The Association between Polymorphism of TNF-α Gene and Hypertensive Disorder Complicating Pregnancy

To study whether the development of hypertensive disorder complicating pregnancy is associated with --308G→A, -850C→T mutation at promoter of TNF-α gene, the --308G→A, --850C→T polymorphism was examined in patients and healthy pregnant women by PCR-RFLP technique. The frequencies of genotype and allele were compared between the two groups. The results showed that with-308G→A polymorphism distribution, the allele frequency of TNF2 and the frequency of the genotype TNF2/1 in the patient group was significantly higher in the patient group than in control group （P〈0.05）. A significant difference in genotype distribution of --850C→T polymorphism was observed between the two groups. The allele frequencies of T in patient group was higher in the control group as compared with the patient group. The frequencies of CT and TT genotypes were lower in the patient group. It is concluded that the TNF2 allele of -308 is associated with the occurrence of hypertensive disorder complicating pregnancy, while T allele of--850 may be the protective factor against the development of the disease. TNF2/1 CC may be susceptibility genotype of hypertensive disorder complicating pregnancy.

Endogenous Ouabain in Hypertensive Disorder Complicating Pregnancy

Expression of endogenous ouabain in placenta and the concentrations of serum ET-1 and NO were examined in 30 patients with hypertensive disorder complicating pregnancy （HDCP） and 30 healthy pregnant women to investigate the effect of endogenous ouabain on HDCP. Compared with the healthy pregnant group, the expression of endogenous ouabain dramatically increased in the HDCP groups （P〈0.01）. There was a significantly positive correlation between the expression of en- dogenous ouabain with ET-1 （r= 0.5567, P〈0.01）, while the correlation of endogenous ouabain and NO was significantly negative （r=-0.6895, P〈0.01）. As expected, the correlation between ET-1 and NO was negative （r=-0.7796, P〈0.01）. ET-1 concentrations of maternal and cord sera in HDCP groups were significantly higher in comparison with healthy pregnant group （P〈0.01）. On the contrast, NO concentrations were much lower in the maternal and cord sera of HDCP groups as compared with healthy pregnant group （P〈0.01）. Our data suggest that endogenous ouabain is directly involved in the nosogenesis of HDCP, with accompanying decreased NO and the elevated of ET-1.

The investigation for the relationship among serum leptin, erythrocyte membrane Ca^(2+)-ATPase activity and hypertensive disorder complicating pregnancy

Objective： To study the significance of Leptin and the activity of erythrocyte membrane Ca^2＋-ATPase（EMCA） in the development of hypertensive disorder complicating pregnancy. Methods： Radioimmunoassay was used to test the level of serum Leptin, and the activity of EMCA was determined chemically in 38 pregnant women with hypertensive disorder complicating pregnancy and 36 normotensive pregnant women. Results： The level of serum Leptin in hypertensive disorder complicating pregnancy（gestational hypertension： 13.76 ± 3.46 ng/ml; preeclampsia： 15.76 ± 5.47 ng/ml; eclampsia： 18.32 ± 6.38 ng/ml）was significantly higher than that in normotensive pregnant women （11.33 ± 2.93 ng/ml） ,respectively. The average EMCA activity of patients with hypertensive disorder complicating pregnancy （gestational hypertension： 1.65 ± 0.24 μmol·pi/mg.h ; preeclampsia： 1.37 ± 0.19 μ mol·pi/mg·h;eclampsia：1.12 ± 0.14 μmol·pi/mg·h） was significantly lower than that of normotensive pregnant women（1.83 ± 0.38 μ mol·pi/mg·h）,respectively. There was a negative correlation between the level of serum Leptin and the activity of RMCA in hypertensive disorder complicating pregnancy （r = -0.63）. Conclusion： Inhibition of EMCA activity of erythrocyte in hypertensive disorder complicating pregnancy may increase cytoplasmic free calcium, which contributes to the development of hypertensive disorder complicating pregnancy. The negative correlation between the level of serum Leptin and the activity of EMCA, also suggested that serum Leptin and the activity of EMCA may play a role in the development of hypertensive disorder complicating pregnancy.

