正常妊娠和妊高征血浆ANP与ET水平及其相互关系的研究

探讨ANP与ET在正常妊娠和妊高征中血浆水平变化规律及相互关系。采用RIA正常孕阳20例,正常妊娠早孕20例,晚孕20例,产后20例,脐血16例以及妊高征孕妇30例,产后20例,脐血16例血浆ANP与ET浓度。结果：（1）血浆ANP水平变化规律：正常妊娠是脐血组＞正常晚孕组＞产后组＞早孕组＞非孕组,后四组之间无显性差异（P＞0．05）,但与脐血组之间有非常显性差异（P＜0．01）;妊高征是脐血组＞孕妇组＞产后组,但无统计学差异（P＞0．05）。（2）血浆ET水平变化规律：正常妊娠是脐血组＞正常晚孕组＞早孕组＞非孕组＞产后组,后四组之间无显性差异（P>0．05）,但与脐血组之间有显性差异（P＜0．05）。妊高征脐血组＞孕妇组＞产后组,但无统计学差异（P＞0．05）。（3）正常妊娠与妊高征血浆ANP和ET水平比较均是：妊高征孕妇组,产后组＞正常晚孕组,产后组（P＜0．01）,脐血组之间变化不明显（P＞0．05）。（4）在正常妊娠和妊高征中,血浆ANP水平与尿蛋白呈负相关(r=-0.33,P<0.05);血浆ET水平与收缩压呈正相关（r=0.20,P<0.05);血浆ANP与ET之间呈正样关（r=0.96,P<0.01).结论：血浆ANP与ET在正常妊娠过程及妊高发病中起着重要作用,并且两之间相互作用,相互影响。     

The Effect of Intrinsic Factor in Pernicious Tape-Worm Anemia

Plasma renin substrate concentration, renin activity, serum sex hormone binding globulin and total protein concentration were measured sequentially in 10 women after elective caesarean section. Plasma renin substrate concentration decreased from 5406 ± 999 μg AI/1 (mean ± SD) at term to 2369 ± 726 μg AI/1 6 days post partum. Plasma renin activity decreased from 6.2 ± 3.3 μg AI/1/h at term to 4.2 ± 4.0 μ AI/1/h 6 days after delivery. Serum sex hormone binding globulin decreased more slowly than plasma renin substrate concentration. Clearance of plasma renin substrate based on plasma renin activity was calculated. This consumption by renin could explain only 12% of the decrement in plasma renin substrate concentration at the steepest part of the plasma renin substrate disappearance curve. It is concluded that metabolic clearance of plasma renin substrate may be much greater than that calculated from plasma renin activity.     

正常产妇产褥初期血液流变性的观察

动态观察 40例正常产妇产后第 １d、第 ５d的血液流变性和产后第 １d的甲皱微循环情况。结果表明，正常产妇产褥初期的血液稀释，粘滞性、聚集性、凝固性增强；产后第１d的甲皱微循环轻度障碍。揭示出血液稀释而粘度增高是其血液流变性异常的表现特点；既影响产褥复旧，又可自行消散是其特性．红细胞变形能力下降和红细胞聚集性增强是其主要内因。     

产褥期妇科急腹症相关因素及预后分析

目的分析产褥期妇科急腹症发病的相关因素并提出预防办法。方法回顾性总结2007-03～2012-03间因产褥期妇科急腹症入住我院的患者42例,就其发病相关因素及预后加以分析。结果 42例患者中有26例行手术治疗,16例行非手术治疗。最后诊断为卵巢囊肿蒂扭转22例(并化脓性阑尾炎1例),(单纯)产褥感染11例,晚期产后出血5例(并感染3例),卵巢囊肿及卵巢癌破裂各1例,浆膜下子宫肌瘤蒂扭转1例,盆腔结核1例。结论产褥期最常见的妇科急腹症是卵巢囊肿蒂扭转,其次是盆腔感染性疾病和晚期产后出血。     

Patterns of Exacerbations of Chronic Non-Infectious Uveitis in Pregnancy and Puerperium

