羊水中白细胞介素-8水平与绒毛膜羊膜炎的关系

目的探讨胎膜早破孕妇羊水中白细胞介素-8（IL-8）水平与绒毛膜羊膜炎的关系。方法用酶联免疫法（ELISA法）测定62例胎膜早破孕妇和46例正常足月妊娠未临产孕妇羊水中IL-8浓度;病理检查两组分娩后的胎膜组织,确定有无绒毛膜羊膜炎。结果胎膜早破组羊水中IL-8浓度高于对照组（P〈0.05）,破膜时间超过24h其羊水中IL-8水平明显高于破膜时间小于12h内的患者,绒毛膜羊膜炎组羊水中IL-8浓度高于对照组（P〈0.05）。结论胎膜早破及绒毛膜羊膜炎孕妇羊水中IL-8水平显著升高,可作为绒毛膜羊膜炎的早期诊断指标。     

胎膜早破孕妇不同时段血清和羊水中MIF、MMP-3及IL-8的对比研究

目的探讨血清和羊水中MIF、MMP-3及IL-8的检测在胎膜早破的意义及与绒毛膜羊膜炎之间的关系。方法采用ELISA法分别检测75例PROM分娩组和70例非PROM分娩组的血清及羊水中MIF,MMP-3及IL-8的水平分布和表达,采用HE染色的方法确诊绒毛膜羊膜炎。结果 PROM组MIF、MMP-3、IL-8水平均明显高于对照组,PROM绒毛膜羊膜炎组MIF、MMP-3、IL-8水平均明显高于PROM非绒毛膜羊膜炎组。在PROM组中,随着破膜时间的延长,血清和羊水中MIF、MMP-3、IL-8水平逐渐增加。经统计学分析,各组间两两比较有显著性差异（P〈0.05）。结论 MIF、MMP-3、IL-8在胎膜早破的发病机制中起着重要的作用,MIF、MMP-3、IL-8与绒毛膜羊膜炎有密切关系。     

血清IL-6水平与胎膜早破合并宫内感染的关系

目的探讨血清IL-6水平与胎膜早破合并宫内感染的关系.方法选取胎膜早破孕妇46例(其中早产早破组22例,足月早破组24例),和产科门诊定期产检的正常孕妇50例为对照组(其中未足月对照组22例,足月对照组28例),用酶联免疫法测定血清IL-6含量,分娩时取部分胎盘胎膜组织送病检.结果胎膜早破孕妇组织学绒毛膜羊膜炎的发生率为52.4%(24/46).早产早破组与足月早破组血清IL-6水平相比无差异(P>0.05),但均高于对照组(P<0.05=),无论是早产早破组还是足月早破组,有组织学绒毛膜羊膜炎者血清IL-6水平均高于无组织学绒毛膜羊膜炎者及对照组(P<0.05=).结论血清IL-6水平升高可作为早期诊断胎膜早破合并宫内感染的指标.     

脐血细胞因子水平与胎膜早破宫内感染及新生儿感染的相关研究

采用双抗体夹心ＥＬＩＳＡ法测定３６ 例正常妊娠妇女及８５ 例胎膜早破患者脐血白细胞介素６（ＩＬ６） 和白细胞介素８（ＩＬ８） 水平。结果发现：胎膜早破合并临床绒毛膜羊膜炎者、病理诊断绒毛膜羊膜炎者及新生儿感染者，其脐血ＩＬ６ 和ＩＬ８ 水平明显高于正常妊娠妇女，胎膜早破未合并感染者及未感染新生儿，差异有显著性意义（Ｐ＜ ０－０１） 。提示：脐血ＩＬ６ 和ＩＬ８ 水平升高可作为胎膜早破合并宫内感染及新生儿感染的指标，用于指导新生儿抗感染治疗。     