Ultrasonic evaluation of central retinal artery hemodynamics in patients with hypertensive disorder complicating pregnancy and the correlation with disease

Objective:To study the correlation between central retinal artery hemodynamic characteristics in patients with hypertensive disorder complicating pregnancy and endothelial injury molecules as well as trophoblast cell apoptosis molecules.Methods: 45 healthy pregnant women, 37 patients with gestational hypertension and 24 patients with preeclampsia who gave birth in Obstetrics Department of our hospital between May 2013 and December 2015 were selected and included in the control group, GH group and PE group respectively. Central retinal artery ultrasonography was done to determine peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistance index (RI), serum was collected to determine interleukin-6 (IL-6), IL-17, IL-24, chemokine ligand 10 (CXCL10) and cartilage glycoprotein 40 (YKL40) content, and placenta tissue was collected to determine Fas, FasL, Bax, Caspase-3, Caspase-9, XIAP, Survivin and Livin expression.Results: Central retinal artery PSV and EDV as well as XIAP, Survivin and Livin expression in placenta of GH group and PE group were significantly lower than those of control group (P<0.05) while central retinal artery RI, serum IL-6, IL-17, IL-24, CXCL10 and YKL40 content as well as Fas, FasL, Bax, Caspase-3 and Caspase-9 expression in placenta were significantly higher than those of control group (P<0.05). Central retinal artery PSV and EDV as well as XIAP, Survivin and Livin expression in placenta of PE group were significantly lower than those of GH group (P<0.05) while central retinal artery RI, serum IL-6, IL-17, IL-24, CXCL10 and YKL40 content as well as Fas, FasL, Bax, Caspase-3 and Caspase-9 expression in placenta were significantly higher than those of GH group (P<0.05). Serum IL-6, IL-17, IL-24, CXCL10 and YKL40 content as well as Fas, FasL, Bax, Caspase-3 and Caspase-9 expression in placenta were negatively correlated with PSV and EDV, and positively correlated with RI;XIAP, Survivin and Livin expression in placenta were positively correlated with PSV and EDV, and negatively correlated with RI. Conclusions:Central retinal artery blood flow characteristics in patients with hypertensive disorder complicating pregnancy are the significantly increased blood flow resistance and the significantly decreased blood flow volume, and the above blood flow characteristics are associated with maternal endothelial injury and trophoblast cell apoptosis.

Effect of low molecular weight heparin therapy on maternal endothelial injury and placental pathological injury after hypertensive disorder complicating pregnancy

Objective: To study the effect of low molecular weight heparin therapy on maternal endothelial injury and placental pathological injury after hypertensive disorder complicating pregnancy. Methods: A total of 70 patients with hypertensive disorder complicating pregnancy who were treated in the hospital between September 2014 and May 2016 were divided into control group and observation group according to the random number table method, 35 cases in each group. Control group received conventional therapy, the observation group received low molecular weight heparin combined with conventional therapy, and both therapies lasted until delivery. The differences in the levels of endothelial injury indexes in serum as well as the expression of oxidative stress indexes and apoptosis molecules in the placental grinding fluid were compared between the two groups of patients. Results: After treatment, serum ET and VCAM-1 levels of both groups of patients were lower than those before treatment while NO and PGE levels were higher than those before treatment, and serum ET and VCAM-1 levels of observation group were lower than those of control group while NO and PGE levels were higher than those of control group;after delivery, AOPP and MDA levels in placental grinding fluid were significantly lower than those of control group while SOD and GSH-Px levels were higher than those of control group;Fas, p53 and caspase-3 mRNA expression in placental grinding fluid were lower than those of control group while Bcl-2 and bax mRNA expression were higher than those of control group. Conclusion: Adjuvant low molecular weight heparin therapy can help to reduce the maternal endothelial injury, reduce the systemic oxidative stress and suppress the placental cell apoptosis in patients with hypertensive disorder complicating pregnancy.

