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目的探讨抵抗素和脂联素与妊娠期高血压疾病(HDCP)的关系及其在发病过程中的作用。方法以100例妊娠期高血压疾病孕妇为观察组,其中轻度子痫前期69例,重度子痫前期31例;选取同期100例正常孕晚期孕妇为对照组。采用酶联免疫吸附法(ELISA法)检测孕妇血清抵抗素和脂联素水平,同时检测空腹血糖(FBG)水平、空腹胰岛素(FINS)水平,计算胰岛素抵抗指数(IRI)。结果随病情进展血清脂联素水平逐渐下降,而抵抗素水平逐渐升高,差异有统计学意义(P<0.01)。轻度、重度子痫前期患者血清抵抗素水平与胰岛素抵抗指数呈现显著正相关(r=0.805、r=0.819,P<0.01),脂联素水平与胰岛素抵抗指数呈现显著负相关(r=-0.784、r=-0.795,P<0.01),抵抗素与脂联素水平呈现显著负相关(r=-0.845、r=-0.858,P<0.01)。结论抵抗素和脂联素在HDCP的发病过程中起着相反的作用,抵抗素的致病作用和脂联素保护作用可能是通过改变胰岛素抵抗实现的,二者有望成为临床预测HDCP发病及严重程度的指标。
Objective To investigate the relationship between resistin and adiponectin and gestational hypertension (HDCP) and its role in pathogenesis. Methods One hundred pregnant women with gestational hypertension were selected as observation group, including 69 cases of mild preeclampsia and 31 cases of severe preeclampsia. 100 pregnant women of the same period as normal pregnant women were selected as the control group. The levels of serum resistin and adiponectin in pregnant women were detected by enzyme-linked immunosorbent assay (ELISA). Fasting blood glucose (FBG) and fasting insulin (FINS) were measured at the same time to calculate the insulin resistance index (IRI). Results Serum adiponectin levels decreased gradually with the progression of the disease, and resistin levels gradually increased (P <0.01). There was a significant positive correlation between serum resistin level and insulin resistance index in patients with mild and severe preeclampsia (r = 0.805, r = 0.819, P <0.01). There was a significant negative correlation between adiponectin level and insulin resistance index (r = 0.784, r = -0.795, P <0.01). There was a significant negative correlation between resistin and adiponectin level (r = -0.845, r = -0.858, P <0.01). Conclusion The resistin and adiponectin play an opposite role in the pathogenesis of HDCP. The pathogenic effect of resistin and the protective effect of adiponectin may be achieved by changing insulin resistance, both of which are expected to become clinically predictive for the incidence and severity of HDCP Degree of indicator.