正常妊娠、妊高征血浆C型利钠肽水平的变化

Changes of plasma C-type natriuretic peptide levels in normal pregnant women and in the patients with pregnancy induced hypertension

目的 :比较不孕龄妇女血浆C型利钠肽 (CNP)水平的变化 ,探讨CNP在妊高征发病机制中的可能作用。方法 :采用放射免疫分析法 ,对门诊及住院的 193例正常妊娠妇女、89例妊高征患者和 46例正常非孕妇女血浆中CNP浓度检测。结果 :早、中和晚期妊娠三组比较 ,血浆CNP差值有极显著性意义 (F =10 84,P <0 0 1) ,早孕组的血浆CNP值显著升高 ,中晚期无变化。不同程度妊高征组之间血浆CNP水平有极显著差别 (F =6 6 17,P <0 0 1)。与正常妊娠对照组相比 ,轻度妊高征者血浆CNP水平降低 ,中度者接近妊娠对照 ,重度者显著升高。正常妇女、正常妊娠、妊高征血浆CNP水平有显著性差别 (F =13 6 1,P <0 0 1) ,主要表现在妊高征血浆CNP值明显升高 ,正常妇女与正常妊娠组间无显著性差别。结论 :在生理状态下 ,CNP以自分泌和旁分泌的形式参与妊娠生理的调节 ;孕期血浆CNP变化特点 :早期升高 ,中晚期无变化。病理状态下 ,CNP作为循环激素 ,与妊高征病理生理变化密切相关。血浆CNP由低到高的变化反映妊高征的病程 ,可作为生化指标监测病情发展 ,指导妊高征的临床治疗及预后判断。

Objective:To investigate the changes and clinical significance of plasma C type natriuretic peptide (CNP) levels in pregnant women of different gestational periods and in patients with pregnancy induced hypertension (PIH). Methods: Plasma CNP levels were detected by radioimmunoassay in 193 subjects with different gestation age, 89 patients with PIH and 46 normal non pregnant women. Results:The plasma CNP concentration in 60 women of the first trimester (2 07±5 59) is greatly higher than that of other trimesters and healthy non pregnant women ( F =10 84, P <0 01). The plasma CNP levels in patients with PIH (30 51±33 61) is significantly higher than that of normal pregnancies (19 43±5 13, F =13 61, P <0 01). The plasma CNP levels of patients with mild PIH is lower, moderate nearby and severe greatly higher than that of normal pregnancies ( F =66 17, P =0 0001)。Conclusion:CNP plays a role in the regulation normal pregnancy as an autocrine/paracrine model under physiological conditions. During the whole pregnancy duration, plasma CNP levels is increased in the first trimester. CNP is also closely related to path physiological changes of PIH as a circulating peptide model under pathological conditions. The changing of plasma CNP levels from low to high is believed to be the reflection of patients PIH progress and can be used as a biochemical index for judging the progress and guiding the therapy and prevention of PIH.