目的探讨子痫前期(PE)患者血清与胎盘组织中一氧化氮(NO)的表达及其意义。方法选取轻度、重度PE患者各20例,分别作为B组和A组,另选同期行剖宫产的单胎初产健康妊娠妇女20例作为对照组(N组)。比较3组患者的平均动脉压(MAP)、24h尿蛋白量,在入院时(T0)、产前(T1)及产后6h(T2)的血清NO水平,以及胎盘组织的NO和环磷酸鸟苷(cGMP)水平。结果 A组、B组患者MAP在T0、T1、T2时点均明显高于N组,差异有统计学意义(A组MAP在T0、T1、T2时点与N组比较t=4.126、3.659、2.922;B组MAP在各时点与N组比较t=3.326、2.685、2.227,均P<0.05),A组和B组T2时点MAP均较T0有明显降低,差异有统计学意义(t=3.243、2.826,均P<0.05)。A组、B组24h尿蛋白定量值显著高于N组,差异有统计学意义(t=13.462、9.698,均P<0.05)。A组、B组血清NO水平在T0、T1、T2时点均显著低于N组,差异有统计学意义(A组血清NO水平在T0、T1、T2时点与N组比较t=5.686、3.452、2.706;B组血清NO水平在T0、T1、T2时点与N组比较t=3.012、2.842、2.361,均P<0.05),且A组比B组降低更明显,差异有统计学意义(A组血清NO水平在各时点与B组比较,t=2.546、2.318、2.109,均P<0.05)。A组、B组血清NO水平在T0、T1、T2时点逐渐增加,差异有统计学意义(A组血清NO水平在T2时点与T1比较,T1时点与T0比较,t=3.090、2.142;B组血清NO水平在T2时点与T1比较,T1时点与T0比较,t=3.106、2.329,均P<0.05)。3组患者血清NO水平与MAP(r=-0.681,P<0.05)和24h尿蛋白定量(r=-0.358,P<0.05)均呈负相关关系。A组、B组胎盘组织NO水平和cGMP浓度均显著低于N组,差异有统计学意义(B组、A组NO水平与N组比较,t=2.633、3.857,B组、A组cGMP浓度与N组比较t=2.846、3.824,均P<0.05)。3组患者胎盘组织中cGMP浓度与NO水平呈正相关关系(r=0.572,P<0.05)。结论孕妇血清与胎盘组织中NO水平与PE发病及病情轻重密切相关。 Objective To investigate the expression of nitric oxide (NO) in serum and placenta of patients with preeclampsia (PE) and its significance. Methods Twenty patients with mild and severe PE were selected as group B and group A respectively. Twenty healthy singleton pregnant women with cesarean section at the same period were selected as the control group (N group). The mean arterial pressure (MAP) and the amount of urinary protein in 24 hours were compared between the three groups. The levels of NO in the serum at admission (T0), prenatal (T1) and postnatal 6h (T2), NO and placental NO (cGMP) level. Results The MAP of group A and group B were significantly higher than that of group N at T0, T1 and T2, the difference was statistically significant (MAP of group A was significantly higher than that of group N at T0, T1 and T2 (t = 4.126, 3.659, 2.922; MAP in group B was significantly lower than that in group T at time point (t = 3.326,2.685,2.227, P <0.05); MAP in group A and group B was significantly lower than that in group T (t = 3.243,2.826, all P <0.05). The quantitative values ​​of 24-hour urinary protein in group A and group B were significantly higher than those in group N (t = 13.462, 9.698, all P <0.05). The levels of serum NO in group A and group B were significantly lower than those in group N at T0, T1 and T2, the difference was statistically significant (group A, serum NO levels at T0, T1 and T2 were significantly lower than those in group N (t = 5.686, 3.452 and 2.706 respectively. The level of serum NO in group B was significantly lower than that in group B at T0, T1 and T2 (t = 3.012, 2.8242, 2.361, P <0.05), and the difference was statistically significant (A group of serum NO levels at each time point compared with the B group, t = 2.546,2.318,2.109, all P <0.05). The level of serum NO in group A and B increased gradually at T0, T1 and T2, the difference was statistically significant (serum NO level in group A compared with T1 at T2, T1 = 3.090 and 2.142 ; The level of serum NO in group B was compared with T1 at T2, T1 at T0, t = 3.106,2.329, all P <0.05). The level of serum NO in the three groups was negatively correlated with MAP (r = -0.681, P <0.05) and 24 h urinary protein (r = -0.358, P <0.05). The levels of NO and cGMP in placenta of group A and group B were significantly lower than those of group N (Group B, group A, the NO level in group A was significantly lower than that in group N, t = 2.633,3.857, Compared with the N group t = 2.846,3.824, all P <0.05). There was a positive correlation between the level of cGMP and the level of NO in the three groups (r = 0.572, P <0.05). Conclusions The levels of NO in serum and placenta of pregnant women are closely related to the incidence of PE and severity of illness.