妊高征患者子宫静脉血中血管活性物质的测定

Vascular Activators in Uterine Vein of Patients with Pregnancy-induced Hypertension Syndrome

目的 :测定妊高征 (PIH)患者外周血及子宫静脉血中一氧化氮 (NO)、内皮素 (ET)的改变 ,判断胎盘是否是其改变的原因。方法 :分别于剖宫产手术前及手术中抽取PIH患者及正常孕妇外周血及子宫静脉血 ,测定血中NO及ET水平。结果 :PIH组外周血ET水平与子宫静脉血ET水平差异无显著性 (P >0 .0 5 )。PIH组外周血NO水平与子宫静脉血NO水平差异无显著性 (P >0 .0 5 )。正常晚孕组外周血ET水平与子宫静脉血ET水平差异无显著性 (P >0 .0 5 )。正常晚孕组外周血NO水平与子宫静脉血NO水平差异无显著性 (P >0 .0 5 )。与正常晚孕组比较 ,PIH组血中ET、NO水平均显著增高 (P <0 .0 1)。结论 :①PIH患者血中NO水平高于正常孕妇。②PIH患者的子宫、胎盘血管系统的功能亦遭到破坏 ,此改变为全身改变的一部分 ,不是血中NO、ET升高的原因。③PIH患者血中NO、ET水平升高是发病的环节 。

Objective: To identify the role of placenta in the alterations of Endothelin(ET)and Nitric Oxide(NO)in patients with pregnancy induced hypertension syndrome(PIH) by measuring and comparing levels of ET and NO in peripheral and uterine vein.Methods:15 women with PIH were compared with 15 normotensive trimester pregnant women.Peripheral venous blood samples were collected from all the cases at the beginning of cesarean section and uterine vein blood samples were taken from the uterine vein draining the placenta before uteruses were incised.NO and ET of the samples were measured.Results:There was no statistic difference between plasma ET of PIH group in uterine vein and in peripheral circulation( P >0.05).There was no statistic difference between serum NO of PIH group in uterine vein and in peripheral circulation( P >0.05).There was no statistic difference between plasma ET of normal pregnant group in uterine vein and in peripheral circulation( P >0.05).There was no statistic difference between serum NO of normal pregnant group in uterine vein and in peripheral circulation( P >0.05).Compared with normal pregnant group,the levels of ET and NO in PIH group were significanly higher( P <0.01).Conclusions:①Serum levels of NO is increased in PIH.②The function of vascular system of uteri placenta is also damaged,but placenta does not appear to be the source of increased ET and NO found in PIH.③The increament of ET and NO is one of the pathophysiological disorders of PIH.It is not the cause of PIH.