Prediction of Hypotension During Neuraxial Anesthesia in Patients with Pregnancy-Induced Hypertension Through Subclavian Vein Collapsibility Index

Objective:To explore and evaluate the predictive value of subclavian vein collapsibility index(SCV-CI)on hypotension during neuraxial anesthesia in patients with pregnancy-induced hypertension(PIH).Methods:Pregnant women with PIH who underwent elective cesarean section in our hospital from January to July 2021 were selected as the research subjects.Patients who experienced hypotension during anesthesia were included into the hypotension group,whereas patients who had a normal blood pressure during anesthesia were included in the normotensive group.The SCV-CI was then calculated for three respiratory cycles,the average value was taken as the base value,and the patient was monitored for another 20 minutes.The blood pressure,heart rate,blood oxygen saturation,and SCV-CI of the patients were measured,and the incidence of maternal nausea and vomiting and cord blood gas were recorded.Then,a correlation analysis was conducted on the relationship between subclavian vein collapsibility index and hypotension.A receiver operating characteristic curve was drawn to seek the threshold value of subclavian vein collapsibility index for post-anesthesia hypotension.Results:There was no significant difference in systolic blood pressure(SBP),diastolic blood pressure(DBP),and heart rate(HR)between the two groups before anesthesia(P>0.05).After anesthesia,the above indexes(SBP,103.25±12.48 mmHg;DBP,58.94±7.46 mmHg;and HR,52.96±6.48 beats/min)were significantly lower than those of the normal blood pressure group,and the difference was statistically significant(P<0.05).In comparison,the SCV-CI in the hypotension group was 35.82±4.93%greater than that in the normal blood pressure group(23.85±5.27%),and the incidence of nausea and vomiting in the hypotension group(40.0%)was significantly higher than that in the normotensive group(10.53%),and the difference was statistically significant(P<0.05).The area under the curve of SCV-CI prediction against hypotension in patients with PIH under neuraxial anesthesia was 0.825(95%CI:0.762-0.893,P<0.001),the cut-off value was 25.68%,the predictive sensitivity was 92.68%,and the specificity was 81.24%.Conclusion:SCV-CI has a good predictive value for the occurrence of hypotension in patients with PIH during neuraxial anesthesia.

Change of hs-CRP,sVCAM-1,NT-proBNP levels in patients with pregnancy-induced hypertension after therapy with magnesium sulfate and nifudipine

Objective:To investigate the change of the hs-CRP,sVC AM-1,NT-proBNP levels of the patients with pregnancy-induced hypertension(PIH) syndrome.Methods:A total of 200 patients with PIH were divided into mild,moderate and severe group,and 50 healthy pregnancy patients served as the control group.The serum sVCAM-1 levels were detected by enzyme-linked immunosorbent assay,hs-CRP were detected by immunity transmission turbidity,and NT-proBNP levels were determined by the colloidal gold method.Patients were treated with magnesium sulfate and nifudipine and the contrastive analysis was performed before and after treatment.And the pathological changes in placental of PIH patients were delected by hematoxylin-eosin staining at the same time.Results:The hs-CRP,sVCAM-l,NT-proBNP levels of patients in the mild, moderate and severe PHI group were significantly higher than that in the control group(P<0.05). The hs-CKP,sVCAM-l,NT-proBNP levels in the severe group were significantly higher than the mild group and the moderate group,the difference was statistically significant(P<0.05).The hsCRP,sVCAM-l,NT-proBNP of the moderate group were significantly higher than the mild group(P<0.05).There was a positive correlation between hs-CRP,sVCAM-1,NT-proBNP expression levels and the degree of the PIH.The expression of hs-CRP,sVCAM-1,NT-proBNP levels of the moderate and the severe group were significantly decreased(P<0.05).The number of placental villi and interstitial blood vessel in the moderate and severe PIH group were significantly less than the control group(P<0.05).Conclusions:The increased levels of serum hs-CRP,sVCAM-1, NT-proBNP may be involved in the process of vascular endothelial cell injury of the PIH,and the hs-CRP,sVCAM-1,NT-proBNP can be used as the auxiliary index for diagnosis of PIH and determination of PIH severity.