Ultrasonic evaluation of fetal ventricular systolic function in hypertensive disorder complicating pregnancy and its correlation with the expression of placental hypoxia-related genes

Objective: To discuss the ultrasonic evaluation of fetal ventricular systolic function in hypertensive disorder complicating pregnancy and its correlation with the expression of placental hypoxia-related genes. Methods: A total of 98 late pregnant women with hypertensive disorder complicating pregnancy who were treated in the hospital between December 2014 and February 2017 were selected as hypertensive disorder complicating pregnancy group and 100 normal late pregnant women who received physical examination in the hospital during the same period were selected as normal control group. The ultrasonic parameters of fetal ventricular systolic function in two groups of pregnant women were detected before delivery, and the expression of hypoxia-related genes in placental tissue was detected by fluorescence quantitative PCR. Pearson test was used to assess the correlation between the parameters of fetal ventricular systolic function and placental hypoxia in hypertensive disorder complicating pregnancy. Results: The fetal left ventricular fractional shortening and right ventricular fractional shortening levels of hypertensive disorder complicating pregnancy group were lower than those of normal control group. Angiogenesis-related genes VEGF, netrin-1 and XIAP mRNA expression in placental tissue of hypertensive disorder complicating pregnancy group were lower than those in placental tissue of normal control group while HIF-1α mRNA expression was higher than that in placental tissue of normal control group;oxidative stress-related genes Nrf2, TAC3 and PrxⅡ mRNA expression in placental tissue were lower than those in placental tissue of normal control group;apoptosis genes Fas, p53 and caspase-9 mRNA expression in placental tissue were higher than those in placental tissue of normal control group while Bcl-2 and SFRP2 mRNA expression were lower than those in placental tissue of normal control group. Pearson test showed that the ultrasonic parameter levels of fetal ventricular systolic function in hypertensive disorder complicating pregnancy were directly correlated with the degree of placental hypoxia. Conclusion:Ultrasonic testing of fetal ventricular systolic function in hypertensive disorder complicating pregnancy can be used as a reliable method to measure the degree of placental hypoxia.

Effect of folic acid and vitamin supplement on endothelial injury and placental blood perfusion in patients with hypertensive disorder complicating pregnancy

Objective: To study the effect of folic acid and vitamin supplement on endothelial injury and placental blood perfusion in patients with hypertensive disorder complicating pregnancy. Methods: A total of 62 patients who were diagnosed with preeclampsia in Wuhan Red Cross hospital between March 2015 and February 2017 were selected as the research subjects and randomly divided into two groups, the observation group received folic acid, vitamin and conventional symptomatic treatment, and control group accepted conventional symptomatic treatment. Serum contents of endothelial injury markers and oxidative stress indexes were detected before treatment and 2 weeks after treatment;the expression of apoptosis genes in the placenta were detected after delivery. Results: 2 weeks after treatment, serum ET-1, tTG, sFlt-1, sEng, MPO, IMA, MDA and AOPP levels of both groups of patients were significantly lower than those before treatment, and serum ET-1, tTG, sFlt-1, sEng, MPO, IMA, MDA and AOPP levels of observation group were significantly lower than those of control group;after delivery, Fas, Bax and Caspase-3 mRNA expression levels in placenta tissue of observation group were significantly lower than those of control group while Bcl-2, Survivin and Livin mRNA expression levels were significantly higher than those of control group. Conclusion:Folic acid and vitamin supplement can significantly improve the endothelial injury and placental blood perfusion in patients with hypertensive disorder complicating pregnancy.

Changes in Number and Biological Function of Endothelial Progenitor Cells in Hypertension Disorder Complicating Pregnancy

To examine the changes in number and function of endothelial progenitor cells （EPCs） from peripheral blood （PB） in hypertension disorder complicating pregnancy （HDCP）, 20 women with HDCP and 20 normal pregnant women at the third trimester were studied. Mononuclear cells （MNCs） from PB were isolated by Ficoll density gradient centrifugation. EPCs were identified by positive expression of both CD34 and CD133 under fluorescence microscope and positive expression of factor Ⅷ as shown by immunocytochemistry. The number of EPCs was flow-cytometrically determined. Proliferation and migration of EPCs were measured by MTT assay and modified Boyden chamber assay, respectively. The adhesion activity of EPCs was detected by counting the number of the adherent cells. The results showed that, compared with normal pregnant women, the number of EPCs was significantly reduced in HDCP （4.29%±1.21% vs 15.32%±2.00%, P〈0.01）, the functional activity of EPCs in HDCP, such as proliferation （13.45%±1.68% vs 18.45%±1.67%）, migration （37.25±7.28 cells/field vs 67.10±9.55 cells/field） and adhesion activity （20.65±5.19 cells/field vs 34.40±6.72 cells/filed） was impaired （P〈0.01）. It is concluded that the number and function of EPCs are significantly decreased in HDCP.

