Background: Pregnancy is implicated in notable physiological changes and the extraordinary kidney physiology during pregnancy is believed to have an effect on kidney functions. However, during pregnancy the glomerular...Background: Pregnancy is implicated in notable physiological changes and the extraordinary kidney physiology during pregnancy is believed to have an effect on kidney functions. However, during pregnancy the glomerular filtration rate (GFR) increases its work rate up to 50%, on the contrary, in preeclampsia the GFR turns back to decline. Objectives: This study aims to measure and compare kidney function between preeclamptic and normal pregnant women. Materials and Methods: A cross-sectional hospital-based study was conducted in the period from March to May 2021 in Wad Medani Obstetrics and Gynecology Teaching Hospital. A total of 100 pregnant women, 50 apparently healthy pregnant women and 50 pregnant ladies proved to have preeclamptic toxemia, their ages ranged from 18 to 44 years old and at the third trimester of pregnancy. Blood samples were taken and serum was separated, then urea, creatinine, uric acid, sodium and potassium were determined. Data were analyzed using Statistical Package for Social Science (SPSS). Results: The results of this study revealed that 92% of preeclamptic pregnant women had the first time of the incidence and 8% were family inherited preeclampsia and injured multiple times. The preeclamptic pregnant women showed elevation in both systolic and diastolic blood pressure compared to the normal pregnant women. Although the creatinine values of all study subjects were in the normal range, the mean of its serum level was found to be higher in normal pregnant women than that in preeclamptic women. The study also showed urea level was elevated in the preeclampsia group in comparison to the normal one, while all values were in the normal range. In addition to the significant difference that observed in the uric acid mean between preeclamptic (higher) and normal pregnant groups, abnormal values were only noticed with many preeclamptic patients. The levels of electrolytes (sodium and potassium) were elevated in the preeclampsia women group, whereas all values were in the normal range. Conclusion: This study concluded that preeclamptics showed significant elevation in the urea, uric acid, sodium and potassium levels and a significant decrease in creatinine level compared to normal pregnant women, although all parameters values for both groups were in the reference values for non-pregnancy.展开更多