Increased Oxidative Stress in Women With Pregnancy-induced Hypertension

Objective To investigate whether pregnancy-induced hypertension （PIH） may increase oxidative stress in women with PIH, and to explore the mechanisms by which PIH may increase oxidative stress and potential free radical damage. Methods Seventy women with PIH and seventy women with uncomplicated normotensive pregnancy （UNP） whose age, nutritional conditions, levels of hemoglobin and albumin were all matched, were enrolled in a randomized controlled trial. Their plasma concentrations of nitric oxide （NO）, vitamin C （VC）, vitamin E （VE）, and β-carotene （β-CAR） as well as their erythrocyte malondialdehyde （MDA）, and activities of superoxide dismutase （SOD）, catalase （CAT） and glutathione peroxidase （GPX） were determined by spcctrophotometry. Results Compared with average values of the above experimental parameters in the women with UNP, the average value of erythrocyte MDA in the women with PIH significantly increased （P〈0.0001）, while the average values of plasma NO, VC, VE, and β-CAR as well as those of erythrocyte SOD, CAT, and GPX in the women with PIH significantly decreased （P〈0.0005-0.0001）. The findings from partial correlation analysis （controlling for age） for 70 women with PIH showed that with elevated systolic blood pressure （SBP） and diastolic blood pressure （DBP）, MDA value gradually increased （P〈0.001）, and NO, VC, VE, β-CAR, SOD, CAT, and GPX values gradually decreased （P〈0.02-0.001）. The findings from reliability analysis for NO, VC, VE, β-CAR, SOD, CAT, GPX, and MDA values used to reflect increased oxidative stress and potential free radical damage in women with PIH showed that the reliability coefficients （alpha, 8 items） = 0.7062, P〈 0.0001, and the standardized item alpha = 0.9116, P〈 0.0001. Conclusion The findings in the present research suggest that pregnancy-induced hypertension can increase oxidative stress and potential free radical damage in women with pregnancy-induced hypertension.

Expression of TGF-β1 in Placenta of the Patients with Pregnancy-induced Hypertension and Its relationship with Serum VCAM-1

The expression of transforming growth factor-β1 (TGF-β1) in placental tissue of pregnancy-induced hypertension (PIH) and the relationship between the level of expression of TGF-β1 and the amount of vascular cell adhesion molecule-1 (VCAM-1) in serum was studied. Immunohistochemistry ABC was used to detect the expression and distribution of TGF-β1 in placental tissues in 40 PIH women and 20 normal pregnancy women. High resolution pathological image analysis system was used to determine the quality of TGF-β1. The VCAM-1 in serum was examined by enzyme linked immunoabsorbent assay (ELISA). The results showed that TGF-β1 could be express in syncytiotrophoblast. The levels of TGF-β1 expression in placental tissues of the patients with moderate and severe PIH were significantly higher (P<0.05), while the serum VCAM-1 was significantly lower than in normal group (P<0.01). There was a significant positive correlation between the expression of TGF-β1 in placental tissues and the serum VCAM-1 (r=0.969, P<0.01). It was concluded that the level of TGF-β1 expression in PIH was increased and was positively correlated with the amount of serum VCAM-1, indicating that they might be involved in the pathogenesis of PIH.

