胰岛素抵抗、TNF-α、PAI-1与妊高征相关性的研究

目的:探讨胰岛素抵抗、肿瘤坏死因子(tumor necrosis factor-alpha,TNF-α)、纤溶酶原激活物抑制物-1(plasminogen activator inhibitor type 1,PAI-1)与妊高征发病的相关性。方法:选择天津市中心妇产科医院住院的先兆子痫患者15例,轻-中度妊高征患者12例,正常孕晚期妇女10例,抽取空腹静脉血测定葡萄糖、胰岛素、TNF-α和 PAI-1水平,计算胰岛素敏感性指数,比较3组患者的胰岛素敏感性、TNF-α和 PAI-1的差异。结果:先兆子痫组空腹血胰岛素值高于对照组(P<0.05),代表胰岛素抵抗的胰岛素敏感性指数亦明显高于轻-中度妊高征组和对照组(P<0.01);3组患者血清 TNF-α值无明显差异;先兆子痫组 PAI-1值明显高于轻-中度妊高征组和对照组(P<0.001和 P<0.01)。结论:胰岛素抵抗和 PAI-1在妊高征的发生、发展中具有重要意义。

Insulin resistance,tumor necrosis factor alpha and plasminogen activator inhibitor 1 in women with pregnancy induced hypertension

The purpose of this study was to assess the role of insulin resistance,tumor necrosis fac tor-alpha and plasminogen activator inhibitor 1 in women with preeclampsia and gestational hypertension.Meth- ods:Insulin resistance was determined with the HOME model in 15 women with preeclampsia,in 12 women with gestational hypertension,and in 10 normotensive control subjects.Blood glucose,tumor necrosis factor-alpha and plasminogen activator inhibitor 1 levels were determined in the fasting state.Results:Women with preeclampsia had a significantly higher insulin sensitivity index and a higher level of plasminogen activator inhibitor 1 than women with gestational hypertension(P<0.05).There was no significant difference in tumor necrosis factor-al- pha levels.Conclusion:Insulin resistance and high plasminogen activator inhibitor 1 level were present in women with preeclampsia.These findings support the assumption that insulin resistance play a role in the development of this complication of pregnancy.