母血白细胞介素6与早产儿近期结局

目的　评估母血白细胞介素 6对早产儿近期结局的预测价值。方法　用酶联免疫吸附实验测定 67例早产孕妇血IL - 6 ,分娩时取部分胎盘胎膜送病检 ,记录 1w内早产儿情况。结果　母血IL - 6≥ 1 0pg/ml比IL - 6 <1 0pg/ml有较高的组织学绒毛膜羊膜炎和明显新生儿发病率。母血IL - 6≥ 1 0pg/ml和组织学绒毛膜羊膜炎阳性对预测明显新生儿发病率的敏感性和特异性分别为 85 0 0 %、48 94%和 70 0 0 %、53 1 9%。结论　母血IL - 6是预测早产明显新生儿发病率一项有用的指标。     

TORCH-IgM阳性孕妇复查结果与妊娠结局的研究

目的探讨TORCH血清筛查IgM阳性孕妇复查结果与不良妊娠结局的关系.方法用酶免疫捕获法检测TORCH-IgM抗体、对阳性孕妇作2～3次TORCH-IgM复查和IgG检测,并对IgM复查阳性孕妇的阴道分泌物进行白细胞介素8(IL-8)检测、B超监测、新生儿脐血检查和妊娠结局观察.结果 TORCH-IgM第1次复检阳性率为33.33%(14/42), 第2次复检阳性率为19.05%(8/42),有4.76%(2/42)的孕妇IgG抗体阴转阳,同时伴阴道分泌物IL-8异常升高,在妊娠早期发生流产,其余TORCH-IgM抗体阳性的孕妇阴道分泌物白细胞介素8检测在正常范围内,妊娠结局正常.结论 TORCH-IgM血清学筛查阳性的孕妇应该多次复查、以便确认是否是活动期感染,进一步结合孕妇阴道分泌物IL-8检测、B超监测、新生儿脐血检查等多种综合检查方法,有助于提高TORCH宫内感染预测诊断的准确性.     

孕妇IL-8、IL-10血清学水平与早期自然流产的相关性研究

目的探讨细胞因子IL-8及IL-10与早期自然流产的关系。方法应用酶联免疫法对46例先兆流产孕妇、56例难免流产孕妇（观察组）进行静脉血IL-8及IL-10的检测,并以53例正常妊娠妇女作为对照（对照组）。结果流产组孕妇血IL-8水平显著高于对照组,而IL-10水平显著低于对照组,差异均有显著性（P〈0.05）;先兆流产治疗成功组孕妇治疗前、后血IL-8、IL-10差异有显著性（P〈0.01）;先兆流产治疗不成功组孕妇治疗前、后血IL-8、IL-10差异无显著性（P〉0.05）。结论早期自然流产孕妇存在细胞因子IL-8、IL-10异常,IL-8可促进早期自然流产发生,而IL-10在维持正常妊娠中可能起重要作用。     

IL-6和CRP在预测未足月胎膜早破亚临床感染中的作用

目的探讨IL-6及CRP在预测未足月胎膜早破亚临床中的作用。方法通过对166例未足月胎膜早破孕妇的血清IL-6及CRP的测定及胎盘病检,将诊断为亚临床绒毛膜羊膜炎的36例及无绒毛膜羊膜炎84例作为研究对象,分析两组病例的IL-6及CRP。结果亚临床绒毛膜羊膜炎组的IL-6及CRP明显高于无绒毛膜羊膜炎组,对比有显著性差异（P〈0.05）。结论 IL-6及CRP可用于预测未足月胎膜早破绒毛膜羊膜炎,两者联合诊断绒毛膜羊膜炎的敏感性及特异性〉90%     

IL-8,MCP-1,RANTES与妊娠的研究进展

趋化因子是一类对中性粒细胞、单核细胞、嗜酸性粒细胞等起激活和趋化作用的细胞因子,介导炎症与免疫反应。其中,白细胞介素-8属于趋化因子CXC亚族,单核细胞趋化蛋白-1和正常T细胞活化后所表达和分泌的调节蛋白属于趋化因子CC亚族,它们与妊娠关系密切,在胚胎植入、宫颈成熟、分娩发动中发挥重要作用,其表达异常可导致宫内感染、早产和流产。     

