子痫前期产妇脂联素、前列腺素E2、孕酮、皮质醇和载脂蛋白的测定及意义

Clinical Values of Adiponectin,PGE2,Progesterone,Cortisol,and Apolipoprotein in the Pregnancy- induced Preeclampsia

目的探讨正常妊娠和子痫前期产妇脂联素、前列腺素E2(PGE2)、孕酮、皮质醇和载脂蛋白水平改变情况,为明确子痫前期病因和临床早期诊断治疗提供依据。方法分别采用放射免疫法、酶联免疫吸附实验、免疫透射比浊法和化学发光等方法对60例子痫前期产妇和60例正常孕妇不同孕周的脂联素、PGE2、孕酮、皮质醇和载脂蛋白水平进行检测。结果随着孕周的增加,正常组产妇脂联素并无明显改变(P>0.05),而PGE2水平、载脂蛋白各项指标、孕酮和皮质醇水平则均逐渐增加,差异均具有统计学意义(P<0.05)。与正常组比较,子痫前期组的Apo-A1、Apo-B100、Apo-CIII水平未见明显差异(P>0.05),而子痫前期组的PGE2水平在分娩和妊娠28周时均明显低于正常组,脂联素则仅在分娩时显著低于正常组(P>0.05);Apo-CII测量值在妊娠早、中、晚期均明显高于正常组(P<0.05),而子痫前期组的孕酮和皮质醇水平仅在分娩时明显改变(P<0.05),而其余时间点组间比较无显著差异(P>0.05)。结论脂联素、PGE2、孕酮、皮质醇和Apo-CII水平异常是导致子痫前期的重要因素,可作为诊断和治疗子痫前期的潜在生物标志。

Objective To investigate the changes of adiponectin,PGE2,progesterone,cortisol and apolipoprotein in both normal pregnancy and preeclampsia pregnant,and reveal the cause of disease and provide the basis for early clinical diagnosis and treatment. Methods The levels of adiponectin,PGE2,progesterone,cortisol and apolipoprotein were detected by using radioimmunoassay,enzyme- linked immunosorbent assay,immune turbidimetric method and chemiluminescence etc respectively in the 60 normal pregnant and 60 preeclampsia cases. Results Adiponectin did not change significantly in both groups with increasing gestational age（ P 〉0. 05）,whereas the PGE2 levels,apolipoprotein progesterone and cortisol were significantly enhanced（ P 〈0. 05）. Compared with normal group,there was no significant change in Apo- A1,Apo- B100 and Apo- CIII,but in the preeclampsia cases,PGE2 was significantly lower than the normal group at both 28 weeks of pregnancy and the delivery time,while adiponectin was significantly decreased at 28 weeks of pregnancy（ P〉 0. 05）. Notably,in the preeclampsia at each tested time,the levels of Apo- CII were significantly higher than the normal group（ P 〈0. 05）,while the progesterone and cortisol levels were significantly changed in the normal group at delivery time（ 〈P 0. 05）. But there wasn＇t significant change at other time points among groups（ P〉 0. 05）. Conclusion Adiponectin,PGE2,progesterone,cortisol and Apo- CII are the important factors for preeclampsia,and also,these indicators can be used as the potential diagnostic and therapeutic biomarkers.