胰岛素抵抗与妊高征发病及围产儿预后的关系

The Relationship of Insulin Resistance and the Pathogenesis and Perinatal Outcome of Pregnancy Induced Hypertension

目的探讨胰岛素抵抗与妊高征发病及围产儿预后的关系。方法选择妊高征孕妇１１１例为妊高征组，正常妊娠妇女１５５例为对照组；分别于孕３２周前和３２周后取母血，分娩后取脐血，测定胰岛素和Ｃ肽浓度；比较新生儿出生体重、Ａｐｇａｒ评分和羊水状况。结果妊高征组Ｃ肽和胰岛素的浓度在孕３２周前、后均明显高于对照组（Ｐ＜０．００１和Ｐ＜０．０１）。在妊高征组，宫内发育迟缓、新生儿窒息和羊水异常时，母儿Ｃ肽和胰岛素浓度均有上升的趋势，并且发生在妊娠３２周之前；在对照组，宫内发育迟缓时，孕妇Ｃ肽和胰岛素浓度有下降的趋势。结论胰岛素抵抗在妊高征的发生、发展，以及围产儿预后不良等方面均有重要意义。

Objective To study the insulin resistance in the pathogenesis of pregnancy induced hypertension (PIH), and its relationship to perinatal outcome. Methods In 111 PIH and 155 control group, the concentration of C peptide and insulin of maternal blood samples before and after 32 gestational weeks, and fetal blood samples just after delivery was determined. Fetal outcomes were assessed by the neonatal weight at delivery, Apgar scores and the quality and quantity of amniotic fluid. Results The maternal concentration of C peptide and insulin in PIH was higher than that of control group( P <0.05,or P <0.01). In PIH group, the maternal concentration of C peptide and insulin in the subgroup of adverse perinatal outcomes tended to be higher than that in the subgroup of good perinatal outcomes; but in control group, there was no significantly difference between these two subgroups.Conclusions Insulin resistance may be one of the factors which couse PIH, and it has significant relationship with advese perinatal outcomes.