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
目的探讨子痫前期孕妇血清内分泌腺源性血管内皮生长因子(EG-VEGF)、中性粒细胞淋巴细胞比值(NLR)、血小板淋巴细胞比值(PLR)表达与病情严重程度的相关性。方法回顾性分析2021年10月~2023年3月在承德市中心医院妇儿院区产检的90例孕妇...目的探讨子痫前期孕妇血清内分泌腺源性血管内皮生长因子(EG-VEGF)、中性粒细胞淋巴细胞比值(NLR)、血小板淋巴细胞比值(PLR)表达与病情严重程度的相关性。方法回顾性分析2021年10月~2023年3月在承德市中心医院妇儿院区产检的90例孕妇临床资料,根据是否患有子痫前期进行分组,将健康正常的30例孕妇纳入健康对照组,将确诊为子痫前期的60例孕妇纳入观察组,且观察组根据子痫前期严重程度分为轻度组(n=30)和重度组(n=30),比较健康对照组和观察组、轻度组和重度组的血清EG-VEGF、NLR、PLR表达水平,并应用ROC曲线分析血清EG-VEGF、NLR、PLR诊断子痫前期和评价病情严重程度的效能。结果观察组的血清EG-VEGF、NLR高于健康对照组[(53.65±17.46)pg ml vs.(28.93±9.37)pg ml、(3.15±1.02)vs.(2.12±0.67)],PLR低于健康对照组[(98.53±21.86)vs.(115.31±18.36)],差异有统计学意义(t=7.237、5.010、3.613,P<0.05)。经ROC曲线分析发现,血清EG-VEGF、NLR、PLR诊断子痫前期效能良好(P<0.05)。重度组的血清EG-VEGF、NLR高于轻度组[(57.93±13.19)pg ml vs.(49.63±15.63)pg ml、(3.40±0.95)vs.(2.93±0.71)],PLR低于轻度组[(163.72±35.41)vs.(146.70±28.63)],差异有统计学意义(t=2.223、2.171、2.047,P<0.05)。经ROC曲线分析,发现血清EG-VEGF、NLR、PLR评价子痫前期病情严重程度的效能良好(P<0.05)。结论子痫前期孕妇血清EG-VEGF、NLR呈高表达水平,PLR呈低水平表达,且病情越严重的孕妇血清EG-VEGF、NLR越高,PLR越低,且经ROC分析血清EG-VEGF、NLR、PLR在子痫前期和病情严重程度诊断评价方面效能良好。展开更多
目的比较分析阿司匹林在不同孕周对子痫前期高风险孕妇干预后的疗效,为提高妊娠安全性提供参考。方法择取2019年9月—2022年9月在南通大学附属江阴医院接受治疗的80例子痫前期高风险孕妇作为研究对象,随机将其分成A组(n=28)、B组(n=28)...目的比较分析阿司匹林在不同孕周对子痫前期高风险孕妇干预后的疗效,为提高妊娠安全性提供参考。方法择取2019年9月—2022年9月在南通大学附属江阴医院接受治疗的80例子痫前期高风险孕妇作为研究对象,随机将其分成A组(n=28)、B组(n=28)、空白对照组(n=24,未服用阿司匹林)。A组患者自妊娠12周服用100 mg阿司匹林,B组患者自妊娠16周服用100 mg阿司匹林,两组妊娠28周时停药,控制血压为130~155/80~105 mm Hg,若并发脏器功能障碍,则控制为130~139/80~89 mm Hg,比较三组子痫前期发生情况与妊娠结局、分娩方式、新生儿相关结局、尿液错误折叠蛋白阳性率。结果A组与B组子痫前期、不良妊娠结局发生率比较,差异无统计学意义(P>0.05);A组、B组子痫前期、不良妊娠结局发生率较对照组低,差异有统计学意义(P<0.05)。A组与B组剖宫产率、顺产率比较,差异无统计学意义(P>0.05);A组、B组剖宫产率低于对照组,顺产率高于对照组,差异有统计学意义(P<0.05)。A组与B组新生儿Apgar评分、新生儿不良结局发生率比较,差异无统计学意义(P>0.05);A组、B组新生儿Apgar评分高于对照组,新生儿不良结局发生率低于对照组,差异有统计学意义(P<0.05)。A组孕28周、32周的尿液错误折叠蛋白阳性率均显著低于对照组,且A组阳性率低于B组,差异有统计学意义(P<0.05)。结论阿司匹林在预防子痫前期中具有显著效果,高风险孕妇在妊娠12周及16周时服用阿司匹林均可有效降低子痫前期发生率,同时还可提高顺产率,降低母婴不良结局发生率。展开更多
目的分析329例孕妇血小板抗体阳性结果,探讨血小板抗体与妊娠次数和流产史的关系。方法选取2017年1月—2021年12月厦门大学附属第一医院329例住院孕妇为研究对象,采用固相凝集法进行血小板抗体筛查,分析孕妇血小板抗体阳性率与年龄、妊...目的分析329例孕妇血小板抗体阳性结果,探讨血小板抗体与妊娠次数和流产史的关系。方法选取2017年1月—2021年12月厦门大学附属第一医院329例住院孕妇为研究对象,采用固相凝集法进行血小板抗体筛查,分析孕妇血小板抗体阳性率与年龄、妊娠次数和流产史等因素之间的关系。结果329例孕妇中,血小板抗体阳性50例,阳性率15.198%;经产妇血小板抗体阳性率(19.431%)高于初产妇(7.627%),差异具有统计学意义(P<0.05),妊娠次数不同阳性率不同(1次7.627%,2次17.582%,>2次20.833%),三者差异具有统计学意义(P<0.05),组间趋势χ^(2)检验显示妊娠次数和血小板抗体有线性趋势(P<0.05);有流产史的孕妇抗体阳性率(23.529%)大于无流产史(13.027%),二者差异具有统计学意义(P<0.05);年龄对孕妇血小板抗体阳性率无影响(P>0.05)。结论孕妇妊娠次数和流产史与血小板阳性率密切相关,妊娠孕妇应该进行血小板抗体筛查,特别是有妊娠史和流产史的孕妇更应重视,这对于预防和减少孕期流产和胎儿/新生儿同种异体免疫血小板减少症(fetal and neonatal alloimmune thrombocytopenia,FNAIT)具有重要的临床意义。展开更多
