Serum Levels Of HsCRP, PTX3, Lipid And The Correlation Of The Three In Severe Preeclampsia

Objective: Hypertensive disorders in pregnancy are common diseasesin realms of obstetrics and are great threat to the health of maternal and child,which is one of the four major reasons of maternal death combined withpostpartum hemorrhage, pregnancy with heart disease and puerperal infection.The incidence of hypertensive disorders in pregnancy is5~8%, accounting forabout10~16%of all maternal deaths. There is still not a clue of the causes ofhypertensive disorders in pregnancy, but the prominent factors of thepathogenic mechanism are trophoblast cell infiltration capacity abnormalities,immune dysfunction, genetic factors, oxidative stress reaction and diet andnutrition factors. The endothelial dysfunction is the major characteristic ofpreeclampsia in which the inflammatory reaction and lipid metabolismdisorders are involved. The family of pentraxins is a huge and multifunctionalone and branch off into two groups: the short constituents and their longcounterparts based on different structures. The short pentraxins is the classicalpentraxins which conclude CRP and SAP. The long pentraxins concludespentraxin-3(PTX3). CRP is the first family member to be found out in the1930s in the separation of pneumonia patients’ serum. In the following fewdecades, along with the further study of CRP, it became clear that CRP isacute-phase protein and is manufactured in the liver mostly and increases asmuch as1000-fold under inflammatory conditions to fulfill its major functionas to identify and clear the invade pathogens, apoptotic and necrosis cells,while displaying anti-inflammatory effects in autoimmune diseases. PTX3wasidentified in the early1990s as the first long PTX member and enjoy a similarC terminal structure but unique N terminal structure which is different fromany other known protein. The main site of synthesis of PTX3is extrahepatictissues and cells, such as ehdothelial cells, fibroblasts, fat tissues and cells, macrophages etc. Its main function is similar to CRP, and the latest researchshows that PTX3display new function about the positive anti-inflammatoryeffects, female fertility and antiangiogenic function, etc. Another risk factor inpreeclampsia is Dyslipidemia. High levels of LDL, low concentration of HDLin circulation is considered to be the CVD diseases risk factors. The mainobjective of this experiment is to know about inflammation meditors, bloodlipoprotein level and the correlation of them both in severe preeclampsiapatients and normal pregnant women.Methods: Randomly select90cases from2011-9to2012-6in theobstetrics inpatient and outpatient department of the second hospital of Hebeimedical university, including41cases as the normal control group and49cases as the severe preeclampsia group (26cases of gestational weeks≥34weeks,23cases＜34weeks). The subjects selected were not carryingmaternity pathological disease, medical complications or taking any drugs.Fasting venous blood from the subjects was collected, and separate serumafter1500r/min to measure the level of PTX3(use the enzyme-linkedimmunosorbent assay) hsCRP,TC,TG, HDL-C,LDL-C(measured in hospital’sbiochemical laboratory). The data was analyzed by SPSS16.0software wrap.The measured data was shown in mean standard deviation or median (QR).One-factor ANOVA, LSD-t inspection method, Kruskal-Wallis H rank test,Mann-Whitney U test, Pearson or Spearman linear correlation analysis wereinvolved. P＜0.05have statistical significance,lgPTX3and lghsCRP make itsaccordance with normal distribution.Results:1LgPTX3, lghsCRP in early onset group, late onset group and controlgroup:lgPTX30.82±0.16,0.69±0.14,0.29±0.2ng/ml;lghsCRP0.78（0.66）,0.65（0.52）,0.45（0.23）mg/l, the serum levels of lgPTX3and lghsCRP in SPgroup is significantly higher than those in the control group(lgPTX3t=11.448、8.965P=0.000,0.000＜0.05；lghsCRP U=264,318.5P=0.004,0.006＜0.05). LgPTX3lghsCRP in EOSP group are higher than those in the LOSPgroup, and lgPTX3has statistical significance between two groups(lgPTX3 2.568P=0.013＜0.05;lghsCRP227P=0.659＞0.05).2The serum levels of lipid and lipoprotein of three group: TC6.16（1.79）、6.58（2.13）,5.2(1.33)； TG2.97±0.81,3.35±1.03,2.77±0.86；HDL-C1.85±0.48,1.94±0.47,1.89±0.44；LDL-C3.09（1.14）,3.41（1.06）,2.80（0.94）mmol/L. The serum levels of lipid and lipoprotein in SP group aresignificantly higher than those in control group (except HDL-C).(TC U=216,149.5P=0.000＜0.05;TG t=0.844,2.574P=0.401＞0.05,0.012＜0.05；HDL-C t=0.344,0.478P=0.739,0.635＞0.05； LDL-C U=313,242P=0.027,0.000＜0.05). There are no statistical significance in blood lipidlevels of EOSP group and LOSP group(U or t=226,1.485、0.722,241P=0.144,0.141,0.472,0.245＞0.05).3There are significantly positive correlation between lgPTX3and lghsCRP in severe preeclampsia patients(r=0.8P=0.000＜0.05). LgPTX3has anegative correlation with TCor LDL-C(r or rs=-0.388,-0.596P=0.006、0.000＜0.05), a positive significant correlation with HDL-C(rs=0.660P=0.000＜0.05). LghsCRP has a significant positive correlation with HDL-C(rs=0.646P=0.000＜0.05),has a negative correlation with LDL-C orTC（rs or r=-0.565、-0.330P=0.000、0.021＜0.05), and has no significant linear correlation withothers lipid or lipoprotein.Conclusion:1Severe preeclampsia is a state of excessive inflammatory response,andthe prediction effect of PTX3of preeclampsia is better than that of hsCRP.2Lipid metabolism disorders may be involved in the onset of severepreeclampsia disease progress, this kind of situation is no correlation withgestational age,and is associated with the severity of the disease.3Inflammatory mediators,lipid and lipoprotein influnce eachother,common involved in preeclampsia endothelial dysfunction occurs.