Purpose: To determine patterns of exacerbations of recurrent non-infectious uveitis during pregnancy and puerperium. Design: Retrospective cohort study. Methods: The medical records of 32 women with a history of chronic non-infectious uveitis, who were pregnant during their follow-up at the Ocular Immunology and Uveitis Service of the Massachusetts Eye and Ear Infirmary, from 1983 through 2003, were reviewed. The uveitis relapse rate during pregnancy was compared to the relapse rate during pregnancy-free periods in these women and to the relapse rate in a control group of women of childbearing age with recurrent non-infectious uveitis. Results: Among the 32 women who were pregnant during follow-up (40 pregnancies), the rate of flare-ups during pregnancy (1.0 recurrence per year) was lower than that observed during non-pregnant periods (2.4 per year; p < 0.001) and lower than that observed in the non-pregnant control group (3.1 per year; p < 0.001). Flare-ups were most frequent in the first trimester of pregnancy and decreased markedly in the second and third trimesters (2.3, 0.5, and 0.4 recurrences per year, respectively; p < 0.001). Conclusions: Pregnancy is associated with lower numbers of flare-ups of non-infectious uveitis compared to the non-pregnant state. If flare-ups do occur during pregnancy, they happen predominantly in the first trimester.     

参加孕妇学校对初产妇分娩方式和产褥期行为的影响

目的探讨参加孕妇学校对初产妇分娩方式和产褥期行为的影响。方法选择220例在本院分娩且产后回访的产妇,根据其是否参加过本院孕妇学校规范健康教育培训分为观察组和对照组,每组各110例。观察组产妇参加孕妇学校安排的孕产期保健知识课程的规范健康教育,对照组无参加孕妇学校规范健康教育。比较两组产妇分娩方式及产褥期行为状况。结果观察组产妇阴道分娩率71.8%,剖宫产率28.2%,对照组产妇阴道分娩率52.7%,剖宫产率47.3%,两组比较,P0.01,差异具有统计学意义,观察组产妇阴道分娩率明显高于对照组。两组产妇医学指征剖官产率与社会因素剖宫产率比较,P0.05,差异具有统计学意义,观察组产妇社会因素剖宫产率明显高于对照组。两组产妇产褥期洗头、洗澡、吃蔬菜水果、刷牙、开冷空调率比较,均P0.01,差异具有统计学意义,观察组明显高于对照组。结论产前产妇是否参加产前规范的孕妇学校健康教育影响其分娩方式的选择及产褥期行为。提示产前产妇应积极参加相关孕产期的保健知识学习,其能帮助产妇建立良好孕期及产褥期行为,降低产妇剖宫产率,有利于产妇顺利、健康、科学地渡过产褥期。     

家庭探访对初产妇产褥期生活质量的影响

目的探讨家庭探访对初产妇产褥期生活质量的影响。方法将110例单胎出院进行家庭探访的初产妇设为家访组,将过去未做家庭探访,只做电话随访的110例单胎初产妇设为对照组。比较两组产后4周时生理问题和生活质量。结果产后4周家访组发生产褥期常见生理问题的例数较对照组明显减少（P〈0.05）。家访组生活质量明显优于对照组,差异有统计学意义（P〈0.01或P〈0.05）。结论家庭探访对促进初产妇产褥期生理机能恢复和维护心理健康具有明显作用,可有效提高初产妇的生活质量。     

Risk factors of aseptic intracranial venous occlusive disease

Introduction – Risk factors for aseptic intracranial venous occlusive disease are varied but only few epidemiologic studies were performed to verify the relative importance of particular factors. Patients and methods – A 2-year hospital-based prospective study was conducted in two hospitals to identify the clinical characteristics and risk factors of patients with confirmed aseptic intracranial venous occlusive disease. Results – 21 patients were identified, representing 0.9% of the total neurological admissions. Men were more commonly affected than women; 81% of the patients presented in a clinical picture indistinguishable from idiopathic intracranial hypertension. Risk factors included Behçet's disease in 4, the puerperium in 3, thrombophelia in 3, familial Mediterranean fever in 2, malignancies in 1, lupus anticoagulant in 1, and the contraceptive pill in 1. Conclusion – Aseptic intracranial venous occlusive disease proved to be not rare in Arabs. It should be considered seriously in the differential diagnosis of idiopathic intracranial hypertension, particularly in males. Several risk factors were incriminated.