瘦素与肿瘤坏死因子在妊娠高血压综合征发病中的关系

目的探讨瘦素和肿瘤坏死因子(TNF-α)在妊娠高血压综合征(妊高征)发病中相互关系。方法采用放射免疫法测定34例妊高征患者(妊高征组)的外周血清瘦素及TNF-α水平,并以20例正常晚期妊娠妇女(正常妊娠组)为对照。将血清瘦素水平与TNF-α、肌酐、尿酸水平进行相关分析。结果(1)妊高征组血清瘦素水平为32.85±11.46ng/ml,明显高于正常妊娠组(18.92±3.03ng/ml,P<0.05);轻度妊高征组血清瘦素水平为21.98±4.83ng/ml,与正常妊娠组比较,差异无显著性(P>0.05);中、重度妊高征患者血清瘦素水平分别31.13±5.18ng/ml,41.84±10.90ng/ml,与轻度妊高征及妊娠正常组比较,差异显著(P均<0.05);轻、中、重度妊高征患者之间血清瘦素水平差异明显(P均<0.05)。妊高征患者的血清瘦素水平与肌酐、尿酸正相关(r分别为0.46、0.59,P均<0.01)。(2)妊高征组血清TNF-α水平为22.65±11.48fmol/ml,明显高于正常妊娠组(9.21±2.14fmol/ml,P<0.05);轻度妊高征患者血清TNF-α水平为11.51±4.12fmol/ml,与正常妊娠组比较,差异无显著性(P>0.05);中、重度妊高征患者血清TNF-α水平分别为19.46±7.41fmol/ml和32.89±8.31fmol/ml,与轻度妊高征及正常妊娠组比较,差异均有显著性(P均<0.05);轻、中、重度妊高征患者之间血清TNF-α水平差异明显(P均<0.05)。(3)妊高征组血清瘦素水平与TNF-α水平呈正相关(r=0.56,P<0.01)。结论妊高征患者血清TNF-α水平增高可能是导致血清瘦素水平升高的原因之一。

Relationship of leptin and tumor necrosis factor in the genesis of pregnancy induced hypertension

Objective To study the relationship between leptin and tumor necrosis factor (TNF-α) in the genesis of pregnancy induced hypertension(PH).Methods Radioimmunoassay were used to measure the levels of serum leptin and TNF-α, in 34 patients PIH and 20 normal pregnant women.The correlations between the levels of serum leptin and the levels of TNF-α creatinine and uric acid were analyzed by the correlative analysis.Results (1)The levels of serum leptin in the patients with PIH 32.85±11.46 ng/ml were higher than those of the normal pregnant women (18.92±3.03 ng/ml,P<0.05).There was no significantly statistical difference in the levels of serum leptin between the mild PIH group 21.98±4.83 ng/ml and the normal pregnant group (P>0.05).The levels of serum leptin in the moderate 31.13±5.18 ng/ml and in the severe 41.84±10.90 ng/ml PIH group were higher than those in the mild PIH group (P<0.05) and the normal pregnant group (P<0.05).There were significantly differences in the levels of serum leptin among the mild,the moderate,and the severe patients with PIH (respectively,P<0.05).The levels of serum leptin at predelivery was positively correlated with the levels of serum creatinine and uric acid concentrations in the PIH group (r分别为0.46、0.59,P均<0.01).(2)The levels of serum TNF-α in the patients with PIH 22.65±11.48 fmol/ml were higher than those of the normal pregnant women (9.21±2.14 fmol/ml,P<0.05).There was no significantly statistical difference in the levels of serum TNF-α between the mild PIH group 11.51±4.12 fmol/ml and the normal pregnant group (P>0.05).The levels of serum TNF-α in the moderate 19.46±7.41 fmol/ml and in the severe 32.89±8.31 fmol/ml PIH group were higher than those in the mild PIH group (P<0.05) and the normal pregnant group (P<0.05).There were significantly differences in the levels of serum TNF-α among the mild,the moderate,and the severe patients with PIH (respectively,P<0.05).(3)The levels of serum leptin were positively correlated with those of serum TNF-α in PIH group (r=0.56,P<0.01).Conclusions The increased serum TNF-α may be a cause of the increased serum leptin levels in the patients with PIH.