BACKGROUND Preeclampsia(PE)is a multisystemic metabolic disease with an undetermined etiology.PE is a worldwide cause of maternal and perinatal morbidity,subdivided into early(EoPE)and late-onset(LoPE)according to 34 ...BACKGROUND Preeclampsia(PE)is a multisystemic metabolic disease with an undetermined etiology.PE is a worldwide cause of maternal and perinatal morbidity,subdivided into early(EoPE)and late-onset(LoPE)according to 34 wk of gestation as a divider.Many researchers investigated biomarkers for predicting PE to halt its consequences on the feto-maternal outcome.Elabela(Ela)is a newly discovered peptide hormone that was implicated in PE pathogenesis.Earlier rodent studies discussed Ela’s role in controlling blood pressure.Moreover,Ela deficiency was associated with PE development.AIM To test whether plasma Ela could serve as a reliable marker for predicting PE based on the time of onset(EoPE vs LoPE)compared to age and body mass matched healthy controls since no definitive treatment exists for PE but to terminate a pregnancy.METHODS This case-control study recruited(n=90)pregnant who fulfilled inclusion criteria;they were allocated into three groups:EoPE(30/90)(<34 wk of gestation);LoPE(30/90)(≥34 wk of gestation);and healthy pregnant(30/90).Demographic criteria;biochemical,hematological,and maternal plasma Ela levels were recorded for comparison.RESULTS Serum Ela was significantly reduced in EoPE compared to LoPE and healthy controls(P=0.0023).The correlation confirmed a strong inverse relationship with mean atrial blood pressure(r=-0.7,P<0.001),while gestational age and platelets count showed a moderate correlation with(r=0.4 with P<0.0001).No correlation was confirmed between the body mass index(BMI)and urine albumin.The predictive ability of 25 centile serum Ela had an Odds ratio of 5.21,95%confidence interval(1.28,21.24),P=0.02 for predicting EoPE.The receiver operator characteristic curve defined the Ela cutoff value at>9.156 with 96.7%and 93.3%sensitivity and specificity,P<0.0001 in predicting EoPE.CONCLUSION A strong correlation of serum Ela with PE parameters with excellent sensitivity and specificity in distinguishing EoPE independent of the BMI,age,and blood pressure which makes Ela a recommendable marker in screening.Further research is warranted to explore prognostic and therapeutic applications for Ela in PE.展开更多
BACKGROUND Preeclampsia(PE)is a pregnancy syndrome of undetermined etiology;inflammation was one of the proposed theories for its development.AIM To examine the platelet to lymphocyte ratio(PLR),an inflammatory biomar...BACKGROUND Preeclampsia(PE)is a pregnancy syndrome of undetermined etiology;inflammation was one of the proposed theories for its development.AIM To examine the platelet to lymphocyte ratio(PLR),an inflammatory biomarker,as a marker to predict poor maternal-neonatal outcomes in early-onset PE(EoPE).METHODS A cross-sectional study enrolled 60 pregnant women with EoPE(at 32-30 wk of gestation)at a university hospital.Demographic criteria and hematological indices were collected,including platelet counts and indices(mean platelet volume and platelet