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Objective To investigate the expression and significance of CD19+CD24hiCD38hi regulatory B lymphocytes and secreted cytokine interleukin-10(IL-10)in hypertensive disorder complicating pregnancy.Methods A total of 15 patients with gestational hypertension(the gestational hypertension group)and 11 pa-tients with preeclampsia(the preeclampsia group)admitted to this hospital from September 2020 to May 2021 were selected,and 12 normal pregnant women(the control group)were selected during the same period.Flow cytometry was used to detect the expression of CD19+B lymphocytes,CD19+CD24hiCD38hi regulatory B lym-phocytes,and IL-10 in peripheral blood of three groups of pregnant women before termination of pregnancy.Results There was no statistically significant difference in the percentage of serum CD19+B lymphocytes a-mong the three groups(P＞0.05).The results of pairwise comparison showed that the percentage of serum CD19+CD24hiCD38hi regulatory B lymphocytes in the control group was higher than that in the gestational hy-pertension group,and it was higher than that in the preeclampsia group.And the differences between the con-trol group and the gestational hypertension group and the preeclampsia group were statistically significant(P＜0.05).The results of pairwise comparison showed that the serum level of IL-10 in the control group was higher than that in the gestational hypertension group,and it was higher than that in the preeclampsia group.And the difference between any two groups was statistically significant(P＜0.05).Conclusion CD19+CD24hiCD38hi regulatory B lymphocytes and secreted IL-10 are abnormally expressed in women with hypertensive disorder complica-ting pregnancy,which may be related to the occurrence and development of gestational hypertension.
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[ Abstract] Objective To investigate the relationship between single nucleotide polymorphism (SNP) Fok (rs2228570 / rs10735810) of vitamin D receptor (VDR) gene and hypertensive disorder complicating pregnancy (HDCP) in Han nationality women of Qinghai province. Methods A total of 137 Han nationality HDCP subjects (HDCP group) and 146 Han nationality normal pregnant subjects (control group) were selected from Qinghai province. The Fok polymorphism typing in HCDP group and control group was analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) . The mutation was confirmed by sequencing. SPSS 19. 0 statistical software was used to test whether there were significant differences between two groups in general clinical data, genotype and allele frequency distribution. Results The frequency of FF Ff ff genotype of Fok in HDCP group and control group were 51. 82%, 37. 96%, 10. 22% and 34. 93%, 43. 15%, 21. 92% respectively (
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Objective To investigate the correlation between the polymorphism of 5,10-methylenetetrahydrofolate reductase ( MTHFR) gene rs!801131 and hypertensive disorders complicating pregnancy ( HDCP ) in Qinghai Han nationality. Methods The polymorphism of MTHFR rsl801131 in 120 pregnant women with HDCP (HDCP group) and 120 normal pregnant women ( control group) were detected by restriction fragment length polymorphism polymerase chain reaction (PCR-RFLP) and verified by sequencing. Results The frequencies of AA, AC, and CC genotype of MTHFR gene in the HDCP group were 56. 67% , 32. 50% , and 10. 83% respectively, and those in the control group were 74.17%, 23.33% and 2. 50% respectively (P<0. 05, the distribution of genotype was different significantly between the two groups). The frequency of AA genotype of HDCP group (56. 67%) was lower than that of control group (74. 17%, P<0. 05) , the frequency of CC genotype of HDCP group ( 10. 83%) was higher than that of control group ( 2. 50% , P< 0. 05) , while there was no significant difference in the frequency of AC genotype between HDCP group and control group ( P<0. 05). The frequency distribution of alleles A and C of MTHFR rsl801131 polymorphism was significantly different between the HDCP group and the control group (P<0. 001) , and the frequency of allele C in the HDCP group was significantly higher than that in the control group (X2 = 12. 229, 0R=L 574, 95% C/= 1. 181-2. 099, P<0. 001). Conclusion The polymorphism of MTHFR rsl801131 is related to the occurrence of HDCP in Qinghai Han population. The C gene might be the susceptibility gene of HDCP, and CC genotype might be the susceptibility genotype of HDCP.
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Background: One of the most severe pain experienced by a woman is during child birth. It is imperative to understand the pain transmission for providing labour analgesia. Hemodynamic status in labour fluctuates greatly during uterine contraction and true labour pains. Therefore, pregnant women with cardiovascular disease need epidural anaesthesia during labour depending upon the type of cardiovascular disease. Objective of this study was to assess the impact of labour analgesia and the obstetric outcome and cardiac events during labour.Methods: This is an observational study conducted in 46 pregnant women with cardiovascular disease during the period of January 2019 to December 2019 (12 months).Results: A total of 46 antenatal mother with cardiovascular disease was admitted in the department of obstetrics and gynecology over a period of one year out of which 25 patients who had epidural analgesia during labour and 21 patients who had no epidural analgesia during labour. Cardiovascular events significantly reduced in epidural group (25 patients) and there was no increase in cesarean section in epidural group.Conclusions: The data showed there was significant decrease in cardiovascular events related to arrhythmia hence decreased maternal morbidity and mortality. There was no associated increase in cesarean section rate but slight increase in instrumental vaginal delivery.
