子痫前期患者血清瘦素及可溶性瘦素受体水平变化及临床意义(一)

详细内容

作者：吴维光，于月成，朱淑平，曹秀琴

【关键词】 妊娠并发症；高血压；瘦素；可溶性瘦素受体

【Abstract】 AIM: To investigate the relations between preeclamptic pathogenesis and changes of serum leptin and soluble leptin receptor in preeclampsia, and their clinical significance. METHODS: The peripheral venous blood samples of 40 preeclampsia and 43 normal pregnant women were obtained before and 7 d after operation. The level of leptin was valued by immunoradioassay, and the level of soluble leptin receptor was measured by enzymelinked immunosorbent assay(ELISA). The correlative analysis between the levels of serum leptin and soluble leptin receptor and the blood pressure was performed. RESULTS: The level of leptin before operation was higher than that after operation in all the pregnant women; The level of leptin before operation in preeclampsia was higher than that in normal pregnancy, and the level of soluble leptin receptor before operation in preeclampsia was lower than that in normal pregnancy ; The leptin before operation in preeclampsia was negatively correlated with the soluble leptin receptor, and there were positive correlations between the leptin before operation in preeclampsia and the diastolic pressure or systolic pressure; There were negative correlations between the soluble leptin receptor before operation in preeclampsia and the diastolic pressure or systolic pressure. CONCLUSION: The high level of leptin in preeclampsia may e from placenta, and it may be related to the preeclamptic pathophysiology. The level of leptin or soluble leptin receptor can be a clinical marker to reflect the degree of preeclampsia.

【Keywords】 pregnancy plications; hypertension; leptin; soluble leptin receptor

【摘要】 目的： 探讨子痫前期血清瘦素及可溶性瘦素受体水平与子痫前期发病之间的关系及其临床意义. 方法： 40例子痫前期孕妇及43例正常妊娠孕妇，取术前及术后7 d外周静脉血，应用放射免疫法检测瘦素水平，应用ELISA法检测可溶性瘦素受体水平，并与子痫前期的血压值进行相关分析. 结果： 子痫前期组和正常妊娠组术后瘦素水平均低于术前；子痫前期组术前瘦素水平高于正常妊娠组，可溶性瘦素受体水平低于正常妊娠组；子痫前期组术前瘦素水平与可溶性瘦素受体水平呈负相关，与收缩压和舒张压呈正相关；子痫前期组术前可溶性瘦素受体水平与收缩压和舒张压均呈负相关. 结论： 子痫前期升高的瘦素可能来源于胎盘，并可能参与子痫前期的病理生理过程. 血清中瘦素及可溶性瘦素受体水平可作为反映疾病程度的临床指标.

【关键词】 妊娠并发症；高血压；瘦素；可溶性瘦素受体

0引言

瘦素是肥胖（obese）基因的蛋白产物，主要是由脂肪细胞合成和分泌，参与机体的能量代谢. 但近年来研究发现，瘦素与妊娠和生殖调节也存在密切关系〔1-2〕. 我们观察了子痫前期患者血清瘦素及可溶性瘦素水平变化，以探讨血清瘦素及可溶性瘦素受体与子痫前期之间的关系及其临床意义.

1对象和方法

1.1对象200401/200511武警医学院附属医院住院手术分娩的子痫前期孕妇40例（子痫前期组），随机选取正常妊娠手术分娩的孕妇43例（正常妊娠组）作为对照. 两组年龄分别为（28.1±2.0）和（25.6±1.9）岁；孕龄分别为（36.0±1.3）和（37.9±1.4） wk，两组患者一般情况及体质量相差均无显著性. 除其他的妊娠合并症和并发症外，术前均未进入产程. 子痫前期诊断标准按文献〔3〕诊断标准.

1.2方法

1.2.1标本采集所有对象均于术前及术后1 wk早晨空腹抽取肘静脉血4 mL，于4℃放置4 h后，离心，取血清至-20℃冰箱保存.

1.2.2检测方法采用放射免疫法（RIA）检测血清瘦素水平，人瘦素放射免疫测定试剂盒为美国Lino Research 公司产品，批内变异系数为5.6%，批间变异系数为7.8%. 采用酶联免疫吸附试验（ELISA）方法检测血清可溶性瘦素受体水平，应用自动酶标仪获取待测样品的吸光度A值，再根据公司提供的标准试剂和对照试剂绘制的标准曲线，将样品的吸光度A值转换成浓度值.

统计学处理： 结果用x±s表示，数据经PSSS11.0软件处理. 组内前后分析用配对t检验，组间差异分析用成组t检验；相关性分析采用直线相关分析.