| Objective: The purpose of this study is to establish an ideal animal model of HDP through chronic stress,and to explore the relationship between different occupations and HDP through retrospective cohort study.Method: 1.Experimental animals: Female borderline hypertension rat(BHR),a offspring of female spontaneously hypertensive rat(SHR)and male Wistar-Kyoto rat(WKY),was selected as experiment rats.Each female BHR rats paired formating overnight with a male WKY rats until mating was confirmed by observation of vaginal plug in the next morning.The observation of vaginal plug was recorded as the first day of pregnancy.2.Grouping and establishment of model: Each female BHR rats paired formating overnight with a male WKY until mating was confirmed by observation of vaginal plug in the next morning.The day observing vaginal plug was defined the 1st pregnant day.Then divided rats into stress group and control group randomly.The stress group was given different stimulation,while the control group was not treated.The general situation,blood pressure,urine protein,the levels of copeptin of rats were monitored.3.Specimen collection and detection indicators: Fetals were taken by cesarean section in the 18 days of pregnant rats.The weight of placenta,weight and body length were recorded.The placenta,liver and kidney tissues were harvested and stained with HE.4.A total of 3501 pregnant women who were hospitalized in our hospital from January 2018 to April 2019 and terminated pregnancy at 28 weeks of gestation or above were collected retrospectively.According to the inclusion exclusion criteria divided into groups.5.Excel software was used to establish the database,and spss22.0 was used to analyze the statistical data.The appropriate statistical method was selected according to the type of data.Result1.General condition,mean arterial pressure(MAP)and 24 hours urinary protein concentration of rats: with the increase of stimulation days,the rats in stress group were irritable,fidgety and eating less.There was no significant difference in MAP and 24 h urinary protein concentration between the two groups before pregnancy(P > 0.05).After chronic stimulation,the blood pressure and urinary protein concentration in the stress group increased significantly,and the difference was statistically significant compared with that in the control group(P< 0.001).2.The levels of copeptin: on the 17 th pregnant day,there were significant differences between the stress group and BHR control group(P< 0.01).3.Compared with the control group,the placental wet weight,fetal weight and body length of the stress group were significantly decreased(P< 0.001).The number of fetal rats in the stress group was lower than that in the control group,and the number of fetal death in the stress group was higher than that in the control group(P<0.05).4.Histopathology of placenta,liver and kidney: there were obvious histological changes of ischemia and hypoxia in every layers of placenta in stress group.Under light microscope,glomerular basement membrane thickening,mesangial cell proliferation and renal tubular epithelial cell edema were observed in kidney.And hepatic sinusoid dilation,fuzzy boundary of hepatic lobules and disordered arrangement of hepatic cell cords were observed in liver.5.Among pregnant women with HDP,farmers(20.60%),workers(15.60%),unemployed persons(12.50%)had large proportion HDP,and administrative staff(3.1%)had less HDP,and the incidence rate of HDP in different occupation status was different(P<0.001).Conclusion1.The animal model of HDP can be successfully established by chronic stress in BHR rats,which shows the clinical manifestations of hypertension and urinary protein.2.The pathological changes of liver,kidney and placenta in the new rat model were consistent with the characteristics of HDP.3.The new rat model has the characteristics of fetal growth restriction and other adverse pregnancy outcomes.4.The level of copeptin increased in the new model rats.It indirectly reflects the increase of AVP level in circulation,indicating that the body is in a state of stress,which may be related to the enhanced activity of hypothalamic-pituitary-adrenal cortex coaxial(HPA)axis.5.Different jobs are related to the incidence of HDP,which may be related to the long-term stress state of the body. |
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