Pregnancy complications effect on the nickel content in maternal blood,placenta blood and umbilical cord blood during pregnancy

BACKGROUND Nickel(Ni)may accumulate in the human body and has biological toxicity and carcinogenicity.Ni has an extensive impact on the health of pregnant women and fetuses during gestation.AIM To evaluate Ni exposure in pregnant women in Kunming,Yunnan Province,China;to describe the distribution of Ni in the maternal-fetal system and placental barrier function;and to investigate the effect of Ni exposure on fetal health in mothers with pregnancy complications.METHODS Seventy-two pregnant women were selected using a case-control design.The women were divided into two groups:The control group(no disease;n=29)and the disease group[gestational diabetes(GDM),hypertensive disorder complicating pregnancy(HDCP),or both;n=43].The pregnant women in the disease group were further divided as follows:14 cases with GDM(GDM group),13 cases with HDCP(HDCP group)and 16 cases with both GDM and HDCP(disease combination group).Basic information on the pregnant women was collected by questionnaire survey.Maternal blood,placenta blood and cord blood were collected immediately after delivery.The Ni content in paired samples was determined using inductively coupled plasma mass spectrometry.RESULTS Compared to the control group,age was higher and body mass index was greater in pregnant women in the disease groups(28.14±2.54 vs 28.42±13.89,P<0.05;25.90±3.86 vs 31.49±5.30,P<0.05).The birth weights of newborns in the HDCP group and the control group were significantly different(2.52±0.74 vs 3.18±0.41,P<0.05).The content of Ni in umbilical cord blood in the entire disease group was higher than that in the control group(0.10±0.16 vs 0.05±0.07,P<0.05).CONCLUSION In the maternal-fetal system of women with pregnancy complications,the barrier effect of the placenta against Ni is weakened,thus affecting healthy growth of the fetus in the uterus.

HDCP患者心肌酶谱与血脂指标的关联性研究

目的探讨妊娠期高血压疾病(HDCP)患者心肌酶谱与血脂指标的关联性。方法收集2014年1月1日至6月30日在深圳沙井医院就诊的91例HDCP患者,其中妊娠期高血压20例、轻度子痫前期45例、重度子痫前期26例,选择50例同期在医院正常分娩产妇作为对照组,测量各组血脂指标及心肌酶谱,对两种指标的相关性进行评估。结果妊娠期高血压组、轻度子痫前期组、重度子痫前期组的体质量指数(BMI)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A(Apo-A)、载脂蛋白B(Apo-B)、乳酸脱氢酶(LDH)、天门冬氨酸氨基转移酶(AST)及肌酸激酶(CK)与对照组比较差异均有统计学意义(t=1.845-13.482,均P<0.05);轻、重度子痫前期组的BMI、LDL-C、TC、TG、HDL-C、Apo-A、Apo-B、LDH、AST及CK与妊娠期高血压组比较差异均有统计学意义(t=1.663-14.258,均P<0.05);重度子痫前期组的BMI、LDL-C、TC、TG、HDL-C、Apo-A、Apo-B、LDH、AST及CK与轻度子痫前期组比较差异均有统计学意义(t=1.488~16.225,均P<0.05);对照组与各HDCP组脂蛋白a(Lpa)及肌酸激酶同工酶(CK-MB)组间比较差异均无统计学意义(均P>0.05)。多因素相关分析表明,LDL-C、Apo-B均为AST和CK的独立相关因素(r^2分别为0.513、0.497和0.391、0.445,均P<0.05)。结论 HDCP患者血清中LDL-C、TC、TG、Apo-B、AST、LDH及CK均有所升高,HDL-C和Apo-A则明显下降,而且随着病情的加重变化更为明显,心肌酶谱指标AST和CK与LDL-C、Apo-B具有一定的相关性。

