妊娠期高血压疾病患者血清瘦素、胰岛素水平变化及相关性研究_临床医学论文.docVIP

妊娠期高血压疾病患者血清瘦素、胰岛素水平变化及相关性研究_临床医学论文 妊娠期高血压疾病患者血清瘦素、胰岛素水平变化及相关性研究_临床医学论文 作者：熊英，孙长学，李玲，关珊 【摘要】 目的： 测定妊娠期高血压疾病(HDCP)患者和正常孕妇血清瘦素（Leptin）及胰岛素(INS)水平，探讨Leptin、INS与妊娠期高血压疾病发病的关系。方法： 采用放射免疫法测定40例HDCP患者和40例正常晚期妊娠妇女的空腹血清Leptin和INS水平，分析两者相关性，同时测量体重指数和血压。结果： (1)HDCP组血清Leptin、INS水平高于正常妊娠组， P＜0.05；(2)HDCP患者中轻度子痫前期组Leptin水平高于妊娠期高血压组，P＜0.05；重度子痫前期及子痫组高于轻度子痫前期组，P＜0.05；(3)HDCP孕妇血清Leptin与INS水平呈明显正相关,相关系数r=0.767,P＜0.01。结论： HDCP患者血清Leptin水平明显升高，且随病情的加重有逐渐升高趋势，HDCP血清Leptin与INS呈正相关关系,高瘦素、高胰岛素血症可能共同参与了HDCP的发生和发展。 【关键词】 高血压； 妊娠； 瘦素； 胰岛素 　　［Abstract］Objective: To explore the changes of leptin and insulin levels in hypertensive disorder complicating pregnancy（HDCP）, and to study the associativity of leptin and insulin at the onset and in the development of HDCP further.Methods: Radioimmunoassay was used to test the levels of fasting serum leptin and insulin in 40 patients with HDCP and 40 normal pregnant women. Their blood pressure and the body mass index（BMI） were also measured. Data were analyzed with SPSS 10.0, and the associativiy of leptin and insulin was explored. Results: Levels of leptin and insulin of HDCP group were significantly higher than those of normal pregnant women (0.01). The serum leptin leve of mild preeclampasia was significantly higher than that of gestational period hypertension group (P＜0.05）, and that in severe pre： Serum leptin level increases in women with HDCP, and rises along with the development of the disease. It can be used as an index for the prediction of the severity of HDCP. Leptin level positively correlates with insulin level, and they may participate the genesis and development of the disease. 　　［Key words］hypertention; pregency; leptin; insulin 　　瘦素(Leptin)是由肥胖基因（Ob）编码，脂肪细胞分泌的多肽激素。在动物研究中发现，Leptin直接作用于下丘脑，一方面使动物食欲降低，另一方面增加能量消耗[1，2]。肥胖妇女有发生妊娠期高血压疾病（HDCP）的倾向，HDCP与肥胖有共同的脂肪代谢障碍、葡萄糖耐量异常和胰岛素抵抗，而这些异常的病理生理状态都可能与Leptin有关。研究发现，高血压患者血清Leptin水平较血压正常者增高[3，4]，推测Leptin可能参与了HDCP的发生和发展。胰岛素（INS）可刺激脂肪组织产生和分泌Leptin，Leptin又可抑制INS的分泌，体内存在脂肪-胰岛素内分泌轴，临床上妊娠期糖代谢异常的孕妇发生HDCP的机率