趋化因子CXCL8/IL-8与急性白血病关系的研究进展

趋化因子CXCL8 (CXCL8),又称白细胞介素8(IL-8),是一种多效性细胞因子.急性白血病细胞结构性表达IL-8及其受体.全反式维甲酸(ATRA)诱导急性早幼粒细胞白血病(APL)细胞向中性粒细胞分化过程中,伴有IL-8表达的变化;且当患者出现分化综合征时外周血IL-8含量显著升高;而成熟的中性粒细胞表达IL-8受体,但不表达IL-8.研究发现具有ELR序列的IL-8与肿瘤发生、发展、治疗的毒副作用及治疗效果密切相关,IL-8及其受体形成的趋化因子轴已经成为新的生物治疗热点及靶向治疗的靶点.本文综述了IL-8与急性白血病特别是急性早幼粒细胞白血病关系的研究进展.     

Intracellular bacteria and adverse pregnancy outcomes

This review considers the role of intracellular bacteria in adverse pregnancy outcomes, such as miscarriage, stillbirths, and preterm labour. The cause of miscarriage, stillbirth and preterm labour often remains unexplained. Intracellular bacteria that grow either poorly or not at all on media used routinely to detect human pathogens could be the aetiological agents of these obstetric conditions. For example, Listeria monocytogenes and Coxiella burnetti are intracellular bacteria that have a predilection for the fetomaternal unit and may induce fatal disease in the mother and/or fetus. Both are important foodborne or zoonotic pathogens in pregnancy. Preventive measures, diagnostic tools and treatment will be reviewed. Moreover, we will also address the importance in adverse pregnancy outcomes of other intracellular bacteria, including Brucella abortus and various members of the order Chlamydiales. Indeed, there is growing evidence that Chlamydia trachomatis, Chlamydia abortus and Chlamydia pneumoniae infections may also result in adverse pregnancy outcomes in humans and/or animals. Moreover, newly discovered Chlamydia-like organisms have recently emerged as new pathogens of both animals and humans. For example, Waddlia chondrophila, a Chlamydia-related bacterium isolated from aborted bovine fetuses, has also been implicated in human miscarriages. Future research should help us to better understand the pathophysiology of adverse pregnancy outcomes caused by intracellular bacteria and to determine the precise mode of transmission of newly identified bacteria, such as Waddlia and Parachlamydia. These emerging pathogens may represent the tip of the iceberg of a large number of as yet unknown intracellular pathogenic agents.     

泰山地区283对不良孕产史夫妇的细胞遗传学分析

目的对泰山地区283对有不良孕产史的夫妇进行细胞遗传学检查,探讨泰山地区染色体畸变与不良孕产的关系。方法取患者外周血淋巴细胞进行染色体制备,利用染色体G显带技术对染色体核型进行分析,并对结果进行统计学分析。结果 566例患者共检出染色体变异39例,男性28例,女性11例,检出率为6.89%。其中大Y 16例,在男性患者中检出率为5.65%;随体变异12例,检出率为2.12%;9ph+2例,检出率为0.35%;染色体易位4例,检出率为0.71%;除大Y外其它性染色体异常5例,检出率为0.88%。结论染色体异常是导致不良孕产的重要因素。     

蓖麻毒素诱导U937细胞分泌IL-6和IL-8的作用

目的：进一步研究蓖麻毒素是否具有诱生Ｕ９３７细胞分泌细胞因子作用。方法：采用ＭＴＴ法检测了蓖麻毒素对Ｕ９３７细胞的毒性，并采用ＥＬＩＳＡ法测定细胞２上清中的Ｉ－６和ＩＬ－８。结果：蓖麻毒素对Ｕ９３７细胞的生具有时间效应及剂量效应。随着作用时间的延长。诱生２种细胞因子的量逐渐增加；随蓖麻毒素剂量的增加，诱生２种细胞因子的量均减少。结论：蓖麻毒素诱导２种细胞因子的产生为其抗癌应用或其它作用提供理论依据     

