内皮型一氧化氮合酶运输介导物在子痫前期患者胎盘组织中的定位及定量研究

目的探讨内皮型一氧化氮合酶运输介导物(endothelial n itric oxide synthase traffic inducer,NOSTR IN)在子痫前期(pre-ec lampsia,PE)患者胎盘血管内皮细胞中表达的变化及其在子痫前期发病过程中的作用。方法HE染色后镜下观察胎盘组织及血管的病理变化,免疫组织化学方法及W estern b lot检测子痫前期患者胎盘组织中NOSTR IN的表达。结果HE染色显示子痫前期患者胎盘绒毛血管变细,数目减少,血管合体膜增厚,纤维素样坏死明显多于正常妊娠;免疫组织化学显示正常妊娠和子痫前期患者胎盘血管内皮细胞中都有NOSTR IN的表达,但子痫前期患者胎盘血管内皮细胞胞浆染色较正常妊娠明显增强;W estern b lot显示子痫前期患者胎盘组织中NOSTR IN的表达显著高于正常妊娠(P<0.01)。结论胎盘组织中NOSTR IN表达增加可能是子痫前期发病机制的重要环节之一。     

HLA-DM基因夫妇共享率与子痫前期相关性

目的:探讨HLA-DM基因夫妇共享率与子痫前期的相关性。方法:用PCR-SSO方法分别测定30对子痫前期患者夫妇及63对正常孕妇夫妇的HLA-DM基因型。结果:夫妇共享等位基因数为2个时,子痫前期组的例数明显多于正常妊娠组,差异有显著性(P﹤0.05);HLA-DM的各等位基因型在子痫前期组夫妇共享率与正常妊娠组夫妇共享率差异无显著性。结论:夫妇共享HLA-DM基因数与子痫前期发病有关。     

Total and free tissue factor pathway inhibitor in pregnancy hypertension.

OBJECTIVE: To clarify the role played by tissue factor pathway inhibitor (TFPI) in pregnancy hypertension. METHODS: Using enzyme-linked immunosorbent assays, hemostatic measurements were obtained for women with pre-eclampsia (n=51), nonproteinuric hypertension of pregnancy (n=62), postpartum pre-eclampsia 24 h after childbirth (n=31), and no hypertension (healthy pregnant controls, n=100). RESULTS: There was a significant increase in circulating free TFPI levels in women with pre-eclampsia (9.7+/-6.2 ng/mL) or nonproteinuric hypertension of pregnancy (8.3+/-5.3 ng/mL) compared with healthy controls (5.3+/-2.1 ng/mL). In women with pre-eclampsia the levels remained elevated after placental delivery (10.6+/-4.0 ng/mL). Free protein S levels were significantly higher in women with pre-eclampsia (40.0%+/-10.7%), nonproteinuric hypertension of pregnancy (37.1%+/-12.5%), or postpartum pre-eclampsia (39.3%+/-9.1%) than in healthy pregnant controls (32.2%+/-8.5%). CONCLUSION: Increased levels of the physiologically active free forms of TFPI and free protein S, 2 coagulation inhibitors, may protect women with pregnancy-induced hypertension from the risks of hemostatic activation.     

妊高征患者胎盘床滋养细胞内皮素(ET-1)的表达与临床意义

目的:观察妊高征患者胎盘床浸润的滋养细胞内皮素(ET-1)的表达情况,探讨妊高征的发病机理。方法:收集正常妊娠病例30例,妊高征共70例,其中轻度30例,中度20例,重度20例,用免疫组化方法对妊高征和正常妊娠的胎盘床蜕膜段和肌层浸润的滋养细胞进行ET-1的标记。结果:ET-1在妊高征胎盘床蜕膜段浸润的滋养细胞的表达与正常妊娠无明显差别(P>0.05),ET-1在妊高征胎盘床肌层浸润的滋养细胞的表达明显高于正常妊娠(P<0.05)。讨论:妊高征时胎盘床肌层浸润的滋养细胞分泌的内皮素明显增多,提示妊高征的发生可能与肌层浸润的滋养细胞分泌的内皮素增多有关。     

Pregnancy outcomes among visually impaired women in Washington State, 1987–2014

BackgroundWomen with visual impairment may have reduced ability to access standard care resources, however, information on their pregnancy and neonatal outcomes is limited.ObjectiveTo assess risk of adverse pregnancy and neonatal outcomes among visually impaired women in Washington State from 1987 to 2014.MethodsWe conducted a retrospective cohort study using linked Washington State birth/fetal death hospital discharge records to compare outcomes among women with and without visual impairment noted at their delivery hospitalization. Pregnancy conditions and outcomes evaluated included gestational diabetes, pre-eclampsia, labor induction and cesarean delivery. Neonatal outcomes included preterm delivery and birth weight <2500 g. We assessed length of maternal and infant delivery hospitalization. We performed Poisson regression to estimate relative risks (RR) and 95% confidence intervals (CIs) for each outcome, adjusting for year of delivery, maternal age, and parity.ResultsMost adverse pregnancy and neonatal outcomes were similar for visually impaired (N = 232) and comparison women (N = 2362). However, visually impaired women had increased risks of severe pre-eclampsia (RR 3.77, 95% CI 1.69–8.43), labor induction (RR 1.33, 95% CI 1.10–1.61) and preterm delivery (RR 1.60, 95% CI 1.06–2.42). They were also more likely to have delivery hospitalizations of 3 or more days following a vaginal (RR 1.86, 95% CI 1.41–2.47). Among cesarean deliveries, infants of visually impaired women had increased risk (RR 1.24, 95% CI 1.02–1.51) of hospitalization for 3 or more days postpartum.ConclusionOur findings may be useful for obstetric providers in counseling their visually impaired patients.     

妊高征患者胎盘床蜕膜T淋巴细胞亚群的表达与临床意义

目的:观察妊娠高血压综合征患者胎盘床蜕膜T淋巴细胞亚群的表达情况,探讨妊高征的免疫发病机理。方法:收集正常妊娠病例30例,妊高征共60例,其中轻度28例,中度17例,重度15例,用免疫组化方法对妊高征和正常妊娠的胎盘床蜕膜段浸润的淋巴细胞进行CD3、CD4、CD8的标记。结果:CD3在妊高征胎盘床蜕膜段浸润的淋巴细胞的表达明显高于正常妊娠(P<0.05);CD8在妊高征胎盘床蜕膜浸润的淋巴细胞的表达明显低于正常妊娠(P<0.05)。结论:妊高征的发生与T淋巴细胞亚群的变化有着密切的关系,胎-母间免疫失衡是妊高征发病的生要因素。