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目的:测定妊娠期糖尿病患者血清一氧化氮(nitric oxide,NO)、内皮素-1(endothelin-1,ET-1)水平的变化,并探讨其与脐血流阻力的关系。方法:连续收集2012年1月～10月在南京医科大学附属南京妇幼保健院进行产前糖尿病筛查阳性和住院待产的45例妊娠期糖尿病妇女作为病例组,同期选择43例正常妊娠妇女作为对照组,在分娩前1周测定脐动脉血流阻力指数(S/D)值,孕妇住院待产时采集静脉血。分别采用硝酸还原酶法和ELISA法测定血清NO、ET-1含量。结果:①与对照组相比,病例组的ET-1含量明显升高(P<0.05),NO含量明显降低(P<0.05),S/D值增加(P<0.05),病例组孕妇静脉血NO含量和S/D呈负相关(r=-0.596,P<0.05),而ET-1含量和S/D值呈正相关(r=0.610,P<0.05)。②病例组胎儿宫内缺氧、巨大儿、早产、羊水过多、妊娠期高血压的发生率和剖宫产率均高于对照组。结论:妊娠期糖尿病患者血清NO水平下降,ET-1水平增加,引起子宫-胎盘血流阻力的增加,可能是导致妊娠期糖尿病患者不良妊娠的一个重要因素。
Objective: To determine the changes of serum nitric oxide (NO) and endothelin-1 (ET-1) levels in gestational diabetes mellitus (DM) patients and to explore their relationship with cord blood resistance. Methods: 45 cases of gestational diabetes mellitus with prenatal diabetes screening positive and hospital stay in Nanjing MCH from Nanjing University of Medical Sciences from January to October 2012 were selected as the case group. Forty-three normal pregnant women were selected as controls The umbilical artery blood flow resistance index (S / D) value was measured one week before delivery and venous blood was collected during the hospitalization of pregnant women. Nitric acid reductase and ELISA were used to determine the content of NO and ET-1. Results: Compared with the control group, the content of ET-1 in the case group was significantly increased (P <0.05), NO content was significantly decreased (P <0.05), S / D value increased There was a negative correlation between serum NO level and S / D (r = -0.596, P <0.05), while ET-1 level was positively correlated with S / D ratio (r = 0.610, P <0.05). ② cases of fetal intrauterine hypoxia, macrosomia, premature delivery, polyhydramnios, the incidence of gestational hypertension and cesarean section rate were higher than the control group. CONCLUSION: The serum level of NO and the level of ET-1 in gestational diabetes mellitus patients are increased, which leads to the increase of uterine-placental blood flow resistance, which may be an important factor in the adverse pregnancy of patients with gestational diabetes mellitus.