文摘Background: Pregnancy is implicated in notable physiological changes and the extraordinary kidney physiology during pregnancy is believed to have an effect on kidney functions. However, during pregnancy the glomerular filtration rate (GFR) increases its work rate up to 50%, on the contrary, in preeclampsia the GFR turns back to decline. Objectives: This study aims to measure and compare kidney function between preeclamptic and normal pregnant women. Materials and Methods: A cross-sectional hospital-based study was conducted in the period from March to May 2021 in Wad Medani Obstetrics and Gynecology Teaching Hospital. A total of 100 pregnant women, 50 apparently healthy pregnant women and 50 pregnant ladies proved to have preeclamptic toxemia, their ages ranged from 18 to 44 years old and at the third trimester of pregnancy. Blood samples were taken and serum was separated, then urea, creatinine, uric acid, sodium and potassium were determined. Data were analyzed using Statistical Package for Social Science (SPSS). Results: The results of this study revealed that 92% of preeclamptic pregnant women had the first time of the incidence and 8% were family inherited preeclampsia and injured multiple times. The preeclamptic pregnant women showed elevation in both systolic and diastolic blood pressure compared to the normal pregnant women. Although the creatinine values of all study subjects were in the normal range, the mean of its serum level was found to be higher in normal pregnant women than that in preeclamptic women. The study also showed urea level was elevated in the preeclampsia group in comparison to the normal one, while all values were in the normal range. In addition to the significant difference that observed in the uric acid mean between preeclamptic (higher) and normal pregnant groups, abnormal values were only noticed with many preeclamptic patients. The levels of electrolytes (sodium and potassium) were elevated in the preeclampsia women group, whereas all values were in the normal range. Conclusion: This study concluded that preeclamptics showed significant elevation in the urea, uric acid, sodium and potassium levels and a significant decrease in creatinine level compared to normal pregnant women, although all parameters values for both groups were in the reference values for non-pregnancy.