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Aim: To explore the role of apoptosis stimulating protein 2 of p53 (ASPP2) on L-NAME induced apoptosis of placental trophoblast cells by regulating glucose-regulated protein78(GRP78), and provide a theoretical basis for the study of clinical pregnancy-induced hypertension. Methods: The HTR-8/SVneo human placental trophoblast cells were cultured in vitro, and in the absence (control group) or presence of 100 μmol · L-1 L-NAME (L-NAME group) for 48 h. The effects of L-NAME on placental trophoblast cell apoptosis were tested using flow cytometry and AO/EB assay. The expressions of caspase-12, GRP78 and ASPP2 were detected by Western blot. The ASPP2 interference with adenovirus was used to transfect the cells, and the mRNA expression level of ASPP2 and the protein expression level of GRP78 were detected by qRT-PCR and Western blot, respectively. After treated with 100 (xrnol · L-1 L-NAME for 48 h, the protein expression of caspase-12 and GRP78 was detected by Western blot and immunofluorescence. Results: Compared with control group, the placental trophoblast cell apoptosis significantly increased in L-NAME group (P < 0. 05). AO/EB staining showed that compared with control group, the majority of cells in L-NAME group showed bright orange and the number of late apoptotic cells increased significantly. At the same time, caspase-12, GRP78 and ASPP2 protein expression increased (P < 0. 05, P < 0. 01). After interfering with ASPP2, caspase-12 and GRP78 protein expressions decreased (P < 0. 05). Conclusions: Down-regulation of ASPP2 could decrease GRP78 expression and inhibit L-NAME-induced apoptosis in placental trophoblast cells.
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Objective To investigate the effect of self-made traditional Chinese medicine(TCM) decoction on pregnancy outcome in patients with hypertensive disorder complicating pregnancy. Methods A total of 124 pregnant hypertensive patients admitted to the Department of Critical Care of Guizhou Provincial People's Hospital from October 2016 to October 2018 were enrolled. The 62 patients who were treated with western medicine conventional method;62 patients who were treated with self-made TCM decoction on the basis of western medicine conventional method. The western medicine conventional treatment group was given magnesium sulfate combined with nicardipine; the self-made TCM treatment group was supplemented with TCM decoction on the basis of conventional western medicine treatment (composition: uncaria, raw oyster 20 g, gastrodia elata, eucommia, salvia miltiorrhiza, medlar rehmannia glutinosa each 15 g, rhizoma, mulberry parasitic, astragalus, ophiopogonis each 10 g. Severe headache and dizziness plus tortoise shell, gentian grass 15 g, anemarrhenae 10 g; severe edema plus cassia twig, aristolochiae 15 g, astragali, ginger skin 10 g), be decocted in water for oral dose, morning and evening oral, one dose a day, 1 week for a course of treatment, the two groups were continued for 4 weeks after the evaluation of clinical efficacy. The changes of blood pressure and blood coagulation parameters, placental bed arterial hemodynamics, pregnancy outcome index were observed before and after treatment; antihypertensive effects and adverse reactions after treatment were recorded. Results After treatment, the systolic blood pressure (SBP), diastolic blood pressure (DBP), Fibrinogen (Fib), placental bed arterial pulsation index (PI), end-systolic blood flow velocity and end-diastolic blood flow velocity ratio (S/D) and resistance index (RI) in both groups were lower than those before treatment, the prothrombin time (PT) and activated partial thromboplastin time (APTT) were significantly longer than before treatment, and the time-averaged flow rate (TAV) increased than that before treatment; SBP, DBP, Fib, PI, S/D and RI were significantly lower in self-made TCM treatment group than those in western medicine conventional treatment group [SBP (mmHg, 1 mmHg = 0.133 kPa): 114.26±17.07 vs. 132.72±17.64, DBP (mmHg): 82.98±6.24 vs. 90.09±6.48, Fib (g/L): 3.21±0.45 vs. 3.64±0.31, PI: 0.59±0.14 vs. 0.75±0.15, S/D: 1.70±0.21 vs. 1.93±0.25, RI: 0.43±0.08 vs. 0.54±0.12, all P < 0.05], PT, APTT, TAV in self-made TCM treatment group were significantly higher than