血清Hcy水平与HDCP的相关性及其在发病机制中的作用

目的探讨血清同型半胱氨酸(Hcy)水平的变化与妊娠期高血压疾病(HDCP)的相关性及在HDCP发病机制中的作用。方法选取2017年1至5月佛山市妇幼保健院产科收治的HDCP患者124例入组研究组,筛选同期健康妊娠妇女124例入组参照组,检测两组Hcy、低密度脂蛋白(ox-LDL)、超敏C反应蛋白(hsCRP)、D-二聚体(D-D)水平,并进行Logistic回归分析。结果研究组Hcy(20.23±1.05)μmol/L、ox-LDL(589.4±134.6)μg/L、hsCRP(25.7±4.2)mg/L及D-D(0.71±0.24)mg/L均明显高于参照组(t值分别为7.582、11.343、12.557、12.352,均P<0.01);HDCP重度患者Hcy(26.25±1.16)μmol/L、ox-LDL(783.6±164.3)μg/L、hsCRP(26.38±6.3)mg/L及D-D(0.89±0.24)mg/L均明显高于中、轻度患者(t值分别为25.64、28.75、20.34、19.87,均P<0.01);经Logistic回归分析,Hcy、ox-LDL、hsCRP及D-D均与HDCP存在明显相关性(β值分别为1.062、0.927、1.103、1.104,均P<0.05)。结论 Hcy、ox-LDL、hsCRP及D-D是与HDCP相关的敏感指标,通过对这些指标水平进行检测,能够有效预测妊娠期高血压疾病的发生及发展;而Hcy水平是引发HDCP形成与发展的重要机制之一。

脂蛋白（a）、SOD、尿酸水平与HDCP关系的研究

目的探讨脂蛋白（a）、超氧化物歧化酶（SOD）、尿酸水平与妊娠期高血压疾病（HDCP）的关系。方法用全自动生化分析仪检测67例HDCP患者血清中脂蛋白（a）、SOD和尿酸水平，根据病情分为妊娠期高血压组21例，轻度子痫前期组19例，重度子痫前期组27例；与50例孕周相近的正常单胎妊娠妇女（对照组）的血清脂蛋白（a）、SOD、尿酸水平进行比较分析。结果①HDCP各组血清脂蛋白（a）和尿酸水平均高于正常对照组，t值分别为-4．879、-7．410，均P〈0．05，各组的SOD低于对照组，t=5．658，P〈0．05；②妊娠期高血压组、轻度子痫前期组和重度子痫前期组孕妇的脂蛋白（a）逐渐升高，重度子痫前期与轻度子痫前期组比较，差异有统计学意义（t=-2．109，P〈0．05），妊娠期高血压与轻度子痫前期组比较，差异无统计学意义（t=-0．274，P〉0．05）；③不同程度的HDCP患者之间s0D水平差异有统计学意义（F=16．868，P〈0．05）；不同程度的HDCP患者之间尿酸的水平差异有统计学意义（F=24．603，P〈0．05）。结论HDCP患者脂蛋白（a）、尿酸水平升高，SOD水平降低。临床上可通过检测脂蛋白（a）、SOD和尿酸综合判断妊娠期高血压疾病患者病情的发展与预后。

