妊娠高血压综合征患者血浆降钙素基因相关肽和神经肽Y含量的变化及其意义

CHANGES AND CLINICAL SIGNIFICANCE OF PLASMA NEUROPEPTIDE Y AND CALCITONIN GENE-RELATED PEPTIDE CONTENTS IN PATIENTS WITH PREGNANCY INDUCED HYPERTENSION

目的 :观察正常妊娠和妊娠高血压综合征 (妊高征 )患者血浆降钙素基因相关肽 (CGRP)和神经肽Y(NPY)含量变化并探讨其与妊高征发病的关系。方法 :运用放射免疫法检测非孕妇女 (正常组 ,2 3例 )、正常妊娠妇女 (妊娠组 ,6 0例 )及妊高征患者 (妊高征组 ,6 7例 )血浆CGRP和NPY的含量。结果 :与正常组 (5 7.31ng/L± 14 .6 2ng/L)相比 ,妊娠组孕妇CGRP含量 (95 .92ng/L± 34.4 6ng/L)明显上升 (P <0 .0 5 ) ,并随孕周的增加而增加 ,到孕晚期升至高峰 (12 1.77ng/L± 4 6 .89ng/L) ;NPY的含量虽然有升高 ,但没有显著性差异 (P>0 .0 5 ) ;与妊娠组晚孕妇女 (12 1.77ng/L± 4 6 .89ng/L)相比 ,妊高征组患者CGRP的含量 (77.5 6ng/L±2 3.96ng/L)显著下降 (P <0 .0 5 ) ,并随妊高征病情的加重而逐渐下降 (P <0 .0 5 ) ,与其平均动脉压呈显著负相关 (r =- 0 .6 14 7,P <0 .0 5 ) ;NPY的含量 (15 2 .6 0ng/L± 4 7.6 8ng/L)则明显上升 (P <0 .0 1) ,并且随妊高征病情加重而上升 ,与其平均动脉压呈显著正相关 (r =0 .3891,P <0 .0 5 )。结论 :妊高征患者血浆CGRP含量下降 ,NPY含量上升 ,提示神经体液因素在妊高征的发病过程中发挥了一定的作用。

Objective:To determine the changes of plasma calcitonin gene-related peptide (CGRP) and Neuropeptide Y (NPY) contents in patients with pregnancy induced hypertension (PIH) as well as to explore the role of CGRP and NPY in the pathogenesis of pregnancy induced hypertension.Methods:The plasma CGRP and NPY contents in 67 patients with PIH (PIH group),60 healthy pregnant women (Control group) and 23 nonpregnant women (Normal group) were assayed by radioimmunoassay. Results: Plasma CGRP content in control group (95.92±34.46ng/L) was significantly higher than that of normal group (57.31±14.62ng/L, P <0.05), increased with the prolongation of pregnancy, and peaked in the third trimester of pregnancy(121.77±46.89ng/L).Plasma NPY content also increased in control group, but was not significantly higher than that in normal group( P >0.05). Compared with late pregnancy women of control group, the plasma CGRP content of PIH group was significantly decreased ( P <0.05), and there was a negative relationship with the mean arterial blood pressure (mABP, r=-6147, P <0.05). The plasma NPY content of PIH group (152.60±47.68ng/L) was significantly higher than that of late pregnancy women of control group (74.65±27.36ng/L, P <0.01). There was a trend that plasma NPY content in PIH group increased with the mABP (r=0.3891, P <0.05). Conclusions:PIH had decreasing CGRP and increasing NPY production and release suggests that the neurohumoral factor play an important role in the pathogenic mechanism of PIH.