妊娠高血压综合征患者血浆与羊水和脐静脉血肾上腺髓质素含量变化

Change of adrenomeduilin concentrations in plasma, amniotic fluid and umbilical vein of pregnancy induced hypertention.

目的:探讨ADM在妊娠高血压综合征(妊高征)患者血浆、羊水和脐静脉血中的变化。方法:对50例正常孕妇和59例妊高征患者血浆进行ADM(1-52)测定,并对其中46例正常孕妇和50例妊高征患者取羊水和脐静脉血进行ADM(1-52)测定。结果:妊高征患者血浆ADM(1-52)值(57.39±16.23)ng/L、羊水(57.09±13.39)ng/L和脐静脉血(61.33±18.75)ng/L,均显著高于正常妊娠妇女血浆(18.59±4.79)ng/L、羊水(20.65±8.75)ng/L和脐静脉血(17.34±6.85)ng/L(P均<0.001)。结论:妊高征患者血浆ADM水平高于正常妊娠妇女,提示妊高征患者ADM的代偿性升高具有保护机体、防止血压进一步升高,防止病情恶化。羊水和脐静脉血中保持高水平的ADM,提示胎儿胎盘可能参与ADM的合成和分泌。

Objective： To study the change of adrenomeduilin concentrations in plasma, amniotic fluid and umbilical vein of pregnancy induced hypertention. Methods： We measured ADM （ I -52） concentrations in plasma collected from 50 normal pregnant women and 59 women with PIH. ADM （ I -52） concentrations were also measured in umbilical vein and amniotic fluid from 46 normal pregnant women and 50 women with PIH. Results： Plasma , amniotic fluid and umbilical vein from women with PIH were associated significantly with higher ADM （ I -52） concentrations （57.39 ± 16.23ng/L, 57.09 ± 13. 39 ng/L and 61.33 ± 18.75ng/L ） than that from normal pregnant women （ 18. 59 ± 4. 79mg/L, 20. 65 ± 8.75 ng/L and 17.34 ± 6. 85ng/L） （ P 〈 0. 001 ） . Conclusion： The increasing of ADM （ 1 - 52） in PIH plasma indicates that it may protect the blood pressure from persisting increase and prevent the state from worsening. The ADM （ I -52） maintains high level in amniotic fluid and umbilical vein of PIH suggests that the placenta and the fetus may contribute to its production and secretion.