western medicine conventional treatment group [PT (s): 12.26±0.57 vs. 11.72±0.44, APTT (s): 27.11±1.34 vs. 25.69±1.48, TAV (cm/s): 15.64±2.88 vs. 12.49±2.76, all P < 0.05]. The rate of cesarean section, postpartum hemorrhage, fetal heart abnormality and neonatal asphyxia in self-made TCM treatment group were significantly lower than those in western medicine conventional treatment group [cesarean section rate: 9.84% (6/61) vs. 27.78% (15/54), postpartum hemorrhage rate: 1.64% (1/61) to 14.81% (8/54), fetal heart abnormal rate: 3.28% (2/61) vs. 16.67% (9/54), the incidence of neonatal asphyxia: 1.64% (1/61) vs. 12.96% (7/54), all P < 0.05]. The total effective rate of the self-made TCM treatment group was significantly higher than that of western medicine conventional treatment group [98.39% (61/62) vs. 87.10% (54/62), P < 0.05]. However, there was no significant difference in the incidence of adverse reactions between the self-made TCM treatment group and western medicine conventional treatment group [16.39% (10/61) vs. 16.67% (9/54), P > 0.05]. Conclusion Self-made TCM decoction can improve the maternal and infant outcomes by improving the hypercoagulable state and placental hemodynamics in hypertensive patients with hyperthyroidism, the antihypertensive effect is remarkable and the safety is good.
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Objective@#To investigate the effect of hypertensive disorder complicating pregnancy (HDCP) on the mortality and early complications of premature infants.@*Methods@#The general clinical data of preterm infants with gestational age 24-36+ 6 weeks were collected from the cooperative units in the task group from January 1, 2013 to December 31, 2014.According to the severity of HDCP, the infants were divided into 4 groups: HDCP group, preeclampsia group, eclampsia group and non HDCP group, the mortality and major complications of preterm infants were compared, and the influencing factors were analyzed.@*Results@#The mortality rate of preterm in the HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ2=9.970, P=0.019). Eclampsia had a highest fatality rate (4.8%) in the early stage, compared with non HDCP group (2.2%), and the difference was statistically significant.Comparison of HDCP group (1.8%) and eclampsia group (3.2%) suggested that there was no statistically significant difference.The incidence of respiratory distress syndrome (RDS) in preterm in HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ2=13.241, P=0.004). Eclampsia group showed the highest incidence (35.4%), compared with non HDCP group (16.2%), the difference was statistically significant, but compared with HDCP group (19.9%), preeclampsia group (17.1%), there was no significant diffe-rence.The incidence of bronchopulmonary dysplasia (BPD) in preterm in HDCP group was significantly higher than that of non HDCP group (χ2=9.592, P=0.022), the highest incidence showed up in eclampsia group (9.7%), compared with non HDCP group (2.0%) and HDCP group (1.7%), the difference was statistically significant.But there was no statistically significant difference, compared with preeclampsia group.As the degree of HDCP aggravated, the incidence of BPD gradually rose.There was no significant impact on necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH) and sepsis of HDCP (χ2=7.054, 7.214, 0.358, 3.852; P=0.070, 0.065, 0.949, 0.278). Considering the overall outcome of the child, that was, whether the child died or survived, he had at least one complication, and HDCP had an effect on it (χ2=15.697, P=0.001), so the incidence increased while the degree of HDCP rose gradually.After adjusting gestational age, birth weight, sex, way of delivery, placental abruption and front placenta, prenatal hormonal, gestational diabetes, neonatal asphyxia and other factors, the results displayed that HDCP was the factor leading to the death of premature baby (OR=2.159, 95%CI: 1.093-4.266), and comparison between preeclampsia and eclampsia showed no statistical difference (P=0.714, 0.389); HDCP had no significant influence on RDS, BDP, ICH, NEC, ROP and sepsis.@*Conclusions@#HDCP leads to increased risk of premature death, but also leads to the increased incidence of RDS and BPD, but it had no obvious effect on NEC, ROP, IVH, sepsis and other complications.
