| ObjectiverPregnancy Induced Hypertension (PIH) is a multisyste disorder of human pregnancy,occurring in 5-10% of all population births and represents the leading cause of both fetal and maternal morbidity and mortality in pregnancy.Symptoms of this syndrome:hypertension and impaired renal function appear during the second or third trimester of pregnancy .Despite intensive efforts to find mechanisms and markers induced PIH,no specific etioligical factor has been identified until now. Many hypotheses have been described, but none can be confirmed completely. According to the Oxford group of researchers,PIH is a placental disease.The first stage is the process that affects the spiral arteries and results in a deficient blood supply to the placenta.The second stage encompasses the effects of the ensuing placental ischemia on both the fetus and the mother. Howe ver,placental ischemia as the cause of endothelial cell dysfunction in PIH is a concept,several clinical symptoms dispute its validity.Since 1989,when Roberts et al in their classic article decleared thatpreeclampsia is an endothelial cell disorder,much work has been stimulated.But Redman etal proposed that endothelial dysfunction is a single part of a more extensive intravascular inflammatory response.Considering the fetal is an allograft for the mother,it is reasonable to explore the change in the maternal immune system to elucidate pathology of pregnancy induced hypertension.A large number of epidemiolgic studies have been carried out and they demonstrate that the immune system is primarily involed the process.The immunological relationship between the mammalian fetus and its mother during pregnancy has been considered similar to that between a transplanted allograft and its recipient.Hence,the change of the immune response in maternal body has been the hot spot to study.Normal pregnancy is thought to be associated with a state of tolerance to the foreign antigens of the fetus.In the past,most people believe that the maternal immune system is suppressed .Recently,many researches suggest that normal pregnancy is characterized by lack of strong maternal cell-mediated immunity and a dominant humoral immune response.In the shift of the maternal immune system, T helper cytokines are critical factors.The importance of T helper l-(Thl) and T helper 2-(Th2)type cytokines imbalance in pregnant woman with pregnancy induced hypertension are recognized.Many studies have approved that the pathological processes involve abnormal levels of cytokines ,resulting in systemic and organic dysfunction such as the aberranttrophoblast invasion of the spiral arteries,placental dysfunction and endothelial cell dysfunction. Cytokines primarily have paracrine and autocrine efFects,and are generally short-range factors that act locally. However, cytokines sometimes act at distant sites in the body to effect their endocrine action.Today, to test whether circulating inflammatory Thl/Th2 type cytokines are implicated in the pathogenesis of PIH, we measured serum levels of immunoreactive tumor necrosis factor (TNF)-alpha and interleukin-10 in woman with PIH and in women throughout normal pregnancy.Methods: Forty-two patients(aged 28?.09 years) (including 20 women develping moderate hypertension and 22 women developing severe hypertension) in the late-gestation pregnancy (gestational age 37.36?.37 weeks) have had blood samples taken at the time of diagnosis of PIH. After verbal informed consent, venous blood was collected into a 10ml sterile plain tube without anticoagulant. The control group consisted of 30 age and gestational age matched pregnant healthy women (aged 28?.75 years; gestational age 37.53?.90weeks) who unederwent the same regime.The samples were allowed to clot before centrifugation.All blood samples were stored at -20 癈 and measured at the same day to avoid interassay variation.Enzyme-linked immunosorbent assaya and Radioimmunoassay were used.The antibodies used in this procedure have no cross-reactivities with othercytokines. SPSS 10.0 was...
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