胎膜早破并发胎盘早剥的临床分析

目的　探讨妊娠晚期胎膜早破并发胎盘早剥的发生率、早期诊断和处理要点。方法　回顾分析2 0 0 1年～2 0 0 4年郑州大学第三附属医院产科分娩的胎膜早破病例,其中并发胎盘早期剥离者8例,与非胎膜早破发生胎盘早剥者进行比较。分析早期诊断和母婴结局。结果　3年分娩总数为4 12 4例,胎膜早破并发胎盘早剥者占全部胎盘早剥的2 8 6 % ,胎膜早破是胎盘早剥的首位发病诱因。胎膜早破并发胎盘早剥的发生率为2 77% ,而非胎膜早破者为0 5 2 % ,两者相比差异有显著性(P <0 0 1)。间断腰痛、血性羊水、胎心异常为常见的临床表现。胎膜早破并发胎盘早剥时围产儿的死亡率为12 5‰,无孕产妇死亡。结论　胎膜早破是胎盘早剥的诱因之一,重视临床表现,并结合B超和胎心监护有助于早期诊断,以降低母儿并发症。     

胎盘早剥的超声诊断

目的:探讨超声对胎盘早剥的诊断价值。方法:对过去16年间我院收治的19例经手术或阴道分娩证实的胎盘早剥患者的声像图与产后结果对照。结果:B超对Ⅰ度胎盘早剥(剥离面积<1/3)的诊断符合率为37.50%,对Ⅱ度(剥离面积1/3左右)、Ⅲ度胎盘剥离(剥离面积>1/2)的诊断符合率为88.89%。结论:超声对中重型胎盘早剥的诊断符合率较轻型患者为高。     

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。     

胎盘早期剥离31例临床分析

目的：探讨胎盘早期剥离(早剥)的发病因素、临床表现及治疗。方法：回顾性分析31例胎盘早剥的临床资料、治疗及预后。结果：胎盘早剥的发生率为0．8％，机械性因素17例(54．8％)，妊娠高血压综合征引起的13例(41．9％)，以中重度为主。临床症状主要以腹痛、阴道流血为多见，分别为64．5％、54．8％，但有部分病例仅表现胎动消失或胎死子宫内，术前确诊较困难。临床类型轻重比例相近，病理类型以隐性和混合性多见，分别为45．2％、51．6％。分娩方式以剖宫产为主(83．9％)，围生儿死亡率54．8％。结论：胎盘早剥的发病因素以机械性因素和中重度妊娠高血压综合征为多见，临床表现以腹痛、阴道流血多见，围生儿病死率高，应做好孕期保健工作，积极推行孕期健康教育。     

胎盘早期剥离13例分析

目的探讨胎盘早期剥离(胎盘早剥)的产前诊断和处理。方法对我院近10年发生的13例胎盘早剥作回顾性分析。结果妊高征及慢性高血压病占本组病因的46．2％。本组围产儿死亡率为23．08％，孕产妇死亡率为0。子宫卒中发生率46．15％，产后出血30．77％，DIC 7．70％。阴道出血、腹痛、胎心异常或消失、血性羊水为主要临床表现。产前诊断率为46．15％，B超检出率为60％。结论胎盘早剥的诊断需结合患者临床表现、发病诱因、B超检查结果全面考虑，确诊后应尽快终止妊娠。     

Natural interferon enhances expression of placental alkaline phosphatase in human seminoma xenograft

The purpose of this study was to investigate the effect of natural interferon (IFN) on the expression of placental alkaline phosphatase (PLAP) in a human seminoma xenograft in severe combined immunodeficient mice. Mice were injected intramuscularly with 3 × 10⁵ U/mouse of IFN, twice a day, for five consecutive days. A significant increase in PLAP level of the xenografts followed IFN treatment. A radiolabeled anti-PLAP monoclonal antibody (MAb) was intravenously injected on the first day of IFN administration in order to determine if IFN has the potential to enhance the efficacy of an anti-PLAP MAb in the detection of seminoma. Enhanced retention of the anti-PLAP MAb was observed at 7 and 11 days after MAb administration. Thus, IFN treatment appears to have some effect on the efficacy of the anti-PLAP MAb in the detection of seminoma xenografts. Received: 26 September 1997 / Accepted: 23 April 1998     

