孕中期血浆前列环素血栓素水平与子痫关系的研究

目的探讨子痫发病前于孕中期检测前列环素(PGI2)、血栓素(TX)血浆浓度预测子痫的价值。方法孕妇在孕12周被纳入研究,并随访至分娩,根据其妊娠结局,分为妊娠期高血压疾病组(子痫组、先兆子痫组)和对照组,于孕12～16周及孕37～39周时采集孕妇静脉血,采用放射免疫法检测孕妇血浆前列环素、血栓素浓度,并检测血清总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平。结果 300名孕妇中34例孕晚期发生妊娠期高血压疾病(子痫13例,先兆子痫21例)为研究组,而266名未发生妊娠期高血压疾病孕妇,剔除流产、早产、妊娠期糖尿病等,剩余190名为对照组。孕中期子痫组血栓素B2水平明显升高,6-酮前列腺素F1α(6-keto-PGF1α)水平明显降低,血栓素B2/6-keto-PGF1α明显升高,与对照组相比,差异有统计学意义(P<0.05);孕中期子痫组甘油三酯、LDL、总胆固醇水平明显升高,HDL水平明显降低,与对照组相比差异有统计学意义(P<0.05)。提示随着妊娠周数增加,血液黏稠度增加,血脂增高,出现血栓素B2/6-keto-PGF1α的平衡失调,进而出现妊娠期高血压疾病。结论子痫患者虽然在孕中期血压正常,但已存在前列环素、血栓素血浆浓度变化,通过检测前列环素、血栓素血浆浓度可预测子痫发生。

The value of abnormal expressions of TXA2 and PGI2 in predicting eclampsia in middle pregnancy

Objective To explore the value of abnormal expressions of TXA2,PGI2 to predict the onset of eclampsia before its clinical manifestations in middle pregnancy.Methods The content of blood TXA2,PGI2,TC and TG were detected for 300 women in middle pregnancy.All of them were followed up till postpartum and enrolled into hypertensive or normal groups.Results Thirty-four cases of pregnancy occurred gestational hypertensive disease(13 eclampsia,21 preeclampsia) in late pregnancy.One hundred and ninty cases of pregnancy did not occur gestational hypertensive disease(normal group).The concentration of TXB2 in eclampsia group was significantly higher than that in normal group(P<0.05).The concentration of 6-keto-PGF1α in eclampsia group was significantly lower than that in normal group(P<0.05).The concentration of TG,LDL and TC in eclampsia group was significantly higher than those in normal group(P<0.05).The concentration of HDL in eclampsia group was significantly lower than that in eclampsia group and preeclampsia group(P<0.05).Conclusion Although the blood pressure in middle stage of hypertensive disorders in pregnancy is normal,the concentration of TXB2 and 6-keto-PGF1α has changed and can be detected.