miR-26b、miR-1233-3p、miR-206与妊娠期高血压血管内皮功能关系及三者联合预测HDCP不良妊娠结局的ROC曲线分析

目的 探讨微小RNA-26b(microRNA-26b, miR-26b)、miR-1233-3p、miR-206与妊娠期高血压(hypertensive disorders complicating pregnancy, HDCP)血管内皮功能关系及三者联合预测HDCP不良妊娠结局的价值。方法 选取2019-04/2021-04月作者医院收治的104例HDCP患者的病历资料进行分析。根据是否发生不良妊娠结局分为发生组(n=25)和未发生组(n=79)。比较两组基线资料、肱动脉内皮依赖性舒张功能(flow mediated dilation, FMD)、miR-26b、miR-1233-3p、miR-206。应用Pearson相关分析探讨miR-26b、miR-1233-3p、miR-206与FMD关系。采用多因素Logistic回归分析探讨不良妊娠结局的相关影响因素。采用受试者工作特征(receiver operating characteristic, ROC)曲线及曲线下面积(area under the curve, AUC)分析miR-26b、miR-1233-3p、miR-206预测HDCP不良妊娠结局的价值。结果 发生组患者病情阶段与未发生组比较,差异有统计学意义(P<0.05)。发生组患者FMD、miR-206低于未发生组,miR-26b、miR-1233-3p高于未发生组(P均<0.05)。miR-26b、miR-1233-3p与FMD呈负相关(r=-0.538、-0.588,P均<0.001),miR-206与FMD呈正相关(r=0.653,P<0.001)。调整病情阶段、FMD后,miR-26b、miR-1233-3p、miR-206仍与HDCP不良妊娠结局相关(P<0.05)。miR-26b、miR-1233-3p、miR-206及三者联合预测HDCP不良妊娠结局的AUC分别为0.771(95%CI:0.658~0.884)、0.790(95%CI:0.673~0.907)、0.772(95%CI:0.678~0.856)、0.840(95%CI:0.743~0.936),三者联合预测价值最大。结论 miR-26b、miR-1233-3p、miR-206与HDCP血管内皮功能、不良妊娠结局有关,三者联合检测可作为HDCP不良妊娠结局的一个有效预测方案。

内蒙古地区HDCP疾病与人类白细胞抗原多态性研究

目的:检测内蒙古地区HDCP患者HLA基因HLA-A,HLA-B位点与HDCP的相关性。方法:采用国内先进的FLOW-SSOP(Luminex流式技术-序列特异性寡核苷酸探针反向杂交)技术检测A、B位点基因频率及基因型频率分布,分析妊娠期高血压疾病与HLA-I类抗原的关系。结果:妊娠期高血压组HLA-A、B位点等位基因的基因频率与正常妊娠组无显著差异(P>0.05)。结论:内蒙古地区妊娠期高血压疾病的发生与HLA-I类抗原无关。

HDCP患者血清miR-181b、PLGF、IL-17与疾病严重程度的关系及其对不良妊娠结局的预测价值

目的:探讨妊娠高血压疾病(HDCP)患者血清miR-181b、胎盘生长因子(PLGF)、白细胞介素17(IL-17)与疾病严重程度的关系及对不良妊娠结局的预测价值。方法:选取126例HDCP孕妇为研究对象,根据HDCP严重程度不同分为妊娠期高血压组(n=61)、子痫前期组(n=37)和重度子痫前期组(n=28);根据妊娠结局分为正常组(n=62)和不良妊娠组(n=64)。比较不同疾病严重程度及不同妊娠结局患者血清IL-17、PLGF、miR-181b水平,分析其与HDCP严重程度的关系及其对不良妊娠结局的预测价值。结果:不同疾病严重程度组患者血清miR-181b、IL-17及PLGF水平差异有统计学意义(P<0.05),且患者血清miR-181b和IL-17水平比较:重度子痫前期组>子痫前期组>妊娠期高血压组;PLGF水平比较:重度子痫前期组<子痫前期组<妊娠期高血压组。miR-181b和IL-17水平与HDCP严重程度正相关(P<0.05),PLGF水平与HDCP严重程度负相关(P<0.05)。早产和产后出血为主要不良妊娠结局,重度子痫前期组不良妊娠结局发生率最高(P<0.05)。不良妊娠组患者miR-181b、IL-17水平高于正常组(P<0.05),PLGF水平明显较低(P<0.05)。miR-181b(AUC=0.725,P<0.05)、IL-17(AUC=0.692,P<0.05)及PLGF(AUC=0.698,P<0.05)对不良妊娠结局均有预测价值,三者联合检测的AUC=0.792,敏感度为85.94%,特异度为64.52%。结论:血清miR-181b、PLGF、IL-17水平与HDCP严重程度相关,对不良妊娠结局有预测价值,联合检测的预测价值更高。