Effect of nifedipine combined with Magnesium Sulfate on oxidative stress,hemorheology,platelet active substances and renal function in patients with pregnancy-induced hypertension

Objective: To investigate effect of nifedipine combined with Magnesium Sulfate on levels of oxidative stress, blood rheology, platelet active substance and renal function in patients with pregnancy-induced hypertension. Methods: A total of 99 cases of patients with pregnancy-induced hypertension were selected as the study object, according to random data table, they were divided into control group (n=50) and observation group (n=49), patients in control group were treated with Magnesium Sulfate, while patients in the observation group received Magnesium Sulfate combined with nifedipine treatment, levels of blood pressure and oxidative stress, blood rheology, platelet activity and renal function index before and after treatment of both groups were compared. Results: There were no significant difference of the level of DBP, SBP, Tac, MDA, SOD, high/low shear blood viscosity, PV, HCT, CD62P, CD63, GPⅡb/Ⅲa, SCr and BUN before treatment between control group and the observation group. Compared with intragroup before treatment, the levels of DBP, SBP, MDA, high/low shear blood viscosity, PV, HCT, CD62P, CD63, GPⅡb/Ⅲa, SCr and BUN after treatment of the two groups were significantly decreased, and the levels of the observation group after treatment was significantly lower than those in the control group, the difference was statistically significant;Compared with level of SOD and Tac, after treatment, the levels of SOD and Tac of the two groups were significantly higher than those in the same group before treatment, and levels of the observation group was significantly higher than in the control group, the difference was statistically significant. Conclusion: Nifedipine combined with magnesium sulfate treatment of pregnancy-induced hypertension, which can effectively reduce the blood pressure level of patients, improve the levels of oxidative stress, blood rheology and platelet active substance, protect renal function, with an important clinical value.

The Expression of PLF in Placenta in Pregnancy-Induced Hypertension and the Relationship between the PLF and Serum VCAM-1

To study the expression of placental isoferritin (PLF) in placental tissue of pregnancy-induced hypertension (PIH) and the relationship between the level of expression of PLF and the amount of vascular cell adhesion molecule-1 (VCAM-1) in serum, immunohistochemical technique was used to detect the expression of PLF in placenta tissue in 45 PIH patients (PIH group) and 15 normal pregnant women (normal group). High resolution pathological image analysis system (HPIAS-100) was employed to determine the quantity of PLF. The VCAM-1 in serum was examined by enzyme linked immunoabsorbent assay (ELISA). The results showed that the levels of PLF expressions in moderate and severe PIH patients were significantly lower than that of normal group (P<0. 01). The serum VCAM-1 was significantly decreased in PIH group (1310±177 ρ/ng/ml) than that of normal group (609±72 ρ/ng/ml, P<0. 01). The significant negative correlation existed between the expression of PLF in placental tissue and the serum VACM-1 (r=-0. 58, P<0. 01). It was concluded that the level of PLF expression in PIH decreases and is negatively correlated with the amount of serum VCAM-1, indicating that these may be involved in the pathogenesis of PIH.

A algorithm for prediction of exudative retinal detachment risk of patients with pregnancy-induced hypertension

AIM:To investigate the risk of exudative retinal detachment(ERD)morbidity in patients with pregnancyinduced hypertension(PIH)by using the logistic regression combined with the receiver operating characteristic(ROC)curve.METHODS:A total of 46 patients with ERD and 142 patients with non-ERD were diagnosed as PIH from January 2017 to February 2020.A retrospective comparison of the clinical manifestations and laboratory tests were conducted.The risk of ERD morbidity with PIH was predicted by using logistic regression combined with an ROC curve model.RESULTS:There was no significant difference in age and body mass index between the two groups before pregnancy(P>0.05).However,significant differences were found in gestational weeks,duration of hypertension,maximum and minimum systolic and diastolic blood pressure(BP),and plasma total protein(PTP)concentration between the two groups(P<0.05).Binary logistic regression analysis showed that the maximum systolic BP(OR=1.050,95%CI:1.016-1.085)and PTP concentration(OR=0.764,95%CI:0.702-0.832)were independent prediction risks of ERD in PIH.The sensitivities of maximum systolic BP,PTP concentration and combined diagnosis were 0.717,0.870,and 0.870,respectively;the specificities were 0.617,0.837,and 0.908,respectively;the area under the curve(AUC)was 0.707(95%CI:0.622-0.792),0.917(95%CI:0.868-0.967),and 0.933(95%CI:0.890-0.975),respectively;the AUC of combined diagnosis was higher than that of single diagnosis(P<0.01).CONCLUSION:Logistic regression and ROC curve model combined with maximum systolic BP and PTP can improve the early identification of high-risk PIH patients in the hospital.