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Objective To explore the new clinical significance of these routine test indexes and find the early biomarkers for predicting hypertension disorder complicating pregnancy(HDP) by the comparative analysis between pregnant women with HDP and normal pregnant women before 20 weeks,including biochemical,blood coagulation and blood routine indexes.Methods A case-control study was conducted to review the clinical data of pregnant women who were undertaken prenatal examination and delivered in Guangzhou Women and Children's Medical Center from 2012 to 2016.The pregnancy were divided into HDP group and control group according to the gestational week and age.Analyzed the related test indexes before 20 weeks of pregnancy.The two groups variables were analyzed by Kolmogorov-Smirnov for normal distribution.Approximate measurement data of normal distribution were mean± standard deviation (x± s) for statistical description,while the data of the skewed distribution was median and percentile[M(P25～P75)]for statistical description.The diagnostic value was analyzed by logistic regression equation and receiver operating characteristic curves (ROC).Results The level of biochemical indexes (AST,γ GT and UA) of HDP group was significantly higher thanthe normal group (t=2.50,3.34,4.56,P＜ 0.05).Meanwhile the level of blood indexes (RBC,PLT and HCT) of HDP group was significantly higher than the normal group (t=2.89,4.51,3.29,all P＜0.01).Other indicators of two groups (ALT,TBIL,Cr,Urea,PT,APTT,TT,FIB and HGB) were not significantly different (t=0.25～ 1.85,all P＞0.05).Then the logistic regression model equation was Y=-5.497+0.010 * PLT+0.043 * γ-GT+0.007 * UA+0.045 * AST.The area under ROC curve (AUC) was 0.746 for the combination of the four indexes.The combination resulted in a higher sensitivity of 0.818 and specificity of 0.523.Conclusion Before 20 weeks of gestation,compared with normal group,liver and kidney function in patients with HDP and high blood coagulation state was damaged.Can by combined detection of AST,UA,γ-GT and PLT index,early prevention and diagnosis of gestational hypertension,effective intervention measures taken as soon as possible to improve the prognosis of pregnancy.
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Objective To investigate the effect of pregnant women with hypertensive disorders of COOK cervical dilatation balloon and Dinoprostone Suppositories on the gestation effect and safety of induction.MethodsThe research object from June 2013 to June 2015 in our hospital for pregnant women with hypertensive disorders in pregnancy in 68 cases (all patients with gestational hypertension and mild preeclampsia) were randomLy divided into the observation.Group and control group, 34 cases in each group.The observation group received COOK cervical dilatation balloon induced labor, the control group to implement Dinoprostone Suppositories induction, comparative analysis of observation group and control group, maternal and perinatal situation, mode of delivery, the cervical Bishop score, the degree of pain.Resultsabnormal fetal heart and uterine hyperstimulation, uterine tonic contraction rate of observation group were significantly lower than the control group(P<0.05).The cesarean section rate in the observation group and the control group had no significant difference.After placement, the cervical Bishop score of observation group was significantly higher than that of control group(P<0.05).The pain degree of observation group was significantly lower than that in control group(P<0.05).ConclusionCOOK balloon dilatation of the cervix and Dinoprostone Suppositories, fewer complications, can significantly improve maternal, perinatal and cervical ripening score of Bishop.
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Objeetive To investigate the clinical significance of combined detection of lipoprotein associated serum phospholipase A2 (Lp-PLa2),homocysteine (Hcy) and cystatin C (CysC) in the diagnosis of hypertensive disorders complicating pregnancy (HDCP).Methods From January 2013 to May 2016 in Changan Hospital,selected 113 cases of pregnancy induced hypertension patients as the observation group,and were divided into three group A,B and C (group A:55 cases of HDCP patients,group B:32 cases of mild preeclampsia and group C for patients with severe preeclampsia 26 cases).At the same period,selected 50 cases of normal college pregnancy as control group,serum Lp-PLa2 (enzyme-linked immunosorbent assay),Hcy (cyclophorase method) and CysC (particle enhanced turbidimetric method),the test results were analyzed and compared.Results Serum Lp-PLa2,Hcy and CysC test results in the control group,the observation group A,observation group B and observation group C increased significantly,in the observation group C increased most obviously.Compared with the control group,the serum levels of Lp-PLa2,Hcy and CysC in the observation group were significantly higher,the difference was statistically significant (F=8.102,7.231 and 6.926,all P＜0.05).Pearson correlation analysis showed that there was a positive correlation between serum Lp-PLa2,Hcy and CysC and blood pressure (r=0.71,0.69,0.63,all P＜0.05).The abnormal rate of serum Lp-PLa2,Hcy and CysC for three joint detection was higher than that of single detection,and the difference was statistically significant (x2 =6.725,P＜0.001).The abnormal rate of serum Lp-PLa2,Hcy and Cys single test results increased with the exacerbation of HDCP,and the difference was statistically significant (x2=9.351,P＜0.000).Conclusion Serum Lp-PLa2,Hey,CysC and pregnancy would be closely related to the occurrence and development of hypertension syndrome,so combined detection of HDCP can improve the detection rate of abnormal results,and it has important clinical significance for early diagnosis and prognosis of HDCP.