CD4^＋CD25^＋Foxp3^＋调节性T细胞在HDCP外周血中水平变化及其意义

目的:探讨妊娠期高血压疾病患者(HDCP)外周血中CD4+CD25+Foxp3+调节性T细胞水平变化及其意义。方法:选取2013年1月至2014年8月在我院治疗的妊娠期高血压疾病(HDCP)患者46例,其中轻度子痫前期22例,重度子痫前期24例,同时选取同期正常孕妇25例,采用流式细胞术检测各组患者外周血CD4+CD25+Foxp3+调节性T细胞。结果:重度子痫前期组CD4+CD25+T细胞比例为(5.01±1.04)%,低于轻度子痫前期组的(7.38±1.26)%和正常孕妇组的(12.59±2.48)%,差异有统计学意义(P<0.05);轻度子痫前期组和重度子痫前期组CD4+CD25+Foxp3+T细胞绝对数分别为(0.96±0.11)×107和(0.63±0.12)×107,CD4+CD25+Foxp3+Treg/CD4+T分别为(2.58±0.93)%和(1.84±0.85)%,均低于正常孕妇组的(1.85±0.17)×107和(5.11±0.99)%,差异有统计学意义(P<0.05);轻度子痫前期组和重度子痫前期组血清雌三醇分别为(6.16±2.17)mg/L和(3.27±1.15)mg/L,明显低于正常孕妇组的(11.34±2.4)mg/L,差异有统计学意义(P<0.05)。结论:妊娠高血压疾病患者CD4+CD25+Foxp3+调节性T细胞明显减少,同时血清雌三醇也有所降低,这些可能与妊娠期高血压疾病的发病机制以及免疫耐受有关。

HDCP与子痫各期外周血D-二聚体及单侧子宫动脉血流比较

目的探讨分析外周血D-二聚体及单侧子宫动脉血流在妊娠期高血压疾病患者中比较的临床意义。方法回顾性分析于2015年2月至2016年7月来淮安市淮阴医院就诊的健康孕妇140例,妊娠期高血压42例,轻度子痫前期68例,重度子痫前期48例,于患者妊娠10~14周和30~34周时测量外周血D-二聚体浓度,妊娠20~24周时测定分析子宫动脉血流频谱,对比分析四组患者的外周血D-二聚体和单侧子宫动脉血流。结果四组患者10~14周D-二聚体水平明显低于30~34周,差异有统计学意义(t值分别为-3.50、-2.98、-6.32、-5.61,均P<0.05)。健康孕妇组10~14周和30~34周检测外周血D-二聚体水平明显低于妊娠期高血压组,差异有统计学意义(t值分别为-3.56、-2.55,均P<0.05)。妊娠期高血压组两次检测外周血D-二聚体水平明显低于轻度子痫前期组,差异有统计学意义(t值分别为-3.72、-3.42,均P<0.05)。轻度子痫前期组10~14周检测外周血D-二聚体水平明显低于重度子痫前期组,差异有统计学意义(t=-3.39,P<0.05)。轻度子痫前期组患者D-二聚体水平30~34周时,与重度子痫前期组比较,差异无统计学意义(t=-1.84,P>0.05)。健康孕妇组S/D比值明显低于妊娠期高血压组、轻度子痫前期组和重度子痫前期组,差异有统计学意义(t值分别为-2.74、-5.26、-5.74,均P<0.05)。妊娠期高血压组患者S/D比值明显低于轻度子痫前期组和重度子痫前期组,差异有统计学意义(t值分别为-2.30、-2.91,均P<0.05)。轻度子痫前期组患者S/D比值明显低于重度子痫前期组,差异有统计学意义(t=-2.05,P=0.04)。结论外周血D-二聚体与子宫动脉血流能够反应患者妊娠高血压的严重程度,具有一定的诊断意义。