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.
文摘目的探讨子痫前期孕妇血清内分泌腺源性血管内皮生长因子(EG-VEGF)、中性粒细胞淋巴细胞比值(NLR)、血小板淋巴细胞比值(PLR)表达与病情严重程度的相关性。方法回顾性分析2021年10月~2023年3月在承德市中心医院妇儿院区产检的90例孕妇临床资料,根据是否患有子痫前期进行分组,将健康正常的30例孕妇纳入健康对照组,将确诊为子痫前期的60例孕妇纳入观察组,且观察组根据子痫前期严重程度分为轻度组(n=30)和重度组(n=30),比较健康对照组和观察组、轻度组和重度组的血清EG-VEGF、NLR、PLR表达水平,并应用ROC曲线分析血清EG-VEGF、NLR、PLR诊断子痫前期和评价病情严重程度的效能。结果观察组的血清EG-VEGF、NLR高于健康对照组[(53.65±17.46)pg ml vs.(28.93±9.37)pg ml、(3.15±1.02)vs.(2.12±0.67)],PLR低于健康对照组[(98.53±21.86)vs.(115.31±18.36)],差异有统计学意义(t=7.237、5.010、3.613,P<0.05)。经ROC曲线分析发现,血清EG-VEGF、NLR、PLR诊断子痫前期效能良好(P<0.05)。重度组的血清EG-VEGF、NLR高于轻度组[(57.93±13.19)pg ml vs.(49.63±15.63)pg ml、(3.40±0.95)vs.(2.93±0.71)],PLR低于轻度组[(163.72±35.41)vs.(146.70±28.63)],差异有统计学意义(t=2.223、2.171、2.047,P<0.05)。经ROC曲线分析,发现血清EG-VEGF、NLR、PLR评价子痫前期病情严重程度的效能良好(P<0.05)。结论子痫前期孕妇血清EG-VEGF、NLR呈高表达水平,PLR呈低水平表达,且病情越严重的孕妇血清EG-VEGF、NLR越高,PLR越低,且经ROC分析血清EG-VEGF、NLR、PLR在子痫前期和病情严重程度诊断评价方面效能良好。
文摘目的比较分析阿司匹林在不同孕周对子痫前期高风险孕妇干预后的疗效,为提高妊娠安全性提供参考。方法择取2019年9月—2022年9月在南通大学附属江阴医院接受治疗的80例子痫前期高风险孕妇作为研究对象,随机将其分成A组(n=28)、B组(n=28)、空白对照组(n=24,未服用阿司匹林)。A组患者自妊娠12周服用100 mg阿司匹林,B组患者自妊娠16周服用100 mg阿司匹林,两组妊娠28周时停药,控制血压为130~155/80~105 mm Hg,若并发脏器功能障碍,则控制为130~139/80~89 mm Hg,比较三组子痫前期发生情况与妊娠结局、分娩方式、新生儿相关结局、尿液错误折叠蛋白阳性率。结果A组与B组子痫前期、不良妊娠结局发生率比较,差异无统计学意义(P>0.05);A组、B组子痫前期、不良妊娠结局发生率较对照组低,差异有统计学意义(P<0.05)。A组与B组剖宫产率、顺产率比较,差异无统计学意义(P>0.05);A组、B组剖宫产率低于对照组,顺产率高于对照组,差异有统计学意义(P<0.05)。A组与B组新生儿Apgar评分、新生儿不良结局发生率比较,差异无统计学意义(P>0.05);A组、B组新生儿Apgar评分高于对照组,新生儿不良结局发生率低于对照组,差异有统计学意义(P<0.05)。A组孕28周、32周的尿液错误折叠蛋白阳性率均显著低于对照组,且A组阳性率低于B组,差异有统计学意义(P<0.05)。结论阿司匹林在预防子痫前期中具有显著效果,高风险孕妇在妊娠12周及16周时服用阿司匹林均可有效降低子痫前期发生率,同时还可提高顺产率,降低母婴不良结局发生率。
文摘目的分析329例孕妇血小板抗体阳性结果,探讨血小板抗体与妊娠次数和流产史的关系。方法选取2017年1月—2021年12月厦门大学附属第一医院329例住院孕妇为研究对象,采用固相凝集法进行血小板抗体筛查,分析孕妇血小板抗体阳性率与年龄、妊娠次数和流产史等因素之间的关系。结果329例孕妇中,血小板抗体阳性50例,阳性率15.198%;经产妇血小板抗体阳性率(19.431%)高于初产妇(7.627%),差异具有统计学意义(P<0.05),妊娠次数不同阳性率不同(1次7.627%,2次17.582%,>2次20.833%),三者差异具有统计学意义(P<0.05),组间趋势χ^(2)检验显示妊娠次数和血小板抗体有线性趋势(P<0.05);有流产史的孕妇抗体阳性率(23.529%)大于无流产史(13.027%),二者差异具有统计学意义(P<0.05);年龄对孕妇血小板抗体阳性率无影响(P>0.05)。结论孕妇妊娠次数和流产史与血小板阳性率密切相关,妊娠孕妇应该进行血小板抗体筛查,特别是有妊娠史和流产史的孕妇更应重视,这对于预防和减少孕期流产和胎儿/新生儿同种异体免疫血小板减少症(fetal and neonatal alloimmune thrombocytopenia,FNAIT)具有重要的临床意义。
