妊娠高血压综合征患者血清总同型半胱氨酸的变化及其临床意义

Changes and clinical significance of concentration of serum total homocysteine in patients with pregnancy induced hypertension

目的 检测妊娠高血压综合征 (妊高征 )患者外周血中总同型半胱氨酸 (tHcy)的水平 ,并探讨其与妊高征发病的关系。方法 应用高效液相色谱电化学检测 (HPLC ED)法检测未妊娠妇女、正常妊娠妇女以及妊高征患者血清中tHcy的水平。结果 ①非妊娠组的tHcy水平 [(7.89± 2 .6 2 )mol/L]与正常妊娠组 [(5 .91± 1.96 ) μmol/L]相比较 ,差异有极显著性 (P <0 .0 0 1) ;正常妊娠组在孕中期tHcy水平 [(5 .2 3± 1.88) μmol/L]降至最低。②妊高征组tHcy水平 [(9.40± 3.0 6 ) μmol/L]明显高于正常妊娠组 (P <0 .0 0 1) ,与非妊娠组妇女相比较 ,tHcy水平呈逐渐升高趋势 (P值分别小于 0 .0 5 ,0 .0 1,0 .0 0 1) ;并随妊高征病情的加重 ,tHcy水平呈逐渐上升趋势 ,重度妊高征明显高于轻度妊高征 (P <0 .0 5 )。结论 妊娠后tHcy水平显著升高可能是妊高征发病机制中的一个重要因素。

Objective To determine the changes in serum total homocysteine (tHcy) concentration that occur in patients with pregnancy induced hypertension (PIH),to explore the relationship between serum tHcy and pathogenesis of PIH.Methods Serum tHcy concentrations were measured in 30 healthy nonpregnant women (nonpregnancy group),36 normal pregnant women (normal pregnancy group) and 42 women with PIH (PIH group) by high pressure liquid chromatography (HPLC) with electrochemical detection.Results ① Serum tHcy concentrations were significantly lower in normal pregnancy group,(5.91±1.96)μmol/L than those in nonpregnancy group,(7.89±2.62)μmol/L ( P <0.001),the lowest level in the second trimester of pregnancy,(5.23±1.88)μmol/L.②Serum tHcy concentrations,(9.40±3.06)μmol/L in PIH group were significantly higher than those in normal pregnancy group,(5.91±1.96)μmol/L( P <0.001).There was a trend that serum tHcy concentrations in PIH group gradually increased as compared with nonpregnancy group( P <0.05, 0.01 ,0.001).There was also a trend that serum tHcy concentrations in PIH group increased with severity of PIH ( P <0.05).Conclusion The increase of serum tHcy concentrations may play an important role in the pathogenic mechanism of PIH.