Levels Of Plasma TXB₂,6-keto-PGF_1a,PRA And ANGⅡ With Seasonal Climate And Its Clinical Significance In Hypertensive Disorder Complicating Pregnancey

Objective:1. To investigate the expression of TXB2,6-keto-PGF1a,PRA and AngⅡin normal pregnancy and hypertensive disorder complicating pregnancy(HDCP) and the calculation of 6-keto-PGF1a/TXB2 (P/T) values at different seasonal climates.Analyzing their status and role in the pathogenesis of HDCP,and the correlation of several vasoative substances.2. To investigate the relationship between the contents of plasma TXB2,6-keto-PGF1a, PRA, AngⅡand P/T ratios in normal pregnant women and HDCP patients with seasonal climate, analyzing the effects of seasonal climate change on their levels, contributing to definitude the pathogenesis of HDCP mechanism, and in order to provide a theoretical basis for prevention and treatment of HDCP.Methods:1. Subject investigated:The pregnant women were in hospial at March 2009-2010 in Jiangxi Province maternity and child care hospital. The year was divided into three seasons: winter-type (from November to February), summer-type (June-August)and transitional-season group (from March to May and from September to October).Study Group:90 cases of HDCP patients(30 cases for each season,divided into gestation hypeterension group,n=15 and severe preeclampsia, n=15);Control group:60 cases of normal pregnant women at the season over the same period (20 cases each season).2. Research methods:The levels of TXB2,6-keto-PGF1a,PRA and AngⅡin plasma and P/T values in 60 cases of normal pregnant women and 90 cases of HDCP patients were detected by radioimmunoassay.Results:1. The comparison of plasma TXB2,6-keto-PGF1a and P/T values between normal pregnancy and HDCP patients at the same seasons:The levels of TXB2 in gestational hypertension groups and severe preeclampsia groups were considerably higher than control groups in three seasonal groups (P< 0.05, P<0.001), and increased with increasing disease (P<0.05).6-keto-PGF1a levels and P/T values were lower than the control groups (P<0.05,0.01), and decreased with increasing disease.2. The comparison of plasma PRA and Ang II between normal pregnancy and HDCP patients at the same seasons:The levels of PRA and Ang II in gestational hypertension groups and severe preeclampsia groups were considerably lower than control groups in transitional-season groups and summer-type groups (P<0.05, P<0.001).The levels of PRA in winter-type gestational hypertension groups and severe preeclampsia groups were lower than control groups (P<0.05, P<0.001), and declined with increasing disease.but the concentration of AngⅡwas no difference between winter-type HDCP group and control group.3. The correlation between plasma TXB2,6-keto-PGF1a,PRA,and Ang II in HDCP patients:Plasma TXB2 and 6-keto-PGF1a was negative correlated(P<0.001),6-keto-PGF1a and PRA was postively correlated(P<0.05),6-keto-PGF1a and Ang II was negative correlated(P<0.05).4. The comparison of plasma TXB2,6-keto-PGF1a, P/T values, PRA and Ang II between normal pregnancy and HDCP patients at the different seasonal climates:The level of 6-keto-PGF1a in Winter-type control group was lower than summer-type control group and transitional seasonal control group (P<0.001), the TXB2 concentration and P/T value in plasma were no difference between groups.The levels of TXB2 in winter and summer type gestational hypertension groups and severe preeclampsia groups were higher than the transitional seasonal group (P<0.01, P<0.05),the 6-keto-PGF1a levels and the P/T values were lower than the transitional seasonal group (P<0.001,0.01).The levels of plasma PRA and Ang II were no difference between three seasonal control groups. The level of PRA was no difference between transitional-season,summer-type and winter-type HDCP groups,but the level of Ang II in winter HDCP groups was remarkable higher than the transitional-season and summer-type HDCP groups (P<0.001, P<0.01) Conclusions:1. Increased synthesis release of TXB2,reduced secretion of 6-keto-PGF1a and disordered P/T value in patients with HDCP. Seasonal climate change can affect the level of 6-keto-PGF1a in normal pregnant women, while the TXB2,6-keto-PGF1a levels have greater impact in patients with HDCP.2. The circulation renin-angiotensin system in HDCP patients was suppressed, the levels of maternal PRA and AngⅡwere significantly reduced. Seasonal climate change had no effect on PRA,AngⅡlevels of normal pregnancies and the PRA level of HDCP patients,but the cold season has a significant influence on the plasma level of AngⅡin HDCP patients.