妊娠期高血压疾病患者血清ET、NO水平及动脉弹性分析

Analysis of serum endothelin,nitric oxide level,and arterial elasticity in patients with hypertensive disorder complicating pregnancy

目的探讨妊娠期高血压疾病患者血清内皮素(ET)、一氧化氮(NO)和动脉弹性状况,为患者的临床预防及治疗提供指导。方法选取2017年6月至2019年6月期间在西安市第四医院妇产科确诊的60例妊娠期高血压疾病孕妇作为研究组,60例健康妊娠期孕妇作为对照组。检测并比较两组受检者的血清ET、NO水平及动脉弹性[单点脉搏波传导速率(PWVβ)超声测量、患者血管的压力-应变弹性系数(Eρ)、硬度指数(β)、膨大系数(AI)、动脉顺应性(AC)],并评估血清ET、NO水平与动脉弹性的相关性。结果研究组和对照组受检者的ET[(67.31±8.64)ng/mL vs(50.65±9.78)ng/mL]、PWVβ[(9.41±1.48)m/s vs(7.22±1.12)m/s]、Eρ[(201.41±22.98)kPa vs(135.88±21.95)kPa]、β(16.41±2.21 vs 10.88±1.95)、AI[(15.41±2.98)%vs(9.88±2.56)%]比较,研究组明显高于对照组,差异均有统计学意义(P<0.05);研究组和对照组受检者的NO[(51.25±5.96)μmol/L vs(61.75±7.44)μmol/L]、AC[(0.07±0.02)mm^(2)/kPa vs(0.15±0.04)mm^(2)/kP]比较,研究组明显低于对照组,差异均有统计学意义(P<0.05);子痫前期和妊娠高血压患者的ET[(88.56±8.79)ng/mL vs(56.34±9.71)ng/mL]、PWVβ[(11.23±1.51)m/s vs(7.67±1.23)m/s]、Eρ[(221.42±25.16)kPa vs(185.94±19.01)kPa]、β(19.66±2.32)vs(14.53±1.78)、AI[(11.33±1.01)%vs(7.88±1.09)%]比较,子痫前期患者明显高于妊娠高血压患者,而NO[(39.78±7.96)μmol/L vs(54.75±6.56)μmol/L]、AC[(0.05±0.01)mm^(2)/kPa vs(0.08±0.01)mm^(2)/k Pa]比较,子痫前期患者明显低于妊娠高血压患者,差异均有统计学意义(P<0.05);经Pearson分析结果显示,妊娠高血压患者NO与ET、PWVβ、Eρ、β、AI均呈负相关(r=-0.75、-0.13、-0.108、-0.149、-0.110,P<0.05),与AC无相关性(r=0.184,P>0.05);妊娠高血压患者ET与PWVβ、Eρ、β、AI均呈正相关(r=0.226、0.63、0.563、0.345,P<0.05),与NO呈负相关(r=-0.75,P<0.05),与AC无相关性(r=0.115,P>0.05)。结论妊娠期高血压疾病患者血清ET、PWVβ、Eρ、β、AI水平明显高于健康者,NO、AC水平明显低于健康者,妊娠期高血压疾病与人体血清中ET、NO、动脉弹性具有相关性。

Objective To investigate the status of serum endothelin(ET),nitric oxide(NO),and arterial elasticity in patients with hypertensive disease during pregnancy,so as to provide guidance for the clinical prevention and treatment.Methods A total of 60 pregnant women with gestational hypertension diagnosed in the Department of Obstetrics and Gynecology,Xi’an Fourth Hospital from June 2017 to June 2019 were selected as the study group,and 60 healthy pregnant women as the control group.The levels of serum ET,NO,and arterial elasticity(single point pulse wave velocity[PWVβ],pressure strain elastic coefficient[Eρ],stiffness index[β],expansion coefficient[AI]and arterial compliance[AC]were measured and compared between the two groups.Results The levels of ET,PWVβ,Eρ,β,AI in study group were(67.31±8.64)ng/mL,(9.41±1.48)m/s,(201.41±22.98)kPa,16.41±2.21,(15.41±2.98)%,respectively,which were significantly higher than(50.65±9.78)ng/m L,(7.22±1.12)m/s,(135.88±21.95)k Pa,10.88±1.95,(9.88±2.56)%in control group(P<0.05).In study group,the levels of ET,PWVβ,Eρ,β,AI of preeclampsia was(88.56±8.79)ng/m L,(11.23±1.51)m/s,(221.42±25.16)k Pa,19.66±2.32,(11.33±1.01)%,which were significantly higher than(56.34±9.71)ng/m L,(7.67±1.23)m/s,(185.94±19.01)k Pa,14.53±1.78,(7.88±1.09)%of patients with pregnancy induced hypertension,but the level of NO and AC were(39.78±7.96)μmol/L,(0.05±0.01)mm^(2)/k Pa of preeclampsia,which were significantly lower than(54.75±6.56)μmol/L,(0.08±0.01)mm^(2)/k Pa of patients with pregnancy induced hypertension(P<0.05).Pearson analysis showed that NO was negatively correlated with ET,PWVβ,Eρ,β,AI(r=-0.75,-0.13,-0.108,-0.149,-0.110,P<0.05),but no correlation with AC(r=0.184,P>0.05).ET was positively correlated with ET,PWVβ,Eρ,β,AI(r=0.226,0.63,0.563,0.345,P<0.05),and negatively correlated with NO(r=-0.75,P<0.05),but no correlation with AC(r=0.115,P>0.05).Conclusion The levels of ET,PWVβ,Eρ,β,AI in patients with hypertensive disorder complicating pregnancy were significantly higher than those in healthy people,while the levels of NO and AC were significantly lower in patients with hypertensive disorder complicating pregnancy(PIH).Hypertensive disorder complicating pregnancy is correlated with ET,NO and arterial elasticity.