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OBJECTIVE:To explore the effects of Xinnaoxin pills on CAT score,cardiopulmonary function and hemorheology of patients with pulmonary heart disease complicating with coronary heart disease. METHODS:In retrospective study,80 cases of pulmonary heart disease complicating with coronary heart disease were randomly divided into control group and observation group with 40 cases in each group. Control group was given routine treatment as relieving asthma,eliminating phlegm and oxygen inhala-tion,anti-infective treatment,correcting acid-base balance,cardiotonic and diuretic treatment. Observation group was additionally given Xinnaoxin pills 1.0 g/time,bid after meal,on the basis of control group. CAT score,cardiopulmonary function and hemorhe-ology index were compared between 2 groups before and after treatment as well as ischemic ECG improvement effect and the occur-rence of ADR after treatment. RESULTS:After treatment,hematocrit hematocrit had changed slightly among hemorheology index-es,and CAT score,other hemorheology indexes and cardiopulmonary function indexes were improved significantly;the improve-ment of observation group was better than that of control group,with statistical significance(P0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Xinnaoxin pills can effectively improve CAT score and cardiopulmonary function of patients with pulmonary heart disease complicating with coronary heart dis-ease. It also can improve hemorheology and shows good clinical efficacy,but great importance should be attached to the safety of drug use in the clinic.
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Objective To observe the effects of SOD ,NO ,TNF‐αand hs‐CRP on atherosclerosis in the patients with hyperten‐sion complicating diabetes mellitus (DM ) .Methods One hundred and thirty‐four inpatients in our hospital from January 2010 to January 2016 were selected ,including 45 cases of hypertension ,44 cases of type 2 diabetes Mellitus(T2DM ) and 45 cases of hyper‐tension complicating T2DM .IMT and serum SOD ,NO ,TNF‐α and hs‐CRP levels were detected .Contemporaneous 45 individuals undergoing healthy physical examination were selected as the healthy control group for conducting the contrastve analysis . Results The SOD and NO levels in the hypertension complicating T 2DM group were significantly lower thin the healthy control group ,hypertension group and T2DM group ,the difference had statistical significance (P0 .05) .IMT was positively correlated with TNF‐αand hs‐CRP(r=0 .636 ,0 .664 ,P< 0 .05)and negatively correlated with NO and SOD (r= -0 .586 ,0 .648 ,P<0 .05) .Conclusion Evaluating the change of SOD ,NO and TNF‐αand hs‐CRP levels can further investigate its occurrence mechanism and also has certain significance to the prevention and treatment of vascular injury chronic diseases such as hypertension and TM .
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Objective To investigate the association between diet during pregnancy and hypertensive dis-order complicating pregnancy ( HDCP ) , so as to provide a theoretical basis guiding appropriate diet during pregnancy.Methods Using 1∶2 matched case-control study method, we selected pregnant women delivered in Anhui Women and Child Health Care Hospital from January to December 2014, and interviewed them with food frequency questionnaire.The relationship between intake frequency of various food and HDCP was analyzed. Results A total of 543 women were included in this study, including 181 cases and 362 controls.Mann-Whit-ney U test results showed that the frequencies of meat and fish, eggs, beans, nuts, milk, and pickled food con-sumption were significantly different between the cases and the controls (all P0.05).Multivariate Logistic regression analysis showed that higher intake frequencies of beans (OR=0.746, 95%CI:0.645-0.862), eggs (OR=0.789, 95%CI:0.693-0.898), and milk (OR=0.822, 95% CI:0.725-0.931) were associated with lower risk of HDCP; in contrast, higher intake fre-quency of pickled food was associated with higher risk of HDCP (OR=1.190, 95% CI:1.054-1.344). Conclusions Beans, eggs, and milk may be protective factors for HDCP, while pickled food may be risk fac-tor of HDCP.Diet during pregnancy should be appropriate and following scientific guidelines.