Effect of low-dose aspirin and Danshen injection on hemorheology, vascular endothelial function and oxidative stress in pregnancy-induced hypertension

Objective:To investigate the effect of low dose aspirin and salvia miltiorrhiza injection on hemorrheology, endothelial function and oxidative stress in patients with pregnancy induced hypertension.Methods: One hundred and eighty pregnancy-induced hypertension patients treated in our hospital from April 2015 to November 2016 were selected as study subjects and randomly divided into control group and observation group with 90 cases in each group. The control group was given routine treatment. The observation group was treated with low-dose aspirin plus Salvia miltiorrhiza in the control group. After treatment, blood rheology, vascular endothelial function and oxidative stress were measured in two groups.Results: The levels of MAP and 24 h Upro in both groups were significantly lower than those before treatment. After treatment, the MAP and 24 h Upro levels in the observation group were significantly lower than those in the control group. After treatment, the level of PT was significantly higher than that before treatment, while the level of DD and Fg was significantly lower than that before treatment. Comparing the two groups after treatment showed that the PT level, and the levels of DD and Fg were significantly lower than those in the control group;After treatment, NO levels in both groups were significantly higher than those before treatment, ET-1 and ET-1/NO levels were significantly lower than before treatment, after treatment, ET-1, NO and ET The NO level in the observation group was significantly higher than that in the control group, while ET-1 and ET-1/NO levels were significantly lower than those in the control group;Compared with those before treatment, the levels of SOD in the two groups were significantly increased and MDA significantly decreased after treatment. The SOD and MDA levels in the two groups after treatment showed that the SOD level in the observation group was significantly higher than that in the control group, while MDA level was significantly lower than that of the control group.Conclusion: The combination of low-dose aspirin and Salvia miltiorrhiza injection has significant therapeutic effect on gestational hypertension, and can effectively improve the hemorheological parameters and endothelial function of patients and reduce the oxidative stress injury in patients. It is worth further clinical promotion.

Analysis of factors related to postpartum depression in pregnancyinduced hypertension syndrome patients and construction and evaluation of nomograms

BACKGROUND It is positive to integrate and evaluate the risk factors for postpartum depression in patients with pregnancy-induced hypertension syndrome and to detect highrisk patients as early as possible,which has application value for the clinical development of personalized prevention programs and prognosis of patients.AIM To analyze factors related to postpartum depression in patients with pregnancyinduced hypertension and construct and evaluate a nomogram model.METHODS The clinical data of 276 patients with pregnancy-induced hypertension admitted to Huzhou Maternity and Child Health Care Hospital between January 2017 and April 2022 were retrospectively analyzed.We evaluated the depression incidence at 6 wk postpartum.The depression group included patients with postpartum depression,and the remainder were in the non-depression group.Multivariate logistic regression analysis and the LASSO regression model were applied to analyze the factors related to postpartum depression in patients with pregnancyinduced hypertension.After that,a risk prediction model nomogram was constructed and evaluated.RESULTS Multivariate logistic regression analysis showed that vitamin A deficiency(VAD)during pregnancy and puerperium,family history of hypertension,maternal intestinal flora imbalance,eicosapentaenoic acid(EPA),and docosahexaenoic acid(DHA)were independent risk factors for postpartum depression in patients with pregnancy-induced hypertension(P<0.05).We constructed the nomogram model based on these five risk factors.The area under the curve,specificity,and sensitivity of the model in predicting postpartum depression in patients with pregnancy-induced hypertension was 0.867(95%confidence interval:0.828–0.935),0.676,and 0.889,respectively.The average absolute error was 0.037(Hosmer-Lemeshow testχ2=10.739,P=0.217).CONCLUSION VAD during pregnancy and puerperium,family history of hypertension,maternal intestinal flora imbalance,EPA,and DHA affect postpartum depression in patients with pregnancy-induced hypertension.

