妊娠期高血压疾病患者CRP变化及与ET-1、NO相关性的研究

The correlation study between the serum levels of CRP and ET-1,NO in the patients with hypertensive disorder complicating pregnancy.

目的:探讨妊娠期高血压疾病患者C反应蛋白(CRP)的变化以及与ET-1、NO的相关性。方法:选择2009年2月～6月在我院住院妊娠期高血压疾病(HDCP)患者40例,根据病情分为妊娠期高血压组(GH)13例,轻度子痫前期组(MP)10例,重度子痫前期组(SP)17例;以同期妊娠末期健康妇女20例为对照组。用酶联免疫吸附法检测血清CRP和ET-1浓度;硝酸还原酶法测定血清NO浓度;将CRP浓度与ET-1、NO做相关性分析。结果:(1)妊娠期高血压疾病组血清CRP(8416.48±3646.64ng/ml),ET-1(340.30±127.16μg/ml)浓度水平均显著高于对照组(1573.60±722.45ng/ml),(61.20±29.44ng/ml);NO(82.69±17.12μmol/L)浓度水平显著低于对照组(105.18±7.12μmol/L),差异有显著的统计学意义(P<0.001);(2)HDCP各组血清CRP(GH:5634.62±1445.57ng/ml)(MP:8027.90±2593.46ng/ml)(SP:10772.35±3845.01ng/ml),ET-1(GH:245.46±62.20μg/ml)(MP:354.30±86.87μg/ml)(SP:404.59±142.41μg/ml)浓度水平较对照组升高,差异有显著的统计学意义(P<0.001)(P<0.001);MP组血清CRP,ET-1浓度水平较GH组升高,差异有统计学意义(P<0.05)(P<0.01);SP组血清CRP,ET-1浓度水平较GH组升高,差异有显著的统计学意义(P<0.001)(P<0.01);SP组血清CRP浓度水平也较MP组高,差异有显著的统计学意义(P<0.01),ET-1浓度水平较MP组有升高趋势,差异无统计学意义(P=0.168);(3)GH血清NO(101.03±4.79μmol/L)浓度水平较对照组(105.18±7.12μmol/L)降低,差异无统计学意义(P=0.197);MP组血清NO(83.47±12.72μmol/L)浓度水平较对照组降低,差异有统计学意义(P<0.001);MP组血清NO浓度水平也较GH组低,差异有统计学意义(P<0.001);SP组血清NO(68.21±10.48μmol/L)浓度水平较对照组、GH组、MP组也降低,差异有显著的统计学意义(P<0.001);(4)CRP浓度与ET-1浓度呈正相关(r=0.805,P=0.000);与NO浓度呈负相关(r=-0.637,P=0.000)。结论:妊娠期高血压疾病患者CRP,ET-1浓度水平升高,NO浓度水平降低,且CRP与ET-1、NO有一定的相关性,临床上可通过检测CRP、ET-1、NO,综合判断病情的发展与预后。

Objective：To investigate the correlation between the serum levels of CRP change and ET-1,NO in the patients with hypertensive disorder complicating pregnancy.Methods：Forty patients（including 13 cases of gestational hypertension,10 cases of mild preeclampsia,17 cases of severe preeclampsia） in Shanghai Renji Hospital from Feb,2009 to June,2009 were analysed and 20 normal pregnancy women were acted as control group.Enzyme-linked immunosorbent assay measured serum levels of total hs-CRP,ET-1,nitrate reductase measured serum levels of total NO;and analyse the correlation between the serum levels of CRP change and ET-1 and NO.Results：（1）The serum concentrations of CRP（8416.48±3646.64ng/ml）,ET-1（340.30±127.16μg/ml） in patients with hypertensive disorder complicating pregnancy increased significantly compared with controls（P0.001）.The serum concentrations of NO（82.69±17.12μmol/L） in patients with hypertensive disorder complicating pregnancy decreased significantly compared with control（105.18±7.12μmol/L）（P0.001）.（2）The serum concentration of CRP（5634.62±1445.57ng/ml）（8027.90±2593.46ng/ml）（10772.35±3845.01ng/ml）,ET-1（245.46±62.20μg/ml）（354.30±86.87μg/ml）（404.59±142.41μg/ml） in GH,MP,SP increased significantly compared with controls（P0.001）（P0.001）,and in MP increased compared with GH（P0.05）（P0.01）,and in SP increased significantly compared with GH（P0.001）（P0.001）.The serum concentrations of CRP in SP increased significantly compared with MP（P0.01）,although the serum concentrations of ET-1 in SP increased compared with MP,no statistical significance（P=0.168）.（3）The serum concentrations of NO in GH（101.03±4.79μmol/L） decreased compared with control（105.18±7.12μmol/L）,but no statistical significance（P=0.197）,and in MP（83.47±12.72μmol/L）decreased significantly compared with GH,controls（P0.001）;and in SP（68.21±10.48μmol/L）decreased significantly compared with controls,GH,MP（P0.001）.（4）The serum concentrations of CRP was significantly positively correlated with ET-1（r=0.805,P=0.000）;and was significantly negtively correlated with NO（r=-0.637,P=0.000）.Conclusion：The serum concentrations of CRP,ET-1 increased in HDCP,and the serum concentrations of NO decreased in HDCP.And there have correlations between CRP,ET-1and NO.So we can measure CRP,ET-1,NO in clinical,to synthetically judge the development and prognosis of the disease.