Lack of effect of ouabain on sodium transport across the rat placenta

The umbilical vascular bed of the rat placenta was perfused in situ. Ouabain (10^–4M) in the perfusion fluid had no effect on the unidirectional flux of Na⁺ from the maternal (electrically negative) to the foetal (electrically positive) side of the placenta, or on the transplacental potential difference. This was taken to indicate that there is no significant active transport of Na⁺ across the placenta of the rat.     

米非司酮终止中期妊娠时胎盘循环与超微结构的变化

观察３０例妊娠１６～２４周需终止妊娠者服用米非司酮前后子宫动脉和脐动脉血流速度波型的变化，并用电镜观察了５例胎盘微血管的改变。结果：服用米非司酮后，子宫动脉阻力指数（ＲＩ）和Ｓ／Ｄ比值及脐动脉的Ｓ／Ｄ比值较用药前明显增高，胎盘微血管壁有损伤性表现。提示：子宫胎盘循环动力学的变化及胎盘微血管的损伤可能是米非司酮终止妊娠的重要环节。     

Generation of peroxynitrite and apoptosis in placenta of patients with chorioamnionitis: possible implications in placental abruption

The reaction of nitric oxide (NO) and superoxide results in the formation of peroxynitrite, a potent and relatively long-lived oxidant. In infectious diseases, these molecules are not only bactericidal but also toxic to host cells. Chorioamnionitis is often complicated by premature rupture of membranes and can be associated with placental abruption. These diseases are significant causes of premature low-birth-weight deliveries and consequently the morbidity and mortality of neonates. Lipopolysaccharide, bacterial endotoxin, is known to be elevated in the amniotic fluid of patients with chorioamnionitis. Lipopolysaccharide is known to induce the formation of NO and superoxide. We report here that nitrite/nitrate, stable metabolites of NO, were increased in serum from patients with chorioamnionitis. Immunohistochemical studies demonstrated enhanced expression of inducible NO synthase and formation of nitrotyrosine, a footprint of peroxynitrite, in the placentae from patients with chorioamnionitis and also in patients with placental abruption. Furthermore, apoptotic cell death was also increased in the placentae from patients with both diseases. These results suggest that chorioamnionitis and a portion of placental abruption may share a common cascade of placental injury. Nitric oxide and its metabolities may play an important role in this cascade.     

早、中、晚孕期胎盘因子体外抗HIV-1的研究

目的 探讨早、中、晚孕期胎盘因子(PF)体外抗人免疫缺陷病毒-1(HIV-1)及在HIV-1垂直传播中的作用.方法 荧光染料Calcien-AM标记的H9/HIV-1ⅢB分别与早、中、晚孕期不同稀释浓度的PF作用后,与MT2细胞培养,荧光显微镜下观察合胞休的形成;用HIV-1ⅢB感染MT2细胞,并分别与早、中、晚孕期不同稀释浓度的PF作用后,用MTT法检测HIV-1感染细胞的存活率,用ELISA方法检测细胞培养上清中p24抗原水平.结果 各孕期PF并不能抑制MT2和H9/HIV-1ⅢB细胞的融合,但可以增加HIV-1感染细胞的存活率及减少HIV-1 p24抗原的表达,且效应以早孕期PF最大,中孕期PF其次晚孕期PF最小,并与剂量呈正相关.结论 PF在体外具有抗HIV-I的作用,并呈现孕期和剂量相关性,可能在阻断HIV-1垂直传播中具有一定作用.