Effect of Salvia Miltiorrhiza Injection on Blood Pressure and Cardiac Function in Rats with Gestational Hypertension and Preeclampsia

Objective: This study is to observe the effects of Salvia miltiorrhiza injection on blood pressure and cardiac function in rats with pregnancy-induced hypertension and preeclampsia. Methodology: Syncytiotrophoblast microvilli (stbm) and l-arginine nitrosyl methyl ester were screened out via caudal vein injection. Twenty gestational hypertension-preeclampsia model SD (Sprague Dawley) rats successfully induced by L-NAME (L-arginine Nitrosyl methyl ester) were randomly divided into 2 groups (model group and Danshen injection group, n = 10). Then another 10 normal pregnant SD rats without model were selected as blank control group. The Salvia miltiorrhiza injection group was given Salvia miltiorrhiza injection (0.5 g?kg?1?d?1) through tail vein, and the control group and model group were given equal volume of normal saline through tail vein injection. All three groups were treated by tail vein injection once a day (d) for 7 days. After treatment, heart rate (HR), Systolic pressure (SP), diastolic pressure (DP) and mean arterial pressure (MAP) were measured by tail artery. Left ventricular end-diastolic diameter (LVDd) and Left ventricular end systolic diameter (LVDs) were recorded by echocardiography. Left ventricular end diastolic pressure (LVEDP), left ventricular systolic pressure (LVSP), left ventricular ejection fraction (left ventricular ejection) fraction, LVEF) and the maximum rate of increase/decrease of left ventricular pressure during isovolemic systole (+dp/dtmax/?dp/dtmax);Endothelin-1 (ET-1) levels in rat tail vein blood were detected by ELISA. Results: SP, DP, MP, HR, LVSP, LVDs and ?dp/dtmaxx were all decreased, plasma ET-1 expression was low, and LVDd, LVEDP, LVEF, and +dp/dtmax were all increased in the Salvia miltiorroot injection group, with statistical significance compared to the model group (p Conclusion: Salvia miltiorrhiza injection can improve the cardiac function and reduce blood pressure in rats with pregnancy-induced hypertension and preeclampsia, and the mechanism may be related to alleviating systemic arteriolar spasm by regulating ET-1 level.

PIH患者血清Cys C、α_1-m、β_2-m联检的临床价值

本文通过对血清中血尿素（Urea）、肌酐（Cr）、胱抑素C（Cystafin C）、血α1-微球蛋白（α1-microglobulin，α1-m）、血β2-微球蛋白（[β2-microglobulin，β2-m）测定分析，旨在探讨妊娠高血压综合征（pregnancy induced hypertension，PIH）患者肾功能的变化及各指标在早期肾损伤诊断中的价值。

不同程度的PIH对妊娠结局的影响

目的探讨不同程度妊娠期高血压综合征疾病(PIH)对妊娠结局的影响。方法将南京市妇幼保健院2008年12月至2013年1月期间收治的256例妊娠期高血压综合征孕妇作为观察组,并选取同期住院的正常妊娠孕妇256例作为对照组,分别就观察组和对照组、不同程度观察组的妊娠结局进行回顾性分析研究。结果在256例观察组产妇中,妊娠期高血压、轻度子痫前期、重度子痫前期分别占49.61%、28.13%、22.27%。观察组产妇早产、剖宫产、胎盘早剥、产后出血、胎儿窘迫、新生儿窒息、围产儿死亡及低体重出生儿的发生率显著高于对照组(x^2值分别为13.20、88.44、6.07、8.15、9.31、33.12、4.03、12.60,均P<0.05)。子痫前期组孕妇早产、剖宫产、胎盘早剥、产后出血、胎儿出现窘迫、新生儿发生窒息、围产儿死亡及低体重出生儿的发生率明显高于妊娠期高血压组,经比较差并有统计学意义(x^2值分别为22.03、49.37、13.63、55.06、20.89、66.25,7.25,19.52,均P<0.05)。结论妊娠期高血压综合征疾病对母婴健康有严重影响,而且程度越重,对妊娠结局影响越大。大力普及孕期保健知识,早发现、早诊断、早治疗,及早控制病情,可有效改善母婴预后。

