目的 探讨孕中期血清脂联素(APN)及胰岛素水平与子痫前期(PE)的相关性.方法 随机选择2009年7月至2010年7月在本院接受产前检查的300例单胎孕妇为研究对象,对其妊娠经过及妊娠结局进行随诊.其中,31例孕晚期时发展为PE,被纳入PE组.对PE组患者按照PE病情分度,将重度子痫前期(SPE)患者纳入SPE组(n-18),轻度子痫前期(MPE)患者,纳入MPE组(n-13),将同时纳入研究孕晚期仍正常的单胎妊娠妇女30例纳入对照组.于24～28孕周时,对SPE组、MPE组和对照组受试者采用放射免疫法(RIA)测定血清APN、胰岛素及其他相关指标,并进行相关分析.SPE组、MPE组与对照组,SPE组与MPE组孕妇年龄、孕龄及孕前体重指数(BMI)比较,差异无统计学意义(P＞0.05)(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象本人的知情同意,并与之签署临床研究知情同意书).结果 ①SPE组、MPE组与对照组血清APN水平呈上升趋势,SPE组较对照组明显降低,差异有统计学意义(P＜0.01);SPE组与MPE组、MPE组与对照组比较,差异无统计学意义(P＞0.05).②3组孕妇孕中期空腹血糖(FBG),总胆固醇(TC),甘油三酯(TG),低密度脂蛋白胆固醇( LDLC)和高密度脂蛋白胆固醇(HDLC)水平比较,差异均无统计学意义(P＞0.05).③3组孕妇的血清胰岛素比较,SPE组较对照组明显升高,差异有统计学意义(P＜0.01),SPE组与MPE组、MPE组与对照组比较,差异无统计学意义(P＞0.05).④SPE组血清APN与胰岛素呈负相关(r=-0.50,P＜0.01),其他两组血清APN与胰岛素无相关性(r=0.33,r=-0.02;P＞0.05).SPE组血清APN与收缩压、舒张压呈负相关(r=-0.97,r=-0.94;P＜0.01),与TG呈负相关(r=-0.63,P＜0.01),与HDLC 呈正相关(r=0.54,P＜0.05),与TC和LDLC无相关关系(r=0.03,r=0.18;P＞0.05).SPE组血清胰岛素与收缩压呈正相关(r=0.90,P＜0.05),与TC和TG呈正相关(r=0.59,r=0.73;P＜0.01).MPE 组血清APN与TG呈负相关(r=-0.71,P＜0.01),血清胰岛素与TG呈正相关(r=0.58,P＜0.05).结论 孕中期血清低APN及高胰岛素血症与PE密切相关.
目的 探討孕中期血清脂聯素(APN)及胰島素水平與子癇前期(PE)的相關性.方法 隨機選擇2009年7月至2010年7月在本院接受產前檢查的300例單胎孕婦為研究對象,對其妊娠經過及妊娠結跼進行隨診.其中,31例孕晚期時髮展為PE,被納入PE組.對PE組患者按照PE病情分度,將重度子癇前期(SPE)患者納入SPE組(n-18),輕度子癇前期(MPE)患者,納入MPE組(n-13),將同時納入研究孕晚期仍正常的單胎妊娠婦女30例納入對照組.于24～28孕週時,對SPE組、MPE組和對照組受試者採用放射免疫法(RIA)測定血清APN、胰島素及其他相關指標,併進行相關分析.SPE組、MPE組與對照組,SPE組與MPE組孕婦年齡、孕齡及孕前體重指數(BMI)比較,差異無統計學意義(P＞0.05)(本研究遵循的程序符閤本院人體試驗委員會所製定的倫理學標準,得到該委員會批準,分組徵得受試對象本人的知情同意,併與之籤署臨床研究知情同意書).結果 ①SPE組、MPE組與對照組血清APN水平呈上升趨勢,SPE組較對照組明顯降低,差異有統計學意義(P＜0.01);SPE組與MPE組、MPE組與對照組比較,差異無統計學意義(P＞0.05).②3組孕婦孕中期空腹血糖(FBG),總膽固醇(TC),甘油三酯(TG),低密度脂蛋白膽固醇( LDLC)和高密度脂蛋白膽固醇(HDLC)水平比較,差異均無統計學意義(P＞0.05).③3組孕婦的血清胰島素比較,SPE組較對照組明顯升高,差異有統計學意義(P＜0.01),SPE組與MPE組、MPE組與對照組比較,差異無統計學意義(P＞0.05).④SPE組血清APN與胰島素呈負相關(r=-0.50,P＜0.01),其他兩組血清APN與胰島素無相關性(r=0.33,r=-0.02;P＞0.05).SPE組血清APN與收縮壓、舒張壓呈負相關(r=-0.97,r=-0.94;P＜0.01),與TG呈負相關(r=-0.63,P＜0.01),與HDLC 呈正相關(r=0.54,P＜0.05),與TC和LDLC無相關關繫(r=0.03,r=0.18;P＞0.05).SPE組血清胰島素與收縮壓呈正相關(r=0.90,P＜0.05),與TC和TG呈正相關(r=0.59,r=0.73;P＜0.01).MPE 組血清APN與TG呈負相關(r=-0.71,P＜0.01),血清胰島素與TG呈正相關(r=0.58,P＜0.05).結論 孕中期血清低APN及高胰島素血癥與PE密切相關.
