妊高征患者血管舒张与收缩因子水平变化的临床意义

Clinical significance of vasodilators and vasoconstrictors in patients with pregnancy induced hypertension

目的 观察妊娠高血压综合征 (妊高征 )患者血浆降钙素基因相关肽 (CGRP)、一氧化氮 (NO)、神经肽Y(NPY)及内皮素 (ET)含量的变化。方法 将非孕妇女 (正常组 ,2 7例 )、正常妊娠妇女 (妊娠组 ,81例 )和妊高征患者 (妊高征组 ,87例 )血浆CGRP、NPY及ET的含量采用放射免疫法检测 ,NO的含量用镉柱比色法检测。结果 ①妊高征组CGRP的含量明显低于妊娠组 (P <0 0 5 ) ,并随病情的加重而降低 ;而NPY和ET的含量均极显著地高于妊娠组 (P <0 0 1) ,并且均随病情严重程度的增加而增加 (P <0 0 5 )。②妊高征组血浆收缩 /舒张因子 (NPY +ET) /(CGRP +NO)的比值明显大于妊娠组和正常组 (P <0 0 5 )。结论 妊娠后血管收缩与舒张因子系统平衡失调在妊高征的发病机制中起着重要作用。

Objective To determine the changes of plasma vasodilator nitric oxide(NO) and calcitonin gene-related peptide (CGRP),vasoconstrictor endothelin(ET) and neuropeptide Y(NPY) concentration in patients with pregnancy induced hypertension(PIH).Methods The plasma CGRP,ET and NPY concentration in 27 non-pregnant women (normal group),81 healhy pregnant women(control group) and 87 patients with PIH (PIH group) were determined by radioimmunoassay, and the plasma NO concentration was determined by cadmium-column reduction spectro-photometry.Results ①Compared with control group,the plasma CGRP concentration in PIH group was significantly decreased (P<0.05)(P<0.05).The more severe the disease,the lower the concentration.The plasma vasoconstrictor NPY and ET in PIH group were significantly higher than those in control group (P<0.01),and increased with the severity of PIH. ②The ratio of plasma vasoconstrictor (NPY+ET) to vasodilator (CGRP+NO) in PIH group was significantly higher than that of control and normal group (P<0.05).Conclusion Imbalance between vasoconstrictor and vasodilator or increased ratio of vasoconstrictor/vasodilator may play an important role in the pathogenesis of PIH.