Ginsenoside Rg3 Promotes the Survival and Migration of Trophoblast Cells in a Rat Model of Gestational Hypertension by Regulating miR-100a/Insulin Growth Factor-2 Axis

Objective:Preeclampsia(PE)is a common complication during pregnancy.miR-100a is expressed in the placenta and regulates the survival and development of placental cells.Insulin growth factor-2(IGF-2)may serve as its downstream target.This study investigated the protective mechanisms of ginsenoside Rg3 against PE in rat model.Materials and Methods:LPS-induced rat PE models were suitable for intravenous administration of the highly expressed miR-100a ginsenoside Rg3 lentiviral vector.Human trophoblasts were cultured in vitro for JEG-3,and PE cell models were constructed.In vivo effects on tumor growth and apoptosis were observed.Ginsenoside Rg3 was treated with different concentrations of shRNA,miR-100a analogs,inhibitors,or IGF-2.Autophagy and the expression of autophagy-related proteins were examined.Trophoblast activity and migration were determined using Cell Counting Kit-8 and Transwell assays.Both drugs strongly inhibited trophoblasts under normal conditions with some synergy between them.Double-luciferase return assay confirmed the binding affinity of miR-100a for IGF-2.Results:In response to Rg3,autophagy and the expression of autophagy-related proteins LC3-I/II,Beclin1,and SQSTM1 were reduced in PE rat placental trophoblasts.Rg3 inhibited autophagy in JEG-3 cells and promoted JEG-3 survival and migration in a concentration-dependent manner.miR-100a upregulated PE expression.These results suggested that autophagy was a vital signaling system.Rg3 intervention inhibited miR-100a expression and miR-100a downregulated IGF-2 expression in placental tissues and promoted autophagy,thereby inhibiting JEG-3cell survival and migration.In rats,Rg3 inhibited PE development by regulating the activity of the miR-100a-IGF-2 signaling axis.Conclusion:Ginsenoside Rg3 positively regulates the miR-100a-IGF-2 axis and protects PE rats by inhibiting trophoblastic autophagy and promoting trophoblastic cell survival and migration.

硝苯地平联合硫酸镁对PIH患者血流动力学及妊娠结局的影响

目的探究硝苯地平联合硫酸镁对妊娠期高血压(PIH)患者血压、血流动力学及妊娠结局的影响。方法选取2015年6月至2017年9月在永康市妇幼保健院就诊的104例PIH患者为研究对象,采用随机数字表法分为对照组及观察组各52例。对照组给予镇静、利尿等基础治疗及硫酸镁治疗,观察组则在对照组的基础上予以硝苯地平治疗。比较两组治疗前及治疗7d后血压[收缩压(SBP)、舒张压(SDP)]、子宫动脉血流动力学指标[收缩期峰值流速(PSV)、搏动指数(PI)、阻力指数(RI)]、内皮功能指标[一氧化氮(NO)、内皮素-1(ET-1)、基质金属蛋白酶9(MMP9)]及母婴结局的差异。结果治疗7d后,两组血压(SBP、SDP)水平、子宫动脉血流动力学指标(PSV、PI、RI)、部分内皮功能指标(ET-1、MMP9)均较治疗前降低(观察组:t值分别为38.008、24.006、7.796、17.169、13.574、18.910、26.685;对照组:t值分别为29.625、15.757、4.227、10.489、8.484、13.680、22.024,均P<0.05),NO水平则较治疗前升高(观察组:t=20.159;对照组:t=14.036,均P<0.05),且观察组变化幅度均大于对照组(t值分别为5.233、4.842、2.065、3.693、2.713、4.228、4.054、4.778,均P<0.05)。两组孕母不良结局总发生率比较差异无统计学意义(P>0.05);观察组胎儿不良结局总发生率明显低于对照组(χ^2=4.887,P<0.05)。结论硝苯地平与硫酸镁联合应用对PIH患者血压改善效果显著,也能纠正子宫动脉血流动力学紊乱状态,并提高机体血管内皮功能,同时还能减少胎儿不良结局。