distribution width),PLR,and the Doppler study,which calculated estimated fetal weight(EFW),amniotic fluid index(AFI),resistance index(RI),and pulsatility index(PI).Participants were followed until delivery,where maternal outcomes were recorded,including;delivery mode and reason for cesarean section,and neonatal outcomes,including fetal growth restriction(FGR),meconium-stained liquid,the 5-min Apgar score,and admission to the intensive care unit.RESULTS There was a trend of insignificant increases in cesarean sections.Sixty-one-point two percent(37/60)fetuses were admitted to the neonatal care unit;70.0%of admitted fetuses were meconium-stained liquor,and 56.7%of them had FGR.PLR was positively correlated with AFI and EFW as r=0.98,0.97,P<0.001;PLR showed negative correlations with PI and RI as r=-0.99,-0.98,P<0.001.The Apgar score and the number of days admitted to the intensive care unit had a positive and negative correlation(0.69,-0.98),P<0.0001,respectively.Receiver operating characteristic calculated a PLR cutoff value(7.49)that distinguished FGR at 100%sensitivity and 80%specificity.CONCLUSION Strong,meaningful relationships between PLR and FGR parameters and a poor neonatal outcome with a significant P value make it a recommendable biomarker for screening EoPE-related complications.Further studies are suggested to see the impact on maternal-neonatal health.展开更多
Background: Preeclampsia (PE) is one of the forms of hypertensive diseases that occur during pregnancy. Early-onset preeclampsia (EOP), which occurred before 34 weeks, proved to be the deadliest. Indeed, it is charact...Background: Preeclampsia (PE) is one of the forms of hypertensive diseases that occur during pregnancy. Early-onset preeclampsia (EOP), which occurred before 34 weeks, proved to be the deadliest. Indeed, it is characterized by a poor maternal and fetal prognosis. EOP has a disparate incidence in the world varying between 0.9% and 31%. Several risks factors are associated with the occurrence of EOP, which is responsible of several adverse obstetrical outcomes. Complications can affect up to 85% of pregnant women with EOP, especially when EOP appears very early, before 28 or even 25 weeks’ gestation. Objectives: To determine frequency of EOP at the University Clinics of Kinshasa, to describe sociodemographic and clinical characteristics of pregnant women with EOP and to identify its risks factors and its association adverse obstetrical outcomes. Methods: The study will be a cross-sectional analytical study in University Clinics of Kinshasa from January 2016 to December 2022. The minimal size will be 119. Our study population will consist of pregnant women who consult for antenatal best care and are neonates in our Clinic. Result will be presented as percentage proportion. Comparison and proportion means between groups will be made using Student’s test and Pearson’s chi-square test, respectively. Our test will be statistically significant for a p-value ≤ than less 0.05. Data will be collected and analysed anonymously and confidentiality. Conclusion: We believe that our study should enable us to identify profile of gestational carriers at risk of EOP in our environment, as well as prognosis associated with this entity, with a view to arousing particular interest in EOP.展开更多
