血清瘦素、血脂水平与妊娠期高血压疾病的关系

目的探讨血清瘦素（leptin）、血脂（serum lipid）在妊娠期高血压疾病（hypertensive disor dercomplicating pregnancy）发病中的意义及相互关系。方法选取2006年7月至2007年2月在山西省临汾市人民医院妇产科住院待产的20例妊娠期高血压、27例子痫前期及同期正常晚期孕妇30例为研究对象。将其分为妊娠期高血压组（A组，n=20），子痫前期组（B组，n=27），正常妊娠组（C组，n=30）（本研究遵循的程序符合山西省临汾市人民医院人体试验委员会所制定的伦理学标准，得到该委员会批准，取得受试对象的知情同意，并签署临床研究知情同意书）。采用放射免疫法测定血清瘦素水平，分别采用COD-PAP法和GPO-PAP法，测定血清总胆固醇（total cholesterol，TC）、甘油三酯（triglyceride，TG）。结果①单因素方差分析表明，三组孕妇母血清中瘦素、总胆固醇、甘油三酯水平上比较，差异有显著意义（P〈0．01）；②血清瘦素水平与血清中总胆固醇、甘油三酯的相关性分析结果表明，A组及C组血清瘦素水平与总胆固醇、甘油三酯呈正相关，而B组血清瘦素水平与总胆固醇呈正相关，与甘油三酯无明显相关性。③血清瘦素水平与孕晚期孕妇体重指数（body mass index，BMI）呈正相关，而C组相关性更显著；血清瘦素水平与收缩压（systolic blood pressure，SBP）、舒张压（diastolic blood pressure，DBP）呈正相关，而C组相关性更显著。结论正常妊娠母体血清瘦素水平与自身体脂积累密切相关。妊娠期高血压疾病患者母血清总胆固醇与血清瘦素水平呈正相关，两者共同参与妊娠期高血压疾病发病。母血清瘦素水平有望成为妊娠期高血压疾病的观察指标之一。

Relationship Between Serum Leptin, Lipid and Hypertensive Disorder Complicating Pregnancy

Objective To study the significance of teptin and serum lipid in the development of hypertensive disorder complicating pregnancy. Methods From July 2006 to February 2007, 77 cases of pregnant women were divided into three groups, gestational hypertension group （group A, n = 20）, pre-eclampsia group（group B, n = 27）, and normal pregnant women group（group C, n = 30）. Informed consent was obtained from all participates. Levels of serum leptin were measured by the immuno-radioassay （RIA） method. Total cholesterol（TC） was measured by the COD-PAP method, and triglyceride（TG） was measured by the GPO-PAP method. Results OANOVA showed that there were significant differences of total cholesterol, triglyceride and serum leptin among 3 groups（P〈0.01）. ②The level of serum leptin was positively connected with total cholesterol and triglyceride in group A and group C. And the level of serum leptin was positively correlated with total cholesterol, but negatively correlated with triglyceride in group B. ③The serum leptin concentrations were positively correlated with body mass index （BMI）, systolic blood pressure （SBP）, diastolic blood pressure （DBP） in normal pregnant women. Conclusion The leptin concentration of the maternal are correlated with fat mass accumulation in the normal pregnant women. Leptin level was positively related to total cholesterol, and they may play a role in the development of hypertensive disorder complicating pregnancy. The maternal serum leptin level may serve as a marker for monitoring hypertensive disorder complicating pregnancy.