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子痫前期的红细胞变化:母血与脐血红细胞损伤之间的关系

Erythrocyte changes in preeclampsia: relationship between maternal and cord blood erythrocyte damage.

作者信息

Catarino Cristina, Rebelo Irene, Belo Luís, Rocha-Pereira Petronila, Rocha Susana, Bayer Castro Elisabeth, Patrício Belmiro, Quintanilha Alexandre, Santos-Silva Alice

机构信息

Faculdade Farmácia, Universidade Porto, Portugal.

出版信息

J Perinat Med. 2009;37(1):19-27. doi: 10.1515/JPM.2009.007.

Abstract

Our aim was to evaluate red blood cell (RBC) changes in normal and preeclamptic cases, and to assess the relationship between maternal and umbilical cord blood (UCB) changes. We evaluated markers of RBC damage: membrane bound hemoglobin (MBH) and band 3 profile - high molecular weight aggregates (HMWSAg), monomer and proteolytic fragments. RBCs are marked for removal by a rise in MBH and in HMWAg. Preeclamptic mothers had significantly higher MBH, RBC count, hemoglobin, hematocrit, reticulocytes and reticulocyte production index (RPI). In UCB from newborns of preeclamptic mothers, we found similar HMWAg, RBC count, hemoglobin and hematocrit; significantly higher MBH, mean cell hemoglobin concentration, mean cell volume, RPI and reticulocyte count. Maternal MBH and HMWAg values were positively and significantly correlated with MBH and HMWAg values in UCB, in normal as well as in preeclamptic pregnancies; in preeclampsia, a significant positive correlation between UCB and maternal bilirubin, and between RPI and proteinuria were found. We conclude that markers of RBC damage/production are altered in preeclampsia, in both UCB and maternal circulation. Our data show similarities between UCB and maternal RBC changes, as suggested by the correlations of markers of RBC damage.

摘要

我们的目的是评估正常妊娠和先兆子痫病例中红细胞(RBC)的变化,并评估母体和脐带血(UCB)变化之间的关系。我们评估了红细胞损伤的标志物:膜结合血红蛋白(MBH)和带3谱——高分子量聚集体(HMWSAg)、单体和蛋白水解片段。MBH和HMWAg升高表明红细胞被标记以便清除。先兆子痫母亲的MBH、红细胞计数、血红蛋白、血细胞比容、网织红细胞和网织红细胞生成指数(RPI)显著更高。在先兆子痫母亲所生新生儿的脐带血中,我们发现了类似的HMWAg、红细胞计数、血红蛋白和血细胞比容;MBH、平均红细胞血红蛋白浓度、平均红细胞体积、RPI和网织红细胞计数显著更高。在正常妊娠和先兆子痫妊娠中,母体MBH和HMWAg值与脐带血中的MBH和HMWAg值呈显著正相关;在先兆子痫中,发现脐带血与母体胆红素之间以及RPI与蛋白尿之间存在显著正相关。我们得出结论,先兆子痫时脐带血和母体循环中红细胞损伤/生成的标志物均发生改变。我们的数据表明,如红细胞损伤标志物的相关性所示,脐带血和母体红细胞变化之间存在相似性。

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