胰岛素抵抗与妊娠高血压综合征发病的关系

Relationship between Insulin Resistance and Pregnancy Induced Hypertension

目的 探讨胰岛素抵抗与妊娠高血压综合征 (妊高征 )发病的关系。方法 选取 1998年在上海市第一人民医院进行产前妊娠期糖尿病筛选异常的 199例孕妇为研究对象 ,进行 75g葡萄糖耐量试验 ,同时进行胰岛素释放试验 ,计算胰岛素曲线下面积及胰岛素敏感性指数 ,并随访至妊娠晚期发生妊高征的情况 ,比较 199例孕妇中 ,发生妊高征者和血压正常者胰岛素敏感性的差异。结果 (1)妊高征发病有 39例 ,空腹血糖为 (4 .2± 0 .7)mmol/L ,空腹胰岛素为 (10 7.8± 48.8)pmol/L ,胰岛素敏感性指数为 - 3.2 5± 0 .2 7。血压正常的孕妇 16 0例 ,空腹血糖为 (3.8± 0 .7)mmol/L ,空腹胰岛素为 (5 0 .4± 40 .5 )pmol/L ,胰岛素敏感性指数为 - 2 .5 8± 0 .6 6 (P <0 .0 5 )。 (2 )胰岛素曲线下面积 ,妊高征患者为 112 5 .6± 331.0 ,血压正常孕妇为 10 5 7.6± 44 2 .2 ,两者比较 ,差异无显著性 (P >0 .0 5 )。结论 孕中期胰岛素抵抗可能是妊高征发病的原因之一。

Objective To investigate whether insulin resistance is a cause of pregnancy induced hypertension (PIH). Methods All patients who had abnormal 50g glucose screening test accepted 75g oral glucose tolerance test (OGTT) and insulin sensitive index (ISI) was calculated. These patients were followed up and divided into two groups (PIH group and normal pregnancy group) at third trimester of pregnancy. The difference of ISI between the PIH group and normal pregnancy group was compared. Results Fast blood glucose, fast blood insulin and ISI were (4.2±0.7)mmol/L vs. (3.8±0.7)mmol/L, (107.8±48.8)pmol/L vs. (50.4±40.5)pmol/L, and -3.25±0.27 vs. -2.58±0.66 in PIH group and normal group, respectively ( P <0.05) . The areas under the curve of insulin were 1 125.6±331.0 and 1 057.6±442.2 in PIH group and normal pregnancy group, respectively ( P >0.05). Conclusions Insulin resistance during second trimester of pregnancy may be one of the causes of pregnancy induced hypertension.