目的本研究旨在筛选出能够区分早发型与晚发型子痫前期的遗传标志物,并评估这些标志物的区分能力。方法从GEO数据库获取早发型及晚发型子痫前期数据集(GSE74341、GSE190639及GSE4707数据集),以GSE74341和GSE190639数据集为实验组,GSE470...目的本研究旨在筛选出能够区分早发型与晚发型子痫前期的遗传标志物,并评估这些标志物的区分能力。方法从GEO数据库获取早发型及晚发型子痫前期数据集(GSE74341、GSE190639及GSE4707数据集),以GSE74341和GSE190639数据集为实验组,GSE4707数据集为验证组,筛选并验证早发型子痫前期与晚发型子痫前期间的差异表达基因。应用最小绝对值收缩与选择算子(least absolute shrinkage and selection operator,LASSO)及支持向量机-递归特征消除(support vector machines-recursive feature elimination,SVM-RFE)两种机器学习方法筛选特征遗传标志物,并通过受试者工作特征(receiver operating characteristic,ROC)曲线评估特征遗传标志物的区分能力。结果与早发型子痫前期相比,检出7个显著上调基因和3个显著下调基因。通过两种机器学习的方法及在验证组中进行基因表达差异分析,共同筛选出1个特征遗传标志物(MME)。ROC曲线的曲线下面积(area under the curve,AUC)在实验组及验证组中分别为0.975(95%CI:0.921~1.000)及1(95%CI:1.000~1.000)。结论MME可能作为区分早-晚发型子痫前期的特征遗传标志物。展开更多
目的探究拉贝洛尔联合低分子肝素对早发型重度子痫前期孕妇凝血功能及血压影响。方法选取2021年1月至2022年7月济南市第一人民医院收治的80例早发型重度子痫前期患者作为研究对象,随机分为A组与B组,每组40例。A组给予拉贝洛尔治疗,B组...目的探究拉贝洛尔联合低分子肝素对早发型重度子痫前期孕妇凝血功能及血压影响。方法选取2021年1月至2022年7月济南市第一人民医院收治的80例早发型重度子痫前期患者作为研究对象,随机分为A组与B组,每组40例。A组给予拉贝洛尔治疗,B组给予拉贝洛尔联合低分子肝素治疗。比较两组治疗前后凝血功能指标、血压、血脂水平、母婴结局、新生儿Apgar评分及不良反应发生情况。结果治疗后,B组凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)均长于A组,新生儿5、10 min Apgar评分均高于A组,纤维蛋白原(FIB)、收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平及不良新生儿结局、不良妊娠结局发生率均低于A组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论拉贝洛尔联合低分子肝素治疗早发型重度子痫前期,可改善患者凝血功能、血脂及血压水平,改善母婴结局,且安全性较高。展开更多
目的:观察低分子肝素联合硫酸镁治疗早发型子痫前期的疗效与预后。方法:选择早发型子痫前期病人80例,根据治疗方法不同分为观察组和对照组,各40例。观察组采用低分子肝素联合硫酸镁治疗,对照组采用硫酸镁治疗。比较2组病人治疗前后血压...目的:观察低分子肝素联合硫酸镁治疗早发型子痫前期的疗效与预后。方法:选择早发型子痫前期病人80例,根据治疗方法不同分为观察组和对照组,各40例。观察组采用低分子肝素联合硫酸镁治疗,对照组采用硫酸镁治疗。比较2组病人治疗前后血压、凝血功能和肾功能指标水平及妊娠结局。结果:2组病人治疗前收缩压、舒张压、尿氮素(BUN)、24 h尿蛋白定量(24 h UP)差异均无统计学意义(P>0.05);治疗后观察组收缩压、舒张压、BUN、24 h UP水平均低于治疗前(P<0.05),且均低于对照组(P<0.05~P<0.01)。2组病人治疗前活化部分凝血活酶时间(APTT)水平差异无统计学意义(P>0.05),凝血酶原时间(PT)、D-二聚体水平差异均有统计学意义(P<0.05和P<0.01);2组治疗后APTT、PT、D-二聚体水平均低于治疗前(P<0.05),且观察组治疗后D-二聚体水平明显低于对照组(P<0.01)。观察组妊娠周数明显长于对照组(P<0.01),新生儿窒息率低于对照组(P<0.05),2组围产儿死亡率差异无统计学意义(P>0.05)。结论:低分子肝素联合硫酸镁治疗早发型子痫前期能够改善病人凝血功能和肾功能,延长妊娠周数,改善母婴结局,值得推广。展开更多
目的:基于CiteSpace软件绘制知识图谱,进行早发型子痫前期发病预测模型相关研究的可视化分析。方法:检索2004年1月1日—2023年12月31日中国知网(CNKI)、万方(Wanfang)、维普(VIP)、PubMed及Web of Science(WoS)数据库关于早发型子痫前...目的:基于CiteSpace软件绘制知识图谱,进行早发型子痫前期发病预测模型相关研究的可视化分析。方法:检索2004年1月1日—2023年12月31日中国知网(CNKI)、万方(Wanfang)、维普(VIP)、PubMed及Web of Science(WoS)数据库关于早发型子痫前期发病预测模型相关研究,利用CiteSpace软件对文献的作者、机构、关键词进行可视化分析,采用对数似然率(logarithmic likelihood rate,LLR)聚类对中文、英文文献关键词进行聚类分析。结果:共纳入693篇文献,中文文献327篇,英文文献366篇。国内及国外发文量大体均呈上升趋势,英文文献数据库作者及机构合作相对紧密,中文文献数据库作者及机构合作相对分散。中文文献得到2个聚类,为早发型及预测;英文文献得到7个聚类,为DNA甲基化、早孕期筛查、早发型子痫前期、氧化应激、多重免疫测定、胎儿体质量估计及HELLP综合征。突现词分析显示中文文献数据库2019年及以前主要侧重于分析早发型子痫前期疾病临床特点及治疗策略;2020年及之后,着重于用子痫发病传统标志物构建预测模型。英文文献数据库以早发型子痫前期独立性风险因素为重点,不仅明确了母体因素(子痫前期病史、妊娠期高血压及胎儿生长受限等)、传统指标(子宫动脉多普勒超声、生化标志物、血管生长因子及胎盘生长因子等)等临床可靠且实用特异性指标,还尝试从免疫、DNA甲基化、氧化应激等方向着手发掘临床可广泛应用的特异性指标,且在传统统计方法基础上创新性融合机器学习算法构建模型预测早发型子痫前期的发生。结论:目前构建早发型子痫前期发病预测模型仍为国内外的研究热点,所发掘的特异性指标在融合机器学习算法大背景下构建的预测模型的可靠效力有望进一步提升。展开更多
基金approved by the Scientific-Ethical Committee of the Mustansiriyah University(Approval No.IRB126).
