妊高征患者瘦素和胰岛素抵抗等代谢因素之间及血压的相关性研究.DOCVIP

临床医学论文-妊高征患者瘦素和胰岛素抵抗等代谢因素之间及血压的相关性研究 ????????????? 作者：梁桂玲，梁宁安，符春晖 【摘要】? 目的 探讨妊娠高血压综合征(妊高征)患者血清瘦素、胰岛素(INS)水平和胰岛素抵抗之间的相关性，以及对血压的影响。方法 以妊高征79例（其中轻度21例、中度19例、重度39例）作为研究对象；并与同期正常产妇30例为对照组。观察各组动脉血压、空腹血糖(FBG)、INS、瘦素水平；并计算胰岛素抵抗指数（IRI）。结果 两组孕妇FBG水平差异无显著性（P0.05）；但妊高征组血浆FBG、INS和IRI水平均明显高于对照组(P＜0.01或0.05)；不同程度的妊高征组瘦素、INS和IRI比较差异也有显著性(P0.01或0.05)。妊高征组血压与胰岛素抵抗呈正相关(P0.01)；与瘦素、INS水平的相关性则不明显。INS和瘦素水平、IRI之间具有明显的相关性(P0.05或0.01)。结论 妊高征患者存在有高INS和高瘦素水平及胰岛素抵抗等代谢紊乱；其中胰岛素抵抗与患者的血压明显相关。 【关键词】? 妊娠并发症；高血压；瘦素；胰岛素抵抗；多元分析；因素分析，统计学 　　Abstract:? Objective? To investigate the association among serum leptin，insulin (INS) level and insulin resistance in patients with pregnancy-induced hypertension (PIH) and their effects on blood pressure.? Methods? Seventy-nine patients with PIH (21 mild，19 moderate and 39 severe PIH) and thirty normal subjects as controls were enrolled in this study.Blood pressure and serum concentration of fasting insulin，fasting blood glucose (FBG)，leptin were measured.Insulin resistance index (IRI) was calculated.? Results? In comparison to the control group，the FBG level was as high as the PIH group (P0.05)；the levels of plasma FBG，INS and IRI in the PIH group were higher (P0.01 or 0.05).In mild to severe PIH，the levels of serum leptin，INS and IRI were significant difference (P0.05 or 0.01).In PIH group，positive association between blood pressure and insulin resistance was found (P0.01)，insignificant correlation between leptin and INS level was found；and positive associations between INS and leptin level，IRI were found (P0.05 or 0.01).? Conclusion? The data indicated that the high serum levels of leptin，insulin，and IRI correlates to the metabolism disorders in women with PIH；and IRI correlates to blood pressure.??? 　　Key words:? pregnancy complication；hypertension；leptin；insulin resistance；multiplicity analysis；factor analysis，statistics 　　妊娠高血压综合征（妊高征）的病理生理特征之一代谢紊乱，即脂肪代谢障碍、高瘦素血症、葡萄糖耐量异常和胰岛素抵抗，这些异常的病理生理状态都可能与血压有关［1］。本组测定了妊高征患者和正常妊娠妇女血浆瘦素和胰岛素(INS)水平以及计算胰岛素抵抗指数(IRI)等，观察妊高征患者与这些