硫酸镁联合胰激肽释放酶治疗对重度子痫前期孕妇LXA4、PTX3及免疫学指标的影响  

Effect of magnesium sulfate combined with pancreatic kallikrein on the LXA4,PTX3 and immunological indexes levels in pregnant women with severe preeclampsia

作　　者：兰瑞红[1] 龚护民[1] Lan Ruihong;Gong Humin(Department of Obstetrics and Gynecology,Hainan People’s Hospital,Haikou 570000,China)

机构地区：[1]海南省人民医院妇产科,海口570000

出　　处：《广西医科大学学报》2019年第2期221-224,共4页Journal of Guangxi Medical University

摘　　要：目的:探讨硫酸镁联合胰激肽释放酶治疗对重度子痫前期(PE)孕妇脂氧素A4(LXA4)、五聚素3(PTX3)水平及免疫学指标的影响。方法:选择2014年11月至2017年6月在海南省人民医院就诊的重度PE孕妇88例,按随机数字表法分为观察组和对照组,每组44例,观察组给予硫酸镁联合胰激肽释放酶治疗,对照组单纯给予硫酸镁治疗。观察两组子宫动脉和脐动脉血流状态及血清LXA4和血浆PTX3水平以及免疫功能指标。结果:治疗后,观察组收缩末期峰值/舒张末期峰值(S/D)、血流灌注指数(PI)及血清胱抑素C(CysC)、可溶性血管内皮生长因子受体1(sVEGFR1)水平均显著低于对照组,胎盘生长因子(PIGF)和一氧化氮(NO)水平显著高于对照组(均P<0.05)。治疗前,两组孕妇外周血LXA4、PTX3、CD28、细胞毒T淋巴细胞相关抗原4(CTLA-4)、CD28/CTLA-4及Th1、Th2及Th1/Th2比较,差异均无统计学意义(均P>0.05);治疗后,观察组外周血LXA4、PTX3、CD28、CD28/CTLA-4、Th2显著高于对照组,CTLA-4、Th1及Th1/Th2显著低于对照组(均P<0.05)。结论:硫酸镁联合胰激肽释放酶治疗可有效改善重度PE孕妇子宫动脉和脐动脉血流状态及外周血LXA4、PTX3水平,减轻炎症反应,促进免疫功能恢复。Objective:To investigate the effect of magnesium sulfate combined with pancreatic kallikrein on the lipoxygenA 4(LXA4),pentraxin 3(PTX3) and immunological indexes levels in pregnant women with severe preeclampsia(PE). Methods:A total of 88 patients with severe PE in our hospital from November 2014 to June 2017 were selected,and randomly divided into an observation group and a control group,with 44 cases in each group.The patients in the observation group received magnesium sulfate combined with pancreatic kallikrein,and those in the control group received magnesium sulfate only.After 3 days of treatment,the uterine artery and umbilical artery blood flow,serum LXA4 level,plasma PTX3 level and the immune function indexes were compared. Results:The blood flow resistance of the uterine artery and umbilical artery,the ratio of end systolic peak/end diastolic peak(S/D),blood perfusion index(PI) and the serum levels of Cystatin C(CysC) and soluble vascular endothelial growth factor receptor 1(sVEGFR1) in the observation group were lower than those in the control group,while the serum placental growth factor(PIGF) and nitric oxide(NO) contents were significantly higher( P <0.05).After treatment,the levels of LXA4 and PTX3,the percentage of CD28 and Th2,and the ratio of CD28 to cytotoxic T lymphocyte associated antigen-4(CTLA-4) in the observation group were higher than those in the control group,whereas the CTLA-4 level,Th1 percentage and Th1/Th2 ratio were notably lower( P <0.05). Conclusion:Magnesium sulfate combined with pancreatic kallikrein could effectively improve the uterine artery and umbilical artery blood flow and the levels of LXA4 and PTX3,attenuate inflammatory response,and promote the recovery of immune function in pregnant women with PE.

关 键 词：硫酸镁 胰激肽释放酶 重度子痫前期 脂氧素A4 五聚素3 免疫学指标 

分 类 号：R714.44[医药卫生—妇产科学]