文摘BACKGROUND Preeclampsia(PE)is a multisystemic metabolic disease with an undetermined etiology.PE is a worldwide cause of maternal and perinatal morbidity,subdivided into early(EoPE)and late-onset(LoPE)according to 34 wk of gestation as a divider.Many researchers investigated biomarkers for predicting PE to halt its consequences on the feto-maternal outcome.Elabela(Ela)is a newly discovered peptide hormone that was implicated in PE pathogenesis.Earlier rodent studies discussed Ela’s role in controlling blood pressure.Moreover,Ela deficiency was associated with PE development.AIM To test whether plasma Ela could serve as a reliable marker for predicting PE based on the time of onset(EoPE vs LoPE)compared to age and body mass matched healthy controls since no definitive treatment exists for PE but to terminate a pregnancy.METHODS This case-control study recruited(n=90)pregnant who fulfilled inclusion criteria;they were allocated into three groups:EoPE(30/90)(<34 wk of gestation);LoPE(30/90)(≥34 wk of gestation);and healthy pregnant(30/90).Demographic criteria;biochemical,hematological,and maternal plasma Ela levels were recorded for comparison.RESULTS Serum Ela was significantly reduced in EoPE compared to LoPE and healthy controls(P=0.0023).The correlation confirmed a strong inverse relationship with mean atrial blood pressure(r=-0.7,P<0.001),while gestational age and platelets count showed a moderate correlation with(r=0.4 with P<0.0001).No correlation was confirmed between the body mass index(BMI)and urine albumin.The predictive ability of 25 centile serum Ela had an Odds ratio of 5.21,95%confidence interval(1.28,21.24),P=0.02 for predicting EoPE.The receiver operator characteristic curve defined the Ela cutoff value at>9.156 with 96.7%and 93.3%sensitivity and specificity,P<0.0001 in predicting EoPE.CONCLUSION A strong correlation of serum Ela with PE parameters with excellent sensitivity and specificity in distinguishing EoPE independent of the BMI,age,and blood pressure which makes Ela a recommendable marker in screening.Further research is warranted to explore prognostic and therapeutic applications for Ela in PE.
基金the ethical committee of Mustansiriyah University(No.160).
