妊娠期高血压疾病患者瘦素水平的变化及其意义

Change and its signifiance of leptin level in PIH patients

目的:研究瘦素在妊娠期高血压疾病患者的表达及其临床意义。方法:对60例妊娠期高血压疾病患者,其中妊娠期高血压组(20例)和子痫前期组(20例重度、20例轻度),正常妊娠组(20例),用ELISA法分别测定分娩前以及分娩后1周母体静脉血、脐静脉血瘦素的浓度;采用免疫组织化学法检测瘦素在胎盘中的定位和表达。结果:妊娠期子痫前期组的瘦素浓度明显高于同期正常妊娠组,差异均有显著意义(P<0.05);分娩后1周后所有病例母体血浆瘦素水平急剧下降,接近正常未孕水平;子痫前期的脐静脉血瘦素水平明显高于妊娠期高血压和正常组,差异有显著性(P<0.05);瘦素在胎盘绒毛合体滋养细胞、细胞滋养细胞、血管内皮细胞胞浆中均有表达;瘦素蛋白表达强度在正常妊娠、妊娠期高血压、子痫前期依次上升,差异均有显著意义(P<0.05)。结论:妊娠期高血压疾病患者随着病情加重,瘦素水平逐步增加,可作为预示妊娠期高血压疾病病情严重程度的敏感指标之一。

Objective： To investigate the change and its signifiance of leptin level in PIH patients. Methods：The maternal plasma samples of 60 PIH pregnant women and 20 normal pregnant women were obtained before and 7 days after delivery. And the umbilical plasma samples of them also were obtained after delivery . The level of leptin was valued by enzyme-linked immunoradioassay technique. The correlative analysis between the levels of serum leptin was performed. And the expression and location of leptin in placenta were explored by immunohistochemistry（SP）. Based on pregnancy outcomes, the subjects were divided into healthy normal pregnant group （20 cases）, gestational hypertension group （20 cases） and preeclamptic group （20 severe and 20 mild）. Results：The levels of maternal plasma leptin in preeclampsia were significantly higher than those in healthy normal pregnant group at the same stages （P〈0. 05, respectively）, but no change existed between gestational hypertension and normal pregnant group （P〉 0. 05, respectively）. The levels of maternal plasma leptin rapidly dropped into the levels of non-pregnancy on all subjects after delivery. The levels of umbilical blood leptin in preeclampsia were significantly higher than those in healthy normal pregnant group . The location of leptin in placentas was existed in the cytoplasm of villous syneytiotrophoblast, eytotrophoblast and vascular endothelial cells. The expressional intensions of leptin protein were higherthan in gestational hypertension（P〈0.05, respectively）, and the intensions in gestational hypertension group were higher than those in healthy normal pregnancy group by turn （P〈0. 05, respectively）. Conclusion： The leptin levels in PIH patients are higer than those in normal pregnancy, and related to the severity of PIH. The level of leptin can be a clinica marker of the degree of preeclampsia.