论文部分内容阅读
目的测定子痫前期(preeclampsia,PE)孕妇孕中期血清脂联素及胰岛素抵抗的变化并探讨其意义。方法随机选择2009年7月至2010年7月在青岛大学医学院第二附属医院门诊检查的孕妇300名,进行前瞻性研究分析,根据妊娠结局,发展为子痫前期共31人纳入研究组(PE,n=31),同时选取30名正常孕妇作为对照组。于24～28孕周时,采用放射免疫吸附法测定血清脂联素(adiponectin,APN)、胰岛素(Fastig insulin,Fins),并测定空腹血糖(fasting blood sugar,FBG)及其他临床指标,稳定模型的胰岛素抵抗指数(homeostatic model assessment-insulin resistance,HOMA-IR)用(Fins×FBG)/22.5来表示。并进行相关分析。结果①子痫前期组孕妇平均动脉压(mean arterial blood pressure,MABP)与对照组比较明显升高,有统计学意义(P<0.01)。②研究组与对照组比较,血清脂联素水平明显降低,有统计学差异(P<0.01)。血清胰岛素及HOMA-IR明显升高,有统计学差异(P均<0.01)。FBG两组比较无统计学差异(P>0.05)。③研究组孕妇血清脂联素与胰岛素、HOMA-IR及MABP呈负相关(r=-0.87,r=-0.44,r=-0.51,P均<0.01),与BMI无相关关系(r=-0.26,P>0.05)。研究组孕妇HOMA-IR与胰岛素、MABP呈正相关(r=0.42,r=0.77,P均<0.01),与BMI无相关关系(r=-0.04,P>0.05)。结论孕中期低脂联素水平及高胰岛素抵抗与子痫前期的发生有关。
Objective To determine the changes of serum levels of adiponectin and insulin resistance in pregnant women with preeclampsia (PE) and to explore its significance. Methods A total of 300 pregnant women who were examined at the Second Affiliated Hospital of Qingdao University Medical College from July 2009 to July 2010 were prospectively studied and prospectively analyzed. Based on the pregnancy outcome, 31 pregnant women were enrolled into the study group PE, n = 31) .30 normal pregnant women were selected as the control group. Serum levels of adiponectin (APN) and insulin (Fins) were measured by radioimmunoassay at 24 to 28 weeks gestation, and fasting blood sugar (FBG) and other clinical indicators were determined. Stable models The homeostatic model assessment-insulin resistance (HOMA-IR) was expressed as (Fins × FBG) /22.5. And make relevant analysis. Results ① The mean arterial blood pressure (MABP) of preeclampsia group was significantly higher than that of the control group (P <0.01). ② Compared with the control group, serum adiponectin levels decreased significantly in study group and control group (P <0.01). Serum insulin and HOMA-IR significantly increased, with statistical significance (all P <0.01). FBG there was no significant difference between the two groups (P> 0.05). (3) There was a negative correlation between serum adiponectin and insulin, HOMA - IR and MABP (r = -0.87, r = -0.44, r = -0.51, P all <0.01) 0.26, P> 0.05). There was a positive correlation between HOMA-IR and insulin and MABP in study group (r = 0.42, r = 0.77, P <0.01), but no correlation with BMI (r = -0.04, P> 0.05). Conclusions The mid-second trimester low adiponectin level and high insulin resistance are associated with the development of preeclampsia.