A Study On The Correlation Between β-HCG And INH-_A And The Morbidity And Severity Of Preeclampsia

Objective: ⑴To evaluate the changes of the levels of β-HCG and INH-A in the serum and placenta of the patients with preeclampsia. ⑵To evaluate the correlation between the abnormality of the levels ofβ-HCG and INH-A in the serum and placenta and the morbidity of preeclampsia. ⑶To valuate the correlation between the levels of β-HCG and INH-A in the serum and the degree of severity of preeclampsia. Methods:1)The study subject: ⑴The study group:32 patients with preeclampsia who had prenatal examinations and delivered in the Obstetrics of the Second Hospital of HeBei Medical University were selected from January 2004 to September 2004. 18 patients with severe preeclampsia were involved in the study. Diagnosis criteria of severe preeclampsia were as follows:blood pressure ≥160/110mmHg; proteinuria ≥2.0g/24 hours or proteinuria of ++; serum creatinine>106umol/L; platelet count<100×109/L; microangiothic hemolysis ( elevation of serum LDH ) ; elevation of serum ALT or AST; persistent headache or other disturbances of cranial nerve or vision ; persistent discomfort of the epigastrium. 16 patients with mild preeclampsia were involved in the study. Diagnosis criteria of mild preeclampsia were as follows: blood pressure ≥140/90mmHg after 20 weeks of gestation; proteinuria ≥300mg/24 hours or proteinuria of +; accompanying of symptoms of epigastric discomfort or headache. Moreover, to select randomly 16 placentas of patients with preeclampsia, including 8 placentas of patients with mild preeclampsia and 8 placentas of patients with severe preeclampsia. Mean age of patients with preeclampsia was 27.00±3.68 years old (21 to 34 years old); Mean weeks of gestation of them was 36.80±2.03 weeks (32+5 to 40 weeks). ⑵The control group: 16 healthy third trimester pregnant women were selected to serve as the control group, 8 placentas of them were randomly selected. Mean age of them was 27.31±3.11 years old (23 to 36 years old); Mean weeks of gestation of them was 38.23±1.59 weeks (35+1 to 40 weeks). Only serum samples from women without multi gestations, chronic hypertension, diabetes, heart disease, chronic renal disease, chronic liver disease and immune disease were considered for analysis. 2)Sample collecting: 3mL of anconeal median venous blood was collected from the study subjects, the blood sample (after separating serum) was preserved for assaying the serum levels ofβ-HCG and INH-A in bathes. The placental tissues were prepared into homogenative fluid for assaying relative concentrations ofβ-HCG and INH-A . 2mL fasting blood was collected from the study subjects, which was used to assay the levels of blood urea nitrogen and serum creatinine. 24-hoururine was collected for assay the concentrations of proteinuria. 3)The experiment methods: To determine the levels ofβ-HCG and INH-A in the serum and placenta by means of enzyme-linked immmunsobent assay (ELISA). To determine the levels of blood urea nitrogen by means of urease test. To assay the levels of serum creatinine by means of picric acid test. To assay the concentrations of proteinuria in the 24-hour urine by means of bromocresol green test. To analyze the results by means of the SPSS 11.5. Results:1.The serumβ-HCG levels in the study group(87.23±30.81ng/mL) were significantly higher than those in the control group(32.74±17.49ng/mL)(P<0.01). Compared with those of the mild preeclampsia group(68.03±20.94ng/mL) and the control group, the serumβ-HCG levels of the severe preeclampsia group(106.40±27.19ng/mL) were significantly high(P < 0.01). The serum β-HCG levels in the mild preeclampsia group were also significantly higher than those in the control group(P<0.01). The serum INH-A levels in the study group(810.79±118.68pg/mL) were significantly higher than those in the control group(665.57±75.05pg/mL)(P<0.01). Compared with those of the mild preeclampsia group(741.71±91.13pg/mL) and the control group, the serum INH-A levels of the severe preeclampsia group(879.87±103.07pg/mL) were significantly high(P<0.01). The serum INH-A levels in the mild preeclampsia group were also significantly higher than those in the control group(P<0.05).In the study group, the serum β-HCG levels correlated positively with the serum INH-A levels(r=0.516, P<0.01). 2.The placenta β-HCG concentrations in the study group(6.91±2.15ng/mg) were significantly higher than those in the control group(3.30±0.84ng/mg)(P<0.01). Compared with those of the mild preeclampsia group(5.47±1.84ng/mg) and the control group, the placentaβ-HCG concentrations of the severe preeclampsia group(8.36 ±1.31ng/mg) were significantly high(P<0.01). The placentaβ-HCG concentrations in the mild preeclampsia group were also significantly higher than those in the control group(P<0.01). The placenta INH-A concentrations in the study group(87.31 ±15.68pg/mg) were significantly higher than those in the control group(58.69±8.04pg/mg)(P<0.01). Compared with those of the mild preeclampsia group(77.13±10.81pg/mg) and the control group, the placenta INH-A concentrations of the severe preeclampsia group(97.48±13.18pg/mg) were significantly high(P<0.01). The placenta INH-A concentrations in the mild preeclampsia group were also significantly higher than those in the control group(P<0.01). In the study group,the placentaβ-HCG concentrations correlated positively with the placenta INH-A concentrations(r=0.529, P<0.05). 3.The blood urea nitrogen levels in the study group(4.68±1.57mmol/L) were significantly higher than those in the control group(3.38±0.81mmol/L)( P<0.01). The serum creatinine levels in the study group(70.59 ±20.17umol/L) weresignificantly higher than those in the control group(53.31±14.07umol/L)(P < 0.01). The 24-hours proteinuria concentrations in the study group were 2.99 ±3.05g, the 24-hours proteinuria concentrations in the control group were all less than 0.15g. The systolic blood pressure in the study group(155.19±12.93mmHg) were significantly higher than those in the control group(117.38±7.93mmHg)( P<0.01). The diastolic blood pressure in the study group(103.91 ±12.49mmHg) were significantly higher than those in the control group(75.44±8.27mmHg)( P<0.01). 4.In the study group, the serumβ-HCG levels correlated positively with the blood urea nitrogen levels(r=0.538,P<0.01)and the serum creatinine levels(r=0.581,P<0.01)and the 24-hours proteinuria concentrations(r=0.607,P<0.01)and the diastolic blood pressure(r=0.578,P<0.01). In the study group, the serum INH-A levels correlated positively with the blood urea nitrogen levels(r=0.444,P < 0.05)and the serum creatinine levels(r=0.556,P < 0.01)and the 24-hours proteinuria concentrations(r=0.395,P < 0.05)and the diastolic blood pressure(r=0.395,P<0.05). Conclusion: ⑴The abnormality of the levels of β-HCG and INH-A in the placental tissues of patients with preeclampsia may influence the development of placental vascular bed by regulating the proliferation and differentiation and invasion of trophoblast.Thus β-HCG and INH-A may participate in the morbidity of preeclampsia. ⑵The abnormality of the levels of...