The Expression Of CRH In Peripheral Blood And Placenta Of Early-Onset Severe Preeclampsia

Objective:(1) To evaluate the chang of the levels of CRH in peripheral blood and placenta of the patients with severe preeclampsia and morbidity of severe preeclampsia. (2)To evaluate the pathogeny between early-onset and late-onset severe preeclampsia may be different.Methods: 1. The study subjects:(1)The early-onset severe preeclampsia group: 15 patients with early-onset severe preeclampsia who had prenatal examinations and delivered in the Obsterics of the Second Hospital of HeBei Medical University were selected from November 2006 to June 2007. Severe preeclampsia before 34w is early-onset.Diagnosis criteria of severe preeclampsia accorded to the diagnostic standard (Obstetrics and Gynecology,the Sixth Edition).Mean age of patients with early-onset severe preeclampsia was 30.06±3.47 years old (23 to 38 years old).Mean weeks of gestation of them was 32.48±0.26 weeks (30 to 33+5 weeks). (2)The late-onset severe preeclampsia group: 15 patients with late-onset severe preeclampsia were selected to serve as the control group,severe preeclampsia after 34w is late-onset.The diagnosis criteria of severe preeclampsia same as above.Mean age of patients with late-onset severe preeclampsia group was 28.40±2.10 years old (25 to 33 years old).Mean weeks of gestation of them was 35.17±2.96 weeks (34 to 38 weeks).⑶The normal pregnancy group: 20 normal pregnancy women match with the two groups were randomly selected. Mean age of patients with normal pregnancy was 29.40±3.68 years old (23 to 40 years old).Mean weeks of gestation of them was 34.73±4.81 weeks (30 to 38weeks).All groups without multiple pregnancy, chronic hypertension, diabetes, cardiovascular disease, chronic nephrosis, chronic liver disease and immune diseases.2.Sample collecting:3 ml of anconeal median venous blood was collected from the study subjects,the blood sample (after separating plasma )was preserved for assaying the plasma level of CRH. The placental tissues were prepared into homogenative fluid for assaying relative concentrations of CRH. 2ml fasting blood was collected from the early-onset and late-onset severe preeclampsia groups,which was used to assay the levels of blood urea nitrogen and serum creatinine.24-hour urine was collected for assay the concentration of proteinuria.3.The experiment methods: To determine the level of CRH in plasma and placenta by means of enzyme-linked immunosorbent assay(ELISA).The levels of CRH Mrna were test by Real-time RT-PCR.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 bromcresol green test. To analyze the results by means of the SPSS13.0.Results:1.The plasma concentration of CRH in the early-onset severe preeclampsia (1.7287±0.3103ng/ml) were significantly higher than the concentration in the late-onset severe preeclampsia (1.4583±0.0879ng/ml) and the normal group (1.3547±0.1942ng/ml) (P < 0.05). Those in the late-onset severe preeclampsia were also higher than those in the normal group (P<0.05).2.The placenta CRH concentration in the early-onset severe preeclampsia (1.6332±0.1914ng/ml) were significantly higher than the concentration in the late-onset severe preeclampsia (1.4363±0.1932ng/ml) (P<0.05).3.The placenta CRH mRNA concentration in early-onset severe preeclampsia (0.0334±0.0042) were significantly higher than the concentration in the late-onset group (0.0243±0.0039) (P<0.05).4.The content of 24 hour proteinuria, mean arterial blood pressure (MABP), the blood urea nitrogen levels and the serum creatinine levels in the early-onset severe preeclampsia were higher than those in the late-onset severe preeclampsia.But there were no statistical difference (P>0.05).5.In the early-onset severe preeclampsia,the plasma CRH levels correlated positively with the mean arterial blood pressure (r=0.657 P<0.05) and urea nitrogen (r=0.539 P<0.05) and creatinine (r=0.303 P<0.05). In late-onset,the plasma CRH levels correlated positively with the mean arterial blood pressure (r=0.564 P<0.05) and urea nitrogen (r=0.356 P<0.05) and creatinine (r=0.314 P<0.05).Conclusion: 1.There would be different etiopathogenisis and potential mechanism between early-onset severe preeclampsia and late-onset severe preeclampsia.The incresed CRH level of the plasma and placenta may be the one of the etiopathogenisis in the early-onset severe preeclampsia.2.The high level of CRH concention of peripheral blood have positive correlation with severity of preeclampsia.