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Objective To observe the features of the changes in the whole blood N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in pregnant patients with complication of hypertensive disorders,its correlation to the severity of the illness,and to investigate the diagnostic value of point-of-care testing of NT-proBNP in patients with hypertensive disorders complicating pregnancy.Methods A prospective observation was conducted.Sixty-nine patients with hypertensive disorders complicating pregnancy admitted to Department of Critical Care Medicine of Liaocheng People's Hospital in Shandong Province from April 2013 to April 2015 were enrolled.All patients were divided into gestational hypertension group (n =16),preeclampsia group (n =30) and eclampsia group (n =23).At the same time,30 age-matched normal pregnant women were enrolled as the control group.The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score of all patients with hypertensive disorders complicating pregnancy were calculated within 24 hours after intensive care unit (ICU) admission.NT-proBNP in venous blood at 1,3,5 days after ICU admission was determined with point-of-care testing,in order to analyze the correlation of changes in NT-proBNP value in each group and the severity of the disorder.Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of NT-proBNP in the whole blood in hypertensive disorder complicating pregnancy.Results The APACHE Ⅱ score of the eclampsia group was significantly higher than that of the preeclampsia group,and it was higher than that of gestational hypertension group (15.91 ± 1.06,13.73 ± 1.09,10.31 ± 1.10,all P ＜ 0.01).The NT-proBNP in normal pregnancy group was lower than 125.00 ng/L,with a mean of 90.00 (79.75,100.00) ng/L.With the aggravation of the disease,NT-proBNP was gradually increased.On the first day in ICU,the NT-proBNP of the eclampsia gronp was significantly higher than that of the preeclampsia group,and it was higher in preeclampsia group than that of gestational hypertension group [ng/L:1960.00 (1 226.00,3 229.00),859.50 (626.75,2439.00),505.00 (171.25,604.05),P ＜ 0.05 or P ＜ 0.01].With the extension of duration of treatment,the levels of NT-proBNP (ng/L) in the eclampsia group,preeclampsia group,and gestational hypertension group was gradually decreased,and had a statistically significant difference on the fifth day as compared with that of the first day [310.00 (210.00,430.00) vs.1 960.00 (1 226.00,3 229.00) in eclampsia group,265.00 (229.50,333.25) vs.859.50 (626.75,2439.00) in preeclampsia group,and 203.00 (115.50,259.25) vs.505.00 (171.25,604.05) in gestational hypertension group,all P ＜ 0.01].APACHE Ⅱ score of the patient with hypertensive disorders complicating pregnancy was positively correlated with the level of NT-proBNP on the first day in ICU (r =0.795,P =0.000).It was shown by ROC curve analysis that the area under the ROC curve (AUC) of NT-proBNP in the whole blood for the diagnosis of the patient with hypertensive disorder complicating pregnancy was 0.986 [95％ confidence interval (95％C/) =0.753-0.924].When the cutoff value was 122.50 ng/L,the sensitivity was 97.1％,and the specificity was 100.0％.No patient died,all the 69 patients recovered and discharged.Conclusions The levels of NT-proBNP in the whole blood in the patients with hypertensive disorder complicating pregnancy,especially those with eclampsia,were significantly higher,and it was correlated with the severity of illness.After treatment,the levels were gradually lowered with the improvement of the disease.Therefore,it is concluded that the point-of-care testing of NT-proBNP in the whole blood has an excellent value for the diagnosis and evaluation of hypertensive disorder complication pregnancy.
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Objective To investigate the clinical effect of magnesium sulfate combined with nifedipine in the treatment of patients with pregnancy induced hypertension( HDCP) .Methods Retrospective study was used in this study and 116 patients with HDCP from January 2013 to July 2015 in department of obstetrics and gynecology from our hospital were divided into two groups, including routine group of 62 patients who received routine treatment +magnesium sulfate) and combination group of 54 patients who received routine treatment +magnesium sulphate +nifedipine.The clinical effect was analyzed after five days’ continuous treatment.Results The systolic blood pressure, diastolic blood pressure,24h urinary protein, random urine protein /creatinine,serum homocysteine (Hcy) and CRP values in combination group were lower than routine group (P<0.05).There were no statistical difference in maternal uterine inertia, neonatal asphyxia, fetal distress, postpartum hemorrhage rate between the two groups after the treatment.But the rate of cesarean section in the combination group(50.00%)was significantly lower than that in the routine group(68.25%)(P <0.05).Conclusion Magnesium sulfate combined with nifedipine in the treatment of patients with HDCP had better antihypertensive effect, and would not increase fetal adverse birth outcomes incidence and significantly reduce the rate of cesarean section.
