P＜0.05）.⑥联合妊娠中、晚期血清β-hCG预测PE发生的阳性率为81.25%;联合妊娠中、晚期血清ADAM12预测PE发生的阳性率为90.48%,均比单一指标的阳性预测值高.结论：检测妊娠中、晚期妇女血清β-hCG及ADAM12水平可作为PE发生的有效预测指标;联合多项指标并动态监测可进一步提高对PE发生的阳性预测值及准确率.     

白血病抑制因子在早期妊娠、先兆流产及难免流产患者蜕膜组织中表达的研究

目的探讨白血病抑制因子(LIF)在蜕膜组织中的表达,及其与早期妊娠、流产的关系. 方法采用放射免疫方法检测正常早孕妇女(正常早孕组)、先兆流产妇女(先兆流产组)及难免流产妇女(难免流产组)的血清孕酮及人绒毛膜促性腺激素(hCG)水平,并采用逆转录-聚合酶链反应(RT-PCR)技术对3组孕妇蜕膜组织中LIF-mRNA的表达进行定量分析.结果 (1)孕酮及hCG水平在3组孕妇间的比较正常早孕组孕妇血清中孕酮、hCG水平分别为(91.5±27.2) nmol/L、(69.9±14.9) kU/L,先兆流产组孕妇分别为(88.4±24.7) nmol/L、(57.6±11.2) kU/L,两组孕妇血清孕酮、hCG水平比较,差异均无显著性(P>0.05);而难免流产组孕妇血清孕酮、hCG水平分别为(33.1±19.6) nmol/L、(10.3±3.2) kU/L,与前两组分别两两比较,差异均有极显著性(P<0.01).(2)LIF-mRNA平均相对含量在3组孕妇间的比较正常早孕组孕妇为2.10±0.32;先兆流产组孕妇为1.92±0.20;难免流产组孕妇为0.70±0.06.正常早孕组与先兆流产组比较,差异无显著性(P>0.05).而难免流产组与前两组分别行两两比较,差异均有显著性(P<0.05).结论 LIF-mRNA在早期妊娠蜕膜组织中的表达量降低,可能是导致hCG及孕酮分泌下降,最终造成难免流产的原因之一.     

妊娠中、晚期血清瘦素、β-hCG及ADAM12水平的变化及其与子痫前期发生的关系

目的：探讨妊娠中、晚期妇女血清瘦素、人绒毛膜促性腺激素β亚单位（β-hCG）及解整合素-金属蛋白酶12（ADAM12）的水平变化及这些指标对子痫前期（PE）发生的预测价值。方法：选择2007年6月—2008年5月在福建省妇幼保健院定期产检和住院分娩的189例妊娠妇女,分别测定妊娠中期（20～24周）和妊娠晚期（30～34周）血清瘦素、β-hCG、ADAM12的浓度,其中25例发展为PE者为病例组,164例正常妊娠者为正常组。根据受试者工作特征（ROC）曲线确定预测界限值。结果：①妊娠中期病例组血清β-hCG、ADAM12浓度显著高于正常组（P＜0.001）。②妊娠晚期病例组血清瘦素、β-hCG、ADAM12浓度明显高于正常组（P＜0.001）。③病例组妊娠晚期血清瘦素、β-hCG及ADAM12水平均较妊娠中期升高（P＜0.05）,正常组妊娠晚期血清瘦素水平较妊娠中期升高（P＜0.001）, 而血清β-hCG与ADAM12水平2组间差异无统计学意义（P＞0.05）。④妊娠中期以血清β-hCG≥32 μg/L、血清ADAM12≥818 μg/L为预测界值,两者联合阳性预测值为82.61%,高于单项阳性预测值（P＜0.05）。两者联合ROC曲线下面积与单项ROC曲线下面积比较差异无统计学意义（P＞0.05）。⑤妊娠晚期以血清瘦素≥23 μg/L、血清β-hCG≥37 μg/L及血清ADAM12≥900 μg/L为预测界值,三者联合阳性预测值达92.31%,高于单项阳性预测值（P＜0.05）。三者联合ROC曲线下面积大于单项β-hCG及瘦素ROC曲线下面积（P＜0.05）,但与单项ADAM12曲线下面积差异无统计学意义（P＜0.05）。⑥联合妊娠中、晚期血清β-hCG预测PE发生的阳性率为81.25%;联合妊娠中、晚期血清ADAM12预测PE发生的阳性率为90.48%,均比单一指标的阳性预测值高。结论：检测妊娠中、晚期妇女血清β-hCG及ADAM12水平可作为PE发生的有效预测指标;联合多项指标并动态监测可进一步提高对PE发生的阳性预测值及准确率。