文摘BACKGROUND Preeclampsia(PE)is a pregnancy syndrome of undetermined etiology;inflammation was one of the proposed theories for its development.AIM To examine the platelet to lymphocyte ratio(PLR),an inflammatory biomarker,as a marker to predict poor maternal-neonatal outcomes in early-onset PE(EoPE).METHODS A cross-sectional study enrolled 60 pregnant women with EoPE(at 32-30 wk of gestation)at a university hospital.Demographic criteria and hematological indices were collected,including platelet counts and indices(mean platelet volume and platelet distribution width),PLR,and the Doppler study,which calculated estimated fetal weight(EFW),amniotic fluid index(AFI),resistance index(RI),and pulsatility index(PI).Participants were followed until delivery,where maternal outcomes were recorded,including;delivery mode and reason for cesarean section,and neonatal outcomes,including fetal growth restriction(FGR),meconium-stained liquid,the 5-min Apgar score,and admission to the intensive care unit.RESULTS There was a trend of insignificant increases in cesarean sections.Sixty-one-point two percent(37/60)fetuses were admitted to the neonatal care unit;70.0%of admitted fetuses were meconium-stained liquor,and 56.7%of them had FGR.PLR was positively correlated with AFI and EFW as r=0.98,0.97,P<0.001;PLR showed negative correlations with PI and RI as r=-0.99,-0.98,P<0.001.The Apgar score and the number of days admitted to the intensive care unit had a positive and negative correlation(0.69,-0.98),P<0.0001,respectively.Receiver operating characteristic calculated a PLR cutoff value(7.49)that distinguished FGR at 100%sensitivity and 80%specificity.CONCLUSION Strong,meaningful relationships between PLR and FGR parameters and a poor neonatal outcome with a significant P value make it a recommendable biomarker for screening EoPE-related complications.Further studies are suggested to see the impact on maternal-neonatal health.
文摘Background: Preeclampsia (PE) is one of the forms of hypertensive diseases that occur during pregnancy. Early-onset preeclampsia (EOP), which occurred before 34 weeks, proved to be the deadliest. Indeed, it is characterized by a poor maternal and fetal prognosis. EOP has a disparate incidence in the world varying between 0.9% and 31%. Several risks factors are associated with the occurrence of EOP, which is responsible of several adverse obstetrical outcomes. Complications can affect up to 85% of pregnant women with EOP, especially when EOP appears very early, before 28 or even 25 weeks’ gestation. Objectives: To determine frequency of EOP at the University Clinics of Kinshasa, to describe sociodemographic and clinical characteristics of pregnant women with EOP and to identify its risks factors and its association adverse obstetrical outcomes. Methods: The study will be a cross-sectional analytical study in University Clinics of Kinshasa from January 2016 to December 2022. The minimal size will be 119. Our study population will consist of pregnant