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Objective To investigate and evaluate the correlation between brain natriuretic peptide (BNP) and gestational hypertension and preeclampsia of hypertensive disorder complicating pregnancy (HDCP).Methods Fifty cases with HDCP and 46 cases with mild and 83 cases with sever stage preeclampsia were selected as our subjects.And 33 cases with regular pregnancy and 31 with irregular pregnancy were served as control group.Plasma brain natriuretic peptide,urinary protein quantity(UBQ),24-hour urinary protein assay (UPA) were measured.The correlations of brain natriuretic peptide and UBQ,UPA,systolic pressure (SP),diastolic pressure (DP) were analyzed.Results The levels of brain natriuretic peptide in the group with gestational hypertension and mild,severe preeclampsia groups were (48.54± 18.27),(79.46± 32.18) and (292.24±213.08) ng/L,higher than that in normal pregnancy and non pregnant group ((27.84± 14.58) and (20.63± 8.28) n/L;F =49.583,P＜0.05).While no significant difference exists between normal pregnancy group and non pregnant group.Grouped on the median values (199) of brain natriuretic peptide of the severe preeclampsia group,the levels of 24-hour UPA,systolic pressure and diastolic pressure were (5.46±2.68) g,(174.55± 13.58) mmHg,(113.74±9.91) mmHg in patients with brain natriuretic peptide ≥ 199 ng/L(n=42),significant higher than those in patients with brain natriuretic peptide ＜ 199 ng/L(n =41;(4.34± 1.95)g,(165.31±11.12) mmHg,(106.05±8.02) mmHg;t=2.603,3.396,2.308;P=＞0.010,0.001,0.024).The levels of 24-hour UPA,systolic pressure and diastolic pressure of patients with brain natriuretic peptide ≥ 86ng/L(n=20) in mild preeclampsia were (1.68±0.27) g,(163.69±8.29) mmHg,(105.45±6.71) mmHg,significant higher than those in patients with brain natriuretic peptide ＜ 86 ng/L (n =26;(1.16 ± 0.31) g,(152.90±7.32) mmHg,(99.19 ± 5.25) mmHg;t =3.180,2.508,2.32;P =0.010,0.016,0.025).Brain natriuretic peptide was closely correlated with UPA,systolic pressure and diastolic pressure in hypertensive disorder complicating pregnancy (HDCP) (r =0.29,0.30;P ＜ 0.01).Brain natriuretic peptide was closely correlated with UPA systolic pressure and diastolic pressure in mild preeclampsia (r =0.39,0.37,0.40;P ＜0.01).And correlation efficacy of brain natriuretic peptide with UPA,systolic pressure and diastolic pressure were 0.44,0.42 and 0.53 (P＜0.01).Conclusion The level of brain natriuretic peptide is closely associated with the severity of gestational hypertension and preeclampsia of hypertensive disorder complicating pregnancy.Correlation of brain natriuretic peptide to the severity of gestational hypertension and preeclampsia is independent of urinary protein and hypertension.Brain natriuretic peptide is an important indicator for the severity of gestational hypertension and preeclampsia of hypertensive disorder complicating pregnancy.
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Objective:To investigate the changes of the levels of CD 4+CD25+Foxp3+regulatory T cells in HDCP peripheral blood and its significance.Methods: From 2013 January to 2014 August 46 hypertensive disorder complicating pregnancy ( HDCP ) patients treated in our hospital ,including 22 patients with mild preeclampsia ,24 cases of severe preeclampsia ,and 25 normal pregnant women,used flow cytometry detected each group patient peripheral blood CD 4+CD25+Foxp3+regulatory T cells.Results: Severe preeclampsia group CD4+CD25+T cell ratio was (5.01±1.04)%,lower than mild preeclampsia group (7.38±1.26)% and normal pregnant women group ( 12.59 ±2.48 )%, the difference was statistically significant ( P<0.05 );Mild preeclampsia and severe preeclampsia group CD4+CD25+Foxp3+T cell absolute number respectively were (0.96±0.11) ×107 and (0.63±0.12) ×107,CD4+CD25+Foxp3+Treg/CD4+T were (2.58±0.93)%and (1.84±0.85)%,were lower than that of normal pregnant women group (1.85± 0.17) ×107 and(5.11±0.99)%,the difference was statistically significant (P<0.05);Mild preeclampsia group and severe preeclampsia blood estriol were (6.16±2.17) mg/L and (3.27±1.15) mg/L,significantly lower than that of normal pregnant women group (11.34±2.4) mg/L,the difference was statistically significant (P<0.05).Conclusion: Hypertensive disorder complicating pregnancy diseases patient CD 4+CD25+Foxp3+regulatory T cells was significantly reduced ,but also serum estriol reduced ,which may be related to the pathogenesis of gestational hypertension disease and immune tolerance .