硫酸镁联合硝苯地平对PIH治疗效果的研究

目的探索硫酸镁联合硝苯地平用于妊娠期高血压疾病(PIH)治疗时对患者血小板活性物质、抗氧化能力及血液流变学的影响。方法收集2013年7月至2014年7月经乐清市妇幼保健院确诊并接受治疗的130例PⅢ患者进行研究,按照就诊顺序被随机分作两组,各65例。对照组为单纯采用硫酸镁治疗,观察组则采用硫酸镁联合硝苯地平进行治疗,对患者治疗前后的血小板活性物质、抗氧化能力及血液流变学各项指标进行检测和比较分析。结果经治疗后观察组孕妇的血小板聚集率(PAgT)、血小板α颗粒膜糖蛋白(CD62P)、血小板溶酶体膜糖蛋白(CD63)和血小板表面膜糖蛋白Ⅱb/Ⅲa(GPⅡb/Ⅲa)与对照组比较均显著降低,差异均有统计学意义(t值分别为7.885、8.560、8.944、9.139,均P<0.05);经治疗后观察组孕妇的总抗氧化能力(TAC)、超氧化物歧化酶(SOD)水平与对照组比较均显著升高,丙二醛(MDA)及脂质过氧化物(LOP)水平均显著降低,差异均有统计学意义(t值分别为6.877、7.467、6.899、7.310,均P<0.05);治疗后观察组的血流变学全血黏度高切、全血黏度低切、血浆黏度、红细胞压积指标与对照组比较均显著降低,差异均有统计学意义(t值分别为6.833、6.640、7.202、6.630,均P<0.05);观察组产后出血、产后子痫、胎盘早剥、早产、新生儿窒息及围产儿死亡发生率较对照组均显著降低(t值分别为8.434、8.822、9.732、8.709、7.322、6.563,均P<0.05)。结论硫酸镁联合硝苯地平用于PIH治疗效果显著。

PIH患者血浆leptin和血清IL-6、CGRP检测的临床意义

妊娠期高血压病（pregnancy hypertension syndrome，PIH）为妊娠期的常见病，本病严重威胁母婴健康，是引起孕产妇和围产儿发病、死亡的主要原因，至今病因尚不十分明确。文献报道^[1]，PIH的发生和发展与活性物质的异常改变有关。leptin是近几年发现的一种由脂肪细胞分泌的调节代谢方面有重要生物活性的多肽激素^[2]。