women who consult for antenatal best care and are neonates in our Clinic. Result will be presented as percentage proportion. Comparison and proportion means between groups will be made using Student’s test and Pearson’s chi-square test, respectively. Our test will be statistically significant for a p-value ≤ than less 0.05. Data will be collected and analysed anonymously and confidentiality. Conclusion: We believe that our study should enable us to identify profile of gestational carriers at risk of EOP in our environment, as well as prognosis associated with this entity, with a view to arousing particular interest in EOP.
文摘目的本研究旨在筛选出能够区分早发型与晚发型子痫前期的遗传标志物,并评估这些标志物的区分能力。方法从GEO数据库获取早发型及晚发型子痫前期数据集(GSE74341、GSE190639及GSE4707数据集),以GSE74341和GSE190639数据集为实验组,GSE4707数据集为验证组,筛选并验证早发型子痫前期与晚发型子痫前期间的差异表达基因。应用最小绝对值收缩与选择算子(least absolute shrinkage and selection operator,LASSO)及支持向量机-递归特征消除(support vector machines-recursive feature elimination,SVM-RFE)两种机器学习方法筛选特征遗传标志物,并通过受试者工作特征(receiver operating characteristic,ROC)曲线评估特征遗传标志物的区分能力。结果与早发型子痫前期相比,检出7个显著上调基因和3个显著下调基因。通过两种机器学习的方法及在验证组中进行基因表达差异分析,共同筛选出1个特征遗传标志物(MME)。ROC曲线的曲线下面积(area under the curve,AUC)在实验组及验证组中分别为0.975(95%CI:0.921~1.000)及1(95%CI:1.000~1.000)。结论MME可能作为区分早-晚发型子痫前期的特征遗传标志物。
文摘目的探究拉贝洛尔联合低分子肝素对早发型重度子痫前期孕妇凝血功能及血压影响。方法选取2021年1月至2022年7月济南市第一人民医院收治的80例早发型重度子痫前期患者作为研究对象,随机分为A组与B组,每组40例。A组给予拉贝洛尔治疗,B组给予拉贝洛尔联合低分子肝素治疗。比较两组治疗前后凝血功能指标、血压、血脂水平、母婴结局、新生儿Apgar评分及不良反应发生情况。结果治疗后,B组凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)均长于A组,新生儿5、10 min Apgar评分均高于A组,纤维蛋白原(FIB)、收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平及不良新生儿结局、不良妊娠结局发生率均低于A组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论拉贝洛尔联合低分子肝素治疗早发型重度子痫前期,可改善患者凝血功能、血脂及血压水平,改善母婴结局,且安全性较高。
文摘目的:观察低分子肝素联合硫酸镁治疗早发型子痫前期的疗效与预后。方法:选择早发型子痫前期病人80例,根据治疗方法不同分为观察组和对照组,各40例。观察组采用低分子肝素联合硫酸镁治疗,对照组采用硫酸镁治疗。比较2组病人治疗前后血压、凝血功能和肾功能指标水平及妊娠结局。结果:2组病人治疗前收缩压、舒张压、尿氮素(BUN)、24 h尿蛋白定量(24 h UP)差异均无统计学意义(P>0.05);治疗后观察组收缩压、舒张压、BUN、24 h UP水平均低于治疗前(P<0.05),且均低于对照组(P<0.05~P<0.01)。2组病人治疗前活化部分凝血活酶时间(APTT)水平差异无统计学意义(P>0.05),凝血酶原时间(PT)、D-二聚体水平差异均有统计学意义(P<0.05和P<0.01);2组治疗后APTT、PT、D-二聚体水平均低于治疗前(P<0.05),且观察组治疗后D-二聚体水平明显低于对照组(P<0.01)。观察组妊娠周数明显长于对照组(P<0.01),新生儿窒息率低于对照组(P<0.05),2组围产儿死亡率差异无统计学意义(P>0.05)。结论:低分子肝素联合硫酸镁治疗早发型子痫前期能够改善病人凝血功能和肾功能,延长妊娠周数,改善母婴结局,值得推广。
文摘目的:基于CiteSpace软件绘制知识图谱,进行早发型子痫前期发病预测模型相关研究的可视化分析。方法:检索2004年1月1日—2023年12月31日中国知网(CNKI)、万方(Wanfang)、维普(VIP)、PubMed及Web of Science(WoS)数据库关于早发型子痫前期发病预测模型相关研究,利用CiteSpace软件对文献的作者、机构、关键词进行可视化分析,采用对数似然率(logarithmic likelihood rate,LLR)聚类对中文、英文文献关键词进行聚类分析。结果:共纳入693篇文献,中文文献327篇,英文文献366篇。国内及国外发文量大体均呈上升趋势,英文文献数据库作者及机构合作相对紧密,中文文献数据库作者及机构合作相对分散。中文文献得到2个聚类,为早发型及预测;英文文献得到7个聚类,为DNA甲基化、早孕期筛查、早发型子痫前期、氧化应激、多重免疫测定、胎儿体质量估计及HELLP综合征。突现词分析显示中文文献数据库2019年及以前主要侧重于分析早发型子痫前期疾病临床特点及治疗策略;2020年及之后,着重于用子痫发病传统标志物构建预测模型。英文文献数据库以早发型子痫前期独立性风险因素为重点,不仅明确了母体因素(子痫前期病史、妊娠期高血压及胎儿生长受限等)、传统指标(子宫动脉多普勒超声、生化标志物、血管生长因子及胎盘生长因子等)等临床可靠且实用特异性指标,还尝试从免疫、DNA甲基化、氧化应激等方向着手发掘临床可广泛应用的特异性指标,且在传统统计方法基础上创新性融合机器学习算法构建模型预测早发型子痫前期的发生。结论:目前构建早发型子痫前期发病预测模型仍为国内外的研究热点,所发掘的特异性指标在融合机器学习算法大背景下构建的预测模型的可靠效力有望进一步提升。
