正常孕妇及子痫前期孕妇体内肾上腺髓质素浓度及临床意义

The study on the clinical significance of plasma adrenomedullin level in normal pregnancy and preeclampsia patients

目的探讨正常孕妇及子痫前期孕妇血浆肾上腺髓质素浓度及临床意义。方法用酶联免疫方法测定202例妇女体内肾上腺髓质素浓度，其中正常孕妇90例（I组：早、中、晚孕各30例）；子痫前期患者42例（轻度20例，重度22例）（Ⅱ组），血压正常非孕妇34例（Ⅲ组），非孕高血压患者36例（Ⅳ组）。结果①正常孕妇组血浆肾上腺髓质素浓度明显高于非孕正常血压的妇女，随孕周的增加而增加，且与孕周有正相关关系。②子痛前期患者血浆肾上腺髓质素浓度明显高于其他组，与收缩压、舒张压、病情严重程度及尿蛋白有正相关关系。结论孕妇体内肾上腺髓质素水平随孕周增加而增加，提示肾上腺髓质素在人类生殖中有重要作用。子痫前期孕妇肾上腺髓质素水平异常增加，可能参与了子痫前期的发病。

Objective To investigate the plasma adrenomedullin （ADM） levels and clinical significance in normal pregnancy and prceclampsia patients. Methods In the prospective clinical study, 202 women were divided into 4 main groups： group I （90 women） ： normotenaive pregnant women at first trimester （ 30 women）, second trimester （30 women）, and third trimester （30 women） of pregnancies. Group Ⅱ（42 women） ： pregnant women with preeclampsia including 20 mild preeclampsia patients and 22 severe preeclampsia patients. Group Ⅲ（34 women） ： Normotensive healthy nonpregnant women. Group Ⅳ（36 women） ： Hypertensive nonpregnant women. The plasma ADM concentration was measured in all women by using enzyme immunoassay kits. Results Plasma ADM levels in pregnant women with normal blood pressure at different gestational were statistically significantly higher than those detected in nonpregnant normotensive women and significantly increased with increasing gestational age. Moreover, there was significant positive correlation between plasma ADM levels and increasing gestational age. Preeclamptie patients had the highest mean plasma ADM levels compared with all other groups, and there was a significant positive correlation between plasma ADM levels and systolic blood pressure, diastolic blood pressure, severity of prceclampsia, and proteinuria in pregnant patients with preeclampsia. Conclusion Maternal plasma ADM concentration increased throughout pregnancy and increases as gestational age progresses, suggesting that it may have an important role in human reproduction from implantation to delivery.Maternal plasma ADM level in preeclampsia appears to be higher than that in normal pregnancy.