柚皮素基于Th1/Th2轴对妊娠高血压大鼠症状的改善

目的 分析柚皮素对改善妊娠高血压(PIH)大鼠症状和对子代生长的影响,并探讨可能的作用机制。方法 雌性大鼠随机分为模型组、柚皮素低剂量(50 mg·kg^(-1))、高剂量组(100 mg·kg^(-1))和阳性对照组(硝苯地平,50 mg·kg^(-1)),各20只,另设对照组。比较大鼠24 h尿蛋白(24 h UTP)、收缩压、舒张压、血清干扰素γ(IFN-γ)、白细胞介素12(IL-12)、白细胞介素10(IL-10)、白细胞介素33(IL-33)水平、仔鼠体质量、出生数量、死亡率、肾组织Th1淋巴细胞趋化因子C-X-C-基元受体3(CXCR3)、C-C趋化因子受体5(CCR5)及Th2淋巴细胞C-趋化因子C受体类型3(CCR3)mRNA和蛋白表达。结果 (1)24 h UTP、收缩压、舒张压、血清IFN-γ、IL-12、仔鼠出生数量、体质量和死亡率:与对照组比较,模型组均升高;与模型组比较,柚皮素低、高剂量组和阳性药组降低;与柚皮素低剂量组比较,高剂量组、阳性药组降低,阳性药组最低(P<0.05)。(2)IL-10、IL-33水平:模型组比对照组降低,与模型组比较,3个给药组均升高;柚皮素高剂量组与阳性药物组比柚皮素低剂量组高,且阳性药物组最高(P<0.05)。(3)CXCR3、CCR5 mRNA及蛋白水平:模型组比对照组增加;3个给药组均比模型组低;与柚皮素低剂量组比较,高剂量组和阳性药物组更低,阳性药物组最低(P<0.05)。(4)CCR3 mRNA及蛋白水平:模型组比对照组低;3个给药组均比模型组高;柚皮素高剂量组和阳性药物组比低剂量组高,阳性药物组最高(P<0.05)。结论 柚皮素可有效改善PIH大鼠症状,促进子代生长,可能与调节Th1/Th2平衡有关。

1556例孕妇妊娠高血压综合征的预测及干预效果观察

目的探讨妊娠高血压综合征的预测及预防效果。方法应用SD-Ⅱ型妊娠高血压预测分析系统,对我院门诊定期产检的1556例孕妇进行妊娠高血压预防性监测,筛选出妊娠高血压疑似患者523例。随机分为干预组和观察组。其中,干预组为264例,给予药物治疗和特殊护理干预;观察组为259例,只定期产前检查,做一般护理干预。结果干预组中发展为妊娠高血压12例,发生率为4.55%;观察组中发展为妊娠高血压26例,发生率为10.16%,干预组妊娠高血压的发病率明显低于对照组(P<0.05)。结论通过应用SD-Ⅱ型妊娠高血压监测系统预测妊娠高血压,并对高危人群进行干预,能有效降低妊娠期高血压疾病的发病率。

妊娠高血压综合征患者凝血指标及血小板参数的检测结果分析

目的探讨妊娠高血压综合征患者凝血指标及血小板参数的变化及其临床意义。方法对正常非孕妇女50例、正常晚孕妇女50例与妊娠高血压综合征患者128例(其中轻度40例,重度68例,子痫20例)进行凝血指标及血小板参数的检测,并进行分析。结果妊娠高血压综合征组的凝血指标、血小板参数与正常晚期妊娠组和正常非孕妇女组比较差异有统计学意义(P<0.05),且随病情加重差异有增大趋势。结论正常晚孕妇女血液处于血栓前状态,而妊娠高血压综合征患者存在明显的血栓前状态,因此,产前测定凝血指标及血小板参数对妊娠高血压综合征的监测和治疗有一定的临床意义。

中药丹参治疗妊高征的机理探讨与临床效果观察

目的 探讨中药丹参对妊娠高血压综合征(简称妊高征)患者血中超氧化歧化酶(SOD)、丙二醛(MDA)、一氧化氮(NO)、内皮素(ET)、血栓素A_2(TXA_2)、前列环素I_2(PGI_2)及母体血压的影响。方法 用丹参治疗中度妊高征患者75例,观察患者的SOD、MDA、NO、ET、TXA_2、PGI_2、平均动脉压的变化情况。结果 治疗后患者血中SOD、NO、PGI_2、ET、MDA、TXA_2较前比较均有显著改善(P均<0.05);但治疗后母体平均动脉压变化及尿蛋白无显著下降(P>0.05)。结论 中药丹参对妊高征患者血中SOD、MDA、NO、ET、TXA_2、PGI_2有显著改善。