文山地区163对不良孕产史夫妇染色体分析

目的了解本地区不良孕产史夫妇中染色体异常情况以及民族间是否存差异,探讨其与生殖异常的关系。方法采集163对（326例）有不良孕产史的夫妇外周血液,用常规技术方法制备染色体,经G显带后显微镜下进行染色体核型分析。结果163对夫妇中检出染色体异常12例,异常检出率3．68％（12／326）。以壮族和汉族最多,各5例,分别各占41．67％;彝族2例,占16．67％。结论染色体异常是不良孕产的重要因素之一。有不良孕产史者染色体异常的发生率明显高于一般人群,对有生育畸形、智力低下、染色体异常儿、死胎死产等不良孕产史患者,有必要进行外周血染色体检查和遗传咨询。对降低遗传缺陷儿的出生率,提高人口素质具有重要的意义。     

Sleep disordered breathing in pregnancy: A review of the pathophysiology of adverse pregnancy outcomes

Sleep disordered breathing (SDB) is a common obesity‐related co‐morbidity with strong associations to cardiometabolic disease. The risk of SDB is increased during pregnancy, particularly among obese pregnant women. Accumulating evidence suggests that an association exists between maternal SDB and the development of adverse pregnancy outcomes, particularly gestational diabetes and hypertensive disorders of pregnancy. Intermittent hypoxia, a central characteristic of SDB, has been shown in animal and clinical studies to dysregulate several biological pathways. This includes the promotion of oxidative stress, increased inflammation, activation of the hypothalamic‐pituitary‐adrenal axis, increased sympathetic activity and impaired glucose and insulin metabolism. This review considers how, during pregnancy, these pathophysiological processes are plausible mechanisms through which SDB may contribute to an increased risk of adverse outcomes, for the mother and perhaps also the offspring. However, a lack of robust evidence specific to the pregnant population, including limited evaluation of the placental function in affected pregnancies, limits our ability to draw definite conclusions on mechanisms contributing to adverse pregnancy outcomes and, indeed, the strength of association between SDB and certain pregnancy complications.     

Elevated risks of pregnancy complications and adverse outcomes with increasing maternal age

BACKGROUND: In the USA, between 1980 and 2004, the proportion of all births increased 2-fold in women aged > or = 30, 3-fold in women aged > or = 35 and nearly 4-fold in women aged > or = 40. The objective of this study was to evaluate the risks of pregnancy complications and adverse outcomes with increasing maternal age using national vital statistics data. METHODS: The study population included 8,079,996 live births of singletons of > or = 20 weeks among women aged 30-54 from the 1995-2000 US Birth Cohort Linked Birth/Infant Death Data Set. Outcomes were modelled by maternal age and parity using multinomial logistic regression to calculate adjusted odds ratios (AORs) and 95% confidence intervals. RESULTS: The risks for most outcomes paralleled increasing maternal age including prolonged and dysfunctional labour, excessive labour bleeding, breech and malpresentation and primary Caesarean delivery. The highest AORs among women aged > or = 45 versus 30-34 by parity (primiparas and multiparas, respectively) were for chronic hypertension (3.70, 4.89), diabetes (2.19, 2.58), primary Caesarean (3.14, 2.85), excessive labour bleeding (1.54, 1.49), pregnancy hypertension (1.55, 2.13) and birth <32 weeks (2.11, 1.77). CONCLUSIONS: Increasing maternal age is associated with significantly elevated risks for pregnancy complications and adverse outcomes, which vary by parity.     