HDCP患者血浆HCY和PTM水平变化及其相关性

目的检测妊娠期高血压疾病患者血浆同型半胱氨酸和血栓调节蛋白水平,探讨同型半胱胺酸和血栓调节蛋白与妊娠期高血压疾病的关系,及同型半胱胺酸与血栓调节蛋白的相关性。方法采用酶联免疫吸附试验分别检测各组患者血浆同型半胱胺酸和血栓调节蛋白水平,与正常晚孕妇女和正常非孕妇女各30名进行比较,并进行相关性分析。结果正常晚孕组血浆同型半胱胺酸(11．75±3．77)和血栓调节蛋白(24．83±9．51)水平高于正常非孕组(8．18±2．51和18．49±8．46),差异有显著性(P＜0．01)。轻度妊娠期高血压疾病组患者血浆同型半胱胺酸(13．89±4．23)和血栓调节蛋白(30．06±9．79)水平与正常晚孕组差异无显著性(P＞0．05)；中、重度组患者血浆同型半胱胺酸(21．26±5．14)和血栓调节蛋白(43．27±16．15)水平明显高于轻度组患者和正常晚孕组,差异均有显著性(P＜0．01)。血浆同型半胱胺酸水平与血栓调节蛋白水平呈显著的正相关(r=0．628、t=6．605、p＜0．01)。结论妊娠期高血压疾病患者血浆同型半胱胺酸及血栓调节蛋白水平均较正常孕妇明显升高,且与患者病情正相关。高同型半胱胺酸血症可能与妊娠期高血压疾病内皮细胞损伤有关,高浓度血栓调节蛋白是血管内皮细胞受损或功能活化标志,血浆同型半胱胺酸水平与血栓调节蛋白水平具有相关一致性。

不同严重程度HDCP患者孕晚期甲状腺功能水平的差异

目的探讨不同严重程度妊娠期高血压疾病(HDCP)患者孕晚期血清促甲状腺激素(TSH)、游离甲状腺素(FT4)和甲状腺过氧化物酶抗体(TPO-Ab)水平差异。方法于2014年9月至2016年10月在国家电网公司北京电力医院妇产科随机选取120例HDCP患者作为实验组,按照病情严重程度不同将其分为妊娠高血压组(45例)、轻度子痫前期组(40例)及重度子痫前期组(35例);并以同期于本院产检的113例健康孕妇为对照组。对比分析各组孕妇孕晚期的血清TSH、FT4和TPOAb水平。结果实验组的TSH及TPO-Ab水平明显高于对照组,而FT4水平显著低于对照组,差异具有统计学意义(t=4.258~8.768,均P<0.05),随着HDCP患者病情的加重,血清TSH水平明显呈升高的趋势(F=50.21,P<0.05),FT4水平则明显呈下降的趋势(F=28.97,P<0.05)。妊娠高血压组、轻度子痫前期组及重度子痫前期组的甲状腺功能异常发生疾病率依次增高,分别为2.22%、15.01%和48.64%;对照组的甲状腺功能异常发生疾病率为8.0%,与实验组相比差异均有统计学意义(χ~2=6.934,P<0.05),且妊娠高血压组、轻度子痫前期组及重度子痫前期组的甲状腺功能异常疾病发生率依次增高,差异具有统计学意义(χ~2值分别为4.575、24.254、9.859,均P<0.05)。结论随着HDCP患者病情的加重,其孕晚期的血清TSH水平明显越高,FT4水平明显越低,甲状腺功能异常疾病发生率显著增高。

HDCP患者血清Apelin蛋白水平与尿蛋白定量的相关性

目的探讨妊娠期高血压疾病(HDCP)患者血清Apelin蛋白水平与24小时尿蛋白定量的相关性。方法选择妊娠期高血压疾病孕妇65例,其中妊娠期高血压(GH)23例,轻度子痫前期(加PE)22例,重度子痫前期(sPE)20例,同期正常孕妇30例为对照组,比较各组孕妇血清Apelin蛋白及24小时尿蛋白定量情况,分析其相关性。结果 GH、mPE及sPE组患者血清Apelin蛋白水平均明显低于对照组(t值分别为18.49、18.34、40.97,均P<0.05),且sPE组明显低于mPE组(t=16.29,P<0.05),mPE组明显低于GH组(t=8.97,P<0.05)。GH、mPE及sPE组患者24小时尿蛋白定量均明显高于对照组(t值分别为3.53、5.93、9.51,均P<0.05)。相关性分析显示,GH、mPE、sPE组患者的血清Apelin蛋白值与24小时尿蛋白定量均呈显著负相关(r值分别为-0.99、-0.92、-0.78,均P<0.01),而对照组中两指标无明显相关性(r=0.23,P>0.05)。结论血清Apelin蛋白与妊娠期高血压病组的尿蛋白水平相关,Apelin蛋白可能参与蛋白尿形成。