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目的检测子痫前期重度患者在妊娠中期血清脂联素水平及胎盘组织中脂联素的表达并研究其与重度子痫前期的关系。方法随机选择来产前检查并于孕晚期发展为子痫前期重度而无其他妊娠并发症或合并症的单胎妊娠妇女22例为实验组,将同一时期进行产前检查孕晚期仍为正常的单胎妊娠妇女30例为对照组。实验组和对照组受试者在妊娠24~28周时采用放射免疫法测定其血清脂联素、血脂水平,并于分娩后采用免疫组化方法检测胎盘脂联素的表达水平。结果实验组在妊娠中期血清脂联素水平低于对照组(P<0.01);实验组血清脂联素与甘油三酯(TG)(r=-0.92,P<0.01)、高密度脂蛋白胆固醇(HDLC)(r=-0.85,P<0.01)呈负相关,与低密度脂蛋白胆固醇(LDL-C)呈正相关(r=0.90,P<0.01),与总胆固醇(TC)无相关关系。实验组胎盘脂联素表达总阳性率明显低于对照组(31.8%vs 86.7%,P<0.01)。结论妊娠中期存在的低脂联素血症及胎盘脂联素表达低水平与重度子痫前期发病关系密切。
Objective To detect the level of serum adiponectin and the expression of adiponectin in placenta of severe preeclampsia patients and to study its relationship with severe preeclampsia. Methods Twenty-two singleton pregnant women, who were randomly selected for prenatal examination and who developed severe preeclampsia without other pregnancy complications or complications during the third trimester of pregnancy, were selected as the experimental group. The first trimester of pregnancy was still normal in the third trimester 30 cases of singleton pregnancy women as the control group. The subjects in the experimental group and the control group were measured serum levels of adiponectin and lipids by radioimmunoassay between 24 and 28 weeks of gestation, and the expression of adiponectin was detected by immunohistochemistry after delivery. Results The level of serum adiponectin in the second trimester of pregnancy was lower than that of the control group (P <0.01). Serum levels of adiponectin and triglyceride (TG) (r = -0.92, P <0.01), high density lipoprotein cholesterol (HDLC) (r = -0.85, P <0.01) and positively correlated with low density lipoprotein cholesterol (LDL-C) (r = 0.90, P <0.01), but not with total cholesterol (TC) The positive rate of adiponectin expression in the experimental group was significantly lower than that in the control group (31.8% vs 86.7%, P <0.01). Conclusions The low levels of hypoadiponectine and placental adiponectin in the second trimester are closely related to the pathogenesis of severe preeclampsia.