肿瘤坏死因子对妊高征的致病作用及与内皮素的关系

Plasma tumor necrosis factor level in patients with PIH and its correlation with endothelin-1.

目的：探讨肿瘤坏死因子在妊高征发病中的作用及与内皮素的关系。方法：采用放射免疫法测定了４６例妊高征患者（妊高征组）和２０例正常晚期妊娠妇女（对照组）血浆肿瘤坏死因子（ＴＮＦ）和内皮素（ＥＴ－１）的质量浓度。结果：妊高征组中、重度患者ＴＮＦ和ＥＴ－１质量浓度明显高于对照组和轻度患者（Ｐ＜０．０５及Ｐ＜０．０１）；产后７２小时两者质量浓度均明显下降。对照组血浆ＴＮＦ与ＥＴ－１质量浓度无相关性，而妊高征组两者的质量浓度呈正相关性（ρ＝０．５１２，Ｐ＜０．００１）。结论：ＴＮＦ对妊高征致病的一个重要环节可能是通过损伤血管内皮，进而引起ＥＴ－１合成和释放增加，导致血管痉挛而发病。

Objective:To investigate the relationship between tumor necrosis factor(TNF) and endothelin-1(ET-1) and to evaluate their potential roles in the pathogenesis of pregnancy-induced hypertension(PIH).Methods:Plasma levels of TNF and ET-1 were measured by radioimmunoassay both before and 72 hours after delivery in 46 patients with PIH and 20 normotensive pregnant women.Results:In the moderate and severe PIH,maternal plasma TNF and ET-1 levels increased singnificantly before delivery and decreased singnificantly at 72 hours after delivery.There was no correlation between TNF and ET-1 in normotensive pregnancy,but a positive correlation in PIH (ρ=0.512,P<0.001).Conclusion:TNF could induce vascular endothelial damage,which results in an increase of ET-1,then PIH occurrs. \ \