목적 탐토잉중기혈청지련소(APN)급이도소수평여자간전기(PE)적상관성.방법 수궤선택2009년7월지2010년7월재본원접수산전검사적300례단태잉부위연구대상,대기임신경과급임신결국진행수진.기중,31례잉만기시발전위PE,피납입PE조.대PE조환자안조PE병정분도,장중도자간전기(SPE)환자납입SPE조(n-18),경도자간전기(MPE)환자,납입MPE조(n-13),장동시납입연구잉만기잉정상적단태임신부녀30례납입대조조.우24～28잉주시,대SPE조、MPE조화대조조수시자채용방사면역법(RIA)측정혈청APN、이도소급기타상관지표,병진행상관분석.SPE조、MPE조여대조조,SPE조여MPE조잉부년령、잉령급잉전체중지수(BMI)비교,차이무통계학의의(P＞0.05)(본연구준순적정서부합본원인체시험위원회소제정적윤리학표준,득도해위원회비준,분조정득수시대상본인적지정동의,병여지첨서림상연구지정동의서).결과 ①SPE조、MPE조여대조조혈청APN수평정상승추세,SPE조교대조조명현강저,차이유통계학의의(P＜0.01);SPE조여MPE조、MPE조여대조조비교,차이무통계학의의(P＞0.05).②3조잉부잉중기공복혈당(FBG),총담고순(TC),감유삼지(TG),저밀도지단백담고순( LDLC)화고밀도지단백담고순(HDLC)수평비교,차이균무통계학의의(P＞0.05).③3조잉부적혈청이도소비교,SPE조교대조조명현승고,차이유통계학의의(P＜0.01),SPE조여MPE조、MPE조여대조조비교,차이무통계학의의(P＞0.05).④SPE조혈청APN여이도소정부상관(r=-0.50,P＜0.01),기타량조혈청APN여이도소무상관성(r=0.33,r=-0.02;P＞0.05).SPE조혈청APN여수축압、서장압정부상관(r=-0.97,r=-0.94;P＜0.01),여TG정부상관(r=-0.63,P＜0.01),여HDLC 정정상관(r=0.54,P＜0.05),여TC화LDLC무상관관계(r=0.03,r=0.18;P＞0.05).SPE조혈청이도소여수축압정정상관(r=0.90,P＜0.05),여TC화TG정정상관(r=0.59,r=0.73;P＜0.01).MPE 조혈청APN여TG정부상관(r=-0.71,P＜0.01),혈청이도소여TG정정상관(r=0.58,P＜0.05).결론 잉중기혈청저APN급고이도소혈증여PE밀절상관.
Objective To study the correlation among the levels of adiponectin(APN),insulin and preeclampsia (PE) in the second trimester of pregnancy.Methods From July 2009 to July 2010,a total of 300 cases with 24-28 gestational weeks were included into this study.They were divided into PE group (n=31 ) and control group (n=30) according to gestational outcomes.PE group were further divided into severe preeclampsia group (SPE group,n=18) and mild preeclampsia group (MPE,n=13) according to the degrees of PE.The levels of serum APN and insulin were measured by radioimmunoassay (RIA).The blood pressure and blood lipids were also measured.The correlation of the levels of serum APN,insulin,blood pressure and blood lipids were analyzed.There had no significant difference of age,gestational age and body mass index (BMI) before pregnancy between SPE group,MPE group and control group,also between SPE group and MPE group (P＞0.05).The study protocol was approved by the Ethical Review Board of Investigation in Human Being of the Second Affiliated Hospital of Qingdao Medical University.Informed consent was obtained from all participants.Results ①An increasing trend was found in the level of serum APN from SPE group,also between MPE group and control group.The level of serum APN in SPE group significantly decreased than that of control group (P ＜ 0.01 ).But no significant difference was found between SPE group and MPE group,MPE group and control group (P＞0.05).② There had no significant difference of fasting blood sugar (FBG),total cholesterol (TC),triglycerides (TG),low density lipoproteins-cholesterol (LDLC) and high density lipoproteins-cholesterol (HDLC) in three groups (P＞ 0.05).③The insulin level was significantly higher in SPE group than that in control group (P＜0.01 ).But no difference was found between SPE and MPE groups (P＞0.05),also between MPE and control group (P＞0.05).④ In SPE group,negative correlation was shown between the levels of APN and insulin (r=-0.50,P＜0.01),no correlation was found in MPE and control group (r=0.33,r=-0.02 ; P＞0.05).In SPE group,negative correlation was also shown between the levels of APN and blood pressure (r=-0.97,r=-0.94:P＜0.01) and TG(r=-0.63,P＜0.01 ).Positive correlation was shown between the levels of APN and HDLC (r=0.54,P＜0.05).No correlation was shown between the levels APN and TC and LDLC (r=0.03,r =0.18;P＞0.05).Positive correlation was detected between the level of insulin and systolic pressure,TC and TG(r=0.90,P＜0.05;r=0.59,P＜0.01;r=0.73,P＜0.01).In MPE group,negative correlation was shown between the level of APN and TG(r=-0.71,P＜0.01),positive correlation was shown between insulin and TG(r=0.58,P＜0.05).Conclusions Lower APN and higher insulin might be associated with the pathogenesis of PE in the second trimester of pregnancy.
