妊娠期高血压疾病患者尿脂联素、内皮素-1和一氧化氮水平变化及意义

目的:探讨尿脂联素、内皮素-1和一氧化氮与妊娠期高血压疾病发病的关系。方法:分别采用酶联免疫吸附法、硝酸还原法测定457例妊娠期高血压疾病患者及148例正常晚期妊娠孕妇尿脂联素、内皮素-1和NO水平。结果:与对照组相比,GH组、MP组、SP组、子痫组尿脂联素、NO逐渐降低,ET-1逐渐升高且各组之间差异有统计学意义(P<0.05)。GH组、MP组、SP组、子痫组尿脂联素水平与ET-1、收缩压、舒张压成负相关(r=-0.42,P<0.05;r=-0.571,P<0.05;r=-0.64,P<0.05),而与NO成正相关(r=0.413,P<0.01)。尿脂联素与HDCP的发病成负相关(r=0.37,P<0.05;β=0.127,P<0.05)。校正年龄、孕次、BMI这些混淆因素后,尿脂联素水平仍与HDCP的发生显著负相关(r=0.33,P<0.05;β=0.129,P<0.05)结论:尿脂联素可预测妊娠期高血压疾病的发生。

Changes and significances of urine adiponectin,endothelin-1,and nitric oxide levels in patients with hypertensive disorder complicating pregnancy

Objective:To explore the relationship between urine adiponectin,endothelin-1,nitric oxide and onset of hypertensive disorder complicating pregnancy(HDCP). Methods:ELISA and nitric acid recovery method were used to detect the urine adiponectin,endothelin-1,and nitric oxide levels in 457 patients with HDCP and 148 normal pregnant women during the third trimester of pregnancy. Results:Compared with control group,the urine adiponectin and nitric oxide levels in gestational hypertension(GH) group,mild preeclampsia(MP) group,severe preeclampsia(SP) group,and eclampsia group decreased gradually,and the level of urine endothelin-1 increased gradually,there was statistically significant difference among different groups(P<0.05).In GH group,MP group,SP group,and eclampsia group,urine adiponectin levels were negatively correlated with endothelin-1,systolic pressure,and diastolic pressure(γ=-0.42,P<0.05;γ=-0.571,P<0.05;γ=-0.64,P<0.05),urine adiponectin levels were positively correlated with nitric oxide(γ=0.413,P<0.01).There was a negative correlation between urine adiponectin level and onset of HDCP(γ=0.37,P<0.05;β=0.127,P<0.05).After adjusting confounding factors,such as age,times of pregnancy,and BMI,there was still a significant negative correlation between urine adiponectin level and onset of HDCP(γ=0.33,P<0.05;β=0.129,P<0.05). Conclusion:Urine adiponectin level can predict the onset of HDCP.