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ObjectiveTo analyze the craniocerebrum ultrasonographic images of the infants born by women with hypertension in pregnancy and investigate the effect of hypertension in pregnancy on neonate brain injury and brain development.MethodsTo assess the brain injury and brain development, 106 infants born by women with hypertension in pregnancy (study group) and 200 infants born by women without high risk factors during perinatal period (control group) in the neonatal intensive care unit of First Affiliated Hospital of Harbin Medical University between 2013 and 2014 underwent brain ultrasonography. The abnormal ultrasound images and the constitution of abnormal ultrasound images distribution in two groups were compared. The relationship between the abnormal ultrasound images and the degree of hypertension in pregnancy were analyzed.ResultsThe brain ultrasonographic result of the infants : (1) In the group with hypertension in pregnancy, the abnormal ultrasound images were found in 78 cases (73.6%). For the preterm infants, the solitary abnormality was found in 41 cases (25 cases of cerebral white matter injury, 14 cases of peri-intraventricular hemorrhage and 2 case of brain hypoevolutism) and multiple abnormalities were found in 15 cases; for the full-term infants, the solitary abnormality was found in 17 cases (12 cases of peri-intraventricular hemorrhage, 3 cases of hypoxic-ischemic encephalopathy and 2 case of brain hypoevolutism) and multiple abnormalities were found in 5 cases. (2) In the group without high risk factors, abnormalities were found in 73 cases (36.5 %). For the preterm infants, abnormal ultrasound images were found in 45 cases, including solitary abnormality found in 30 cases (24 cases of cerebral white matter injury, 4 cases of peri-intraventricular hemorrhage and 2 case of brain hypoevolutism) and multiple abnormalities found in 15 cases; for the full-term infants, the abnormal ultrasound images were found in 30 cases, including solitary abnormality found in 24 cases (10 cases of peri-intraventricular hemorrhage and 14 cases of hypoxic-ischemic encephalopathy) and multiple abnormalities found in 6 cases. (3) There were obvious statistical significances between the comparativeness of two groups (χ2=38.119,P<0.001), but there were no statistical significances in the constitution of the abnormal ultrasound images distribution between the two groups (χ2=0.552,P=0.759). (4) There were statistical significances between the comparativeness of the abnormal ultrasound images and the degree of hypertensive disorder complicating pregnancy (P<0.001). ConclusionCraniocerebrum ultrasonography is the first choice to detect and monitor brain abnormal and can provide basis for clinical diagnosis, treatment and intervention at early stage for the infants born by women with hypertension in pregnancy.
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Objective To observe the change of protein levels of large conductance calcium activated potassium channel (BK‐Ca) in placental arteriole smooth muscle cells from hypertensive disorder complicating pregnancy and discuss its role .Methods Western blot analysis was used to examine protein expression of α subunit andβ1 subunit of BKCa channels in placental arteriole smooth muscle cells from hypertensive disorder complicating pregnancy .Results The relative protein expression level of α‐subunit in the HDCP group was 1 .001 2 ± 0 .169 8(n=15) ,and the NT group was 1 .028 2 ± 0 .180 6 (n=15) .There was no significant differences between the two groups (P> 0 .05);the relative protein expression level of β1 subunit in the HDCP group was 0 .418 1 ± 0 .080 8 (n=15) ,and the NT group was 1 .616 8 ± 0 .012 6 (n=15) ,theβ1‐subunit protein expression levels of HDCP group were significantly lower (P<0 .05) .Conclusion The protein expression ofβ1‐subunit ,but notα‐subunit ,was reduced in pla‐cental arteriole smooth muscle cells from hypertensive disorder complicating pregnancy .Therefore ,BKCa channel activity may have been involved in hypertensive disorder complicating pregnancy ;and the abnormal expression ofβ1 subunit maybe an important basis in hypertensive disorder complicating pregnancy .
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Objective To explore the correlation between the levels of uric acid(UA),plasma total cholesterol(TC),triglyceride (TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol (LDL-C),lipoprotein A(LPL)and hyper-sensitive C-reactive protein(hs-CRP)with type 2 diabetes mellitus(T2DM)complicating gout.Methods The levels of UA,TC, TG,HDL-C,LDL-C,LPL and hs-CRP in the T2DM complicating gout group,the T2DM without gout group and the gout group were measured and statistically analyzed to evaluate whether the differences of these indicators among 3 groups having statistical significance.Results Compared with the T2DM without gout group,the TG,LDL-C,hs-CRP and UA levels in the T2DM compli-cating gout were increased (P <0.05),while the HDL-C level was decreased(P <0.05).Ccompared with the gout group,the GLU, TG,LDL-C,LPL,hs-CRP and UA levels in the T2DM complicating gout group were significantly increased (P <0.05 )and the HDL-C level was decreased(P <0.05).The UA level in the T2DM complicating gout group was positively correlated with GLU, TC,TG,LDL-C,LPL and hs-CRP levels(P <0.05),the correlation coefficient were 0.313,0.283,0.422,0.297 and 0.436 respec-tively,which was negatively correlated with HDL-C(P <0.05),the correlation coefficient was -0.523.Conclusion The UA,TC, TG,HDL-C,LDL-C,LPL and hs-CRP levels have close correlation with T2DM complicating gout,detecting these biochemical indi-cators is helpful to monitor and control the occurrence and the development of T2DM complicating gout.