D、G组染色体随体变异与不良孕产史关系分析

目的分析染色体随体变异与不良孕产的关系。方法对在我院遗传咨询、妇产科门诊中,有不良孕产史夫妇共1374对,作外周血淋巴细胞培养,染色体核型分析。结果发现D、G组染色体随体变异25例,检出率为0.91%。单纯随体变异23例(其中的2例为一对夫妇),随体变异合并其他染色体异常2例;随体增大11例,占44%,随体丢失14例,占56%;G组染色体随体变异率64%明显大于D组染色体随体变异率36%。结论不良孕产史不但与染色体畸变有关,与随体变异也有关联,同时,D、G组染色体随体变异携带者夫妇,完全有可能生育染色体正常或随体变异表型正常子女。     

Human herpesvirus-8 infection in pregnancy and labor: lack of evidence of vertical transmission

To investigate whether vertical transmission of the human herpesvirus 8 (HHV-8) may occur during pregnancy or at delivery, we enrolled 295 women recruited attending the Division of Obstetrics and Gynecology of a University Teaching of Rome Tor Vergata, S. Eugenio Hospital. The study population was divided in two groups: 245 pregnant women who underwent amniocentesis for genetic screening at 16-18 weeks gestation (group 1) and 50 women at the childbirth (group 2). Maternal blood was obtained from all women. Amniotic fluid (group 1) and cord blood (group 2) were obtained at midtrimester and at delivery, respectively. The presence of anti-HHV-8 antibodies in serum samples was investigated by an immunfluorescence assay. All amniotic fluids, maternal blood, and cord blood samples from HHV-8 seropositive women were tested for the presence of HHV-8 DNA sequences by the polymerase chain reaction. Thirty women, 27 of the group 1 and three of the group 2, were found to have anti-HHV-8 antibodies. Two neonates of the three seropositive mothers of the group 2 had anti-HHV-8 antibodies in cord blood. HHV-8 DNA sequences were detected in the blood of one woman of the group 2. None of the amniotic fluid and cord blood samples had detectable HHV-8 DNA sequences. This study suggests that vertical transmission of HHV-8 is unlikely or, at least, very rare.     

妊娠糖尿病规范化治疗与妊娠结局的临床分析

目的观察妊娠糖尿病患者经规范化治疗后母婴患病率及不同血糖水平对妊娠结局的影响。方法对86例妊娠糖尿病患者采用规范化治疗后,分析其妊娠结局。结果妊娠糖尿病规范化治疗后与正常孕妇母婴患病率无显著性差异;空腹血糖在4.0~4.8mmol/l、餐后2h血糖在4.8~7.0mmol/l、糖化血红蛋白在5%~6.2%范围内妊娠糖尿病患者母婴患病率最低。结论妊娠糖尿病经规范化治疗能减少母婴并发症,妊娠结局与血糖及糖化血红蛋白水平密切相关。     

轻微血糖升高对不良妊娠结局的影响

目的回顾性分析轻微血糖升高对大陆地区孕妇不良妊娠结局的影响。方法符合以下入选标准：①年龄大于18岁;②单胎、头胎、胎龄符合孕周;③于孕24～32周行50 g GCT试验,1 h PG≥7.8 mmol/L者于1周内行75 g OGTT试验,且OGTT试验在正常范围内（FBG〈5.1 mmol/L、1 h〈10.0 mmol/L、2 h〈8.5 mmol/L）。结果共有527例符合入选标准,根据血糖水平高低将FBG、1 h BG、2 h BG等各分为4个亚组,每个亚组相差一个标准差。随着FBG、1 hBG、2 h BG水平升高,大于胎龄儿、新生儿高胆红素血症的发生率也随着增加;而胎儿宫腔内感染、先兆子痫、1 minApgar评分低及转儿科监护治疗的发生率并未达到差异具有统计学意义的升高。结论对于轻微血糖升高的孕妇而言,大于胎龄儿、新生儿高胆红素血症的血糖阈值是4.6 mmol/L