妊高征患者β-hCG、ET和NO的测定及临床意义

Estimation of β-hCG , Endothelin and Nitric Oxide in Patients with Pregnancy Induced Hypertension and Its Clinical Significance

目的探讨绒毛膜促性腺激素 (β hCG)、内皮素 (ET)、一氧化氮 (NO)的含量及变化与妊娠高血压综合征 (妊高征 )的关系。方法采用放射免疫分析法测定 87例妊高征患者 (妊高征组 )和 90例正常晚期妊娠妇女 (对照组 )血清β hCG ,血浆ET ,血清NO水平。并将两组胎盘组织进行病理学检查、比较。结果妊高征组β hCG、ET、NO分别为 (4 5 .2 8± 2 0 .92 )IU/L ,(74 .33± 9.87)ng/L ,(10 4 .95± 2 1.0 7) μmol/L ;对照组 β hCG、ET、NO分别为 (18.0 2± 7.97)IU/L ,(5 2 .4 3± 10 .34)ng/L ,(139.15± 2 1.98) μmol/L ,两组相比 ,妊高征组 β hCG、ET明显高于对照组 (P <0 .0 1) ,NO明显低于对照组 (P <0 .0 1) ,且随妊高征病情加重 ,上述升高和降低的幅度更大。胎盘病检 :妊高征组除轻度患者胎盘未见明显异常改变外 ,中、重度患者的胎盘绒毛及血管内皮细胞均有损伤性表现以及胎盘滋养层细胞增生。结论妊高征重要的病理学改变为胎盘缺血、缺氧致滋养层细胞增生及血管内皮细胞损伤。β hCG、ET升高及NO降低 ,可作为妊高征诊断的实验室指标。

ObjectivesTo investigate the relatonship of changes in human chorionic gonadotropin(hCG), endothelin(ET) and nitric oxide (NO) to pregnancy induced hypertension (PIH).MethodsThe levels of serum β hCG, plasma ET, and serum NO in eighty seven women with PIH (PIH group) and 90 normal pregnant women at late terms of gestation (control group) were estimated. by RIA. Pathological examinations of placenta tissues in both groups were performed and compared.ResultsThe levels of serum β hCG, plasma ET and serum NO in PIH group were ( 45.28±20.92) IU/L, (74.33±9.87) ng/L and (104.95±21.07) μmol/L; whereas .those in control group were (18.02±7.97) IU/L,(52.43±10.34) ng/L and (139.15±21.98) μmol/L, respectively .The levels of serum β hCG and plasma ET in PIH group were significantly higher than those in control group (P<0.01) ;while the serum NO levels in PIH group were obviously lower than those of the controls (P<0.01).The changes of these 3 criteria were closely related with the severity of PIH. As for pathological examination, the chorions and vascular endothelial cells of placentas in moderate and severe PIH patients revealed damaged profiles and proliferation of placental trophoblastic cells; no distinct abnormal change was found in placentas of mild PIH patients.ConclusionThe important pathological changes in the placenta of PIH are placental ischemia and hypoxia, leading to proliferation of trophoblastic cells and damage of vascular endothelial cells. The changes in levels of serum β hCG, plasma ET and serum NO may serve as laboratory criteria for diagnosis of PIH.