糖尿病合并妊娠的脐血一氧化氮、内皮素与脐动脉血流阻力关系

目的 探讨糖尿病合并妊娠患者脐血一氧化氮（NO）和内皮素（ET-1）水平的变化，以及脐血NO／1三T-1水平与脐动脉血流阻力的关系。方法 随机选择糖尿病合并妊娠（DMP）30例，妊娠期糖尿病（GDM）36例，同期选择36例正常孕妇（NP）为对照组。所有孕妇分娩后立即采集脐静脉血，分别以Griess法和放免法测定NO和ET-1含量，同时在分娩前测定脐动脉血流阻力（S／D）。结果 与对照组相比，DMP组NO含量显著降低，ET-1含量明显升高，脐动脉血流阻力S／D明显增加（P〈0．05）。DMP组脐血NO水平与脐动脉血流阻力S／D成负相关（r=-0．688，P〈0．05），而ET-1水平与脐动脉血流阻力S／D成正相关（r=0．620，P〈0．05）。GDM组和对照组之间在脐血NO和ET-1含量、脐动脉血流阻力S／D等方面差异均无统计学意义（P〉0．05）。结论 糖尿病合并妊娠患者脐血NO和ET-1水平异常、从而引起子宫胎盘一胎儿血流阻力增加，并最终可能导致不良妊娠结局。

Nitric oxide and endotnelin-1 concentrations of venous cord blood and its relationship with umbilical arteries blood flow velocity in pregnant women with diabetes mellitus

Objective To investigate the changes of venous cord blood nitric oxide(NO) and endotnelin-1(ET-1) levels and to find out its relationship with umbilical arteries blood flow velocities in the pregnant women with diabetes mellitus.Methods 66 cases of the pregnant women with diabetes mellitus(DM) were selected at random,including 30 diabetes mellitus complicated with pregnancies(DMP) and 36 gestational diabetes mellitus(GDM).36 cases of the normal pregnant(NP) women were selected as the control group.Venous cord blood samples were collected from all the subjects after delivery.Cord blood NO and ET-1 levels were detected by Griess assay and radioimmuno-assay respectively,and umbilical arteries blood flow velocities(S/D) were measured just before delivery.Results Compared with the control group,cord blood NO levels decreased and ET-1 levels increased and S/D increased in the DMP group significantly(P<0.05).NO level was positive(r=-0.688,P<0.05),but ET-1 level was negative(r=0.620,P<0.05),related with S/D value in the DMP group.There were no significant differences in NO and ET-1 levels and S/D value between the GDM group and the control group(P>0.05).Conclusion Umbilical blood NO and ET-1 levels are abnormal in DMP,which induces the high resistance of fetal-placental circulation,and finally might cause adverse pregnancy outcomes.