妊高征眼底视网膜血管病变与雌激素 孕激素水平的相关性研究

A study of relativity between retinal vascular lesions and serum estrogens and progestins levels in patients with pregnancy-induced hypertension

目的 :探讨血清 6种雌激素、孕激素在妊高征眼底视网膜血管病变发病中的作用以及与临床症状的相关性 ,研究妊高征患者眼底视网膜病变的分子机制。方法 :随机选择符合诊断标准的 75例住院妊高征病人作为研究组 ,正常足月妊娠待产孕妇 2 0例为对照组。专人检查妊高征病人产前、产后眼底视网膜病变情况 ,采用放射免疫分析法检测轻、中、重度妊高征产前和产后血清 6种激素水平。结果 :重度妊高征组血清 FSH水平显著高于正常妊娠组 ,而血清 PRL、 E2水平明显低于正常妊娠组 ;轻度、中度妊高征组血清 PRL水平显著低于正常妊娠组 ;中度妊高征组血清 E2水平显著低于正常妊娠组 ;妊高征患者产后血清 FSH水平明显低于正常妊娠组 ,而产后血清 PRL 水平显著高于正常妊娠组。血清孕酮、雌二醇水平与妊高征眼底病变高度相关。结论 :血清雌激素、孕激素水平与妊高征病情严重程度有关 ,可能在妊高征眼底视网膜病变发生发展过程中发挥重要作用。

Objective: To investigate the role of pathogenesis, symptomatic relativity, and molecular mechanisms of 6 kinds of serum levels of estrogens and progestins in retinal vascular lesions of patients with pregnancy induced hypertension. Methods: Seventy five patients with pregnancy induced hypertension according to diagnostic criteria were randomly selected as study group. Twenty women with physiologic full term pregnancy were as control group. Retinal lesions were examined by single ophthalmologist before and after delivery. By using radioimmunoassay, 6 kinds of serum estrogens and progestrogens levels were determined before and after childbirth in mild, moderate, and severe pregnancy induced hypertension patients. Results: In the severe pregnancy induced hypertension group, serum follicle stimulating hormone(FSH)level was significantly higher than that in physiologic pregnancy group, while serum prolactin(PRL) and estradiol(E 2) levels were significantly lower in former group than that in latter one. In mild and moderate pregnancy induced hypertension group, serum PRL level was significantly lower than that in physiologic pregnancy group. Serum E 2 level was significantly lower in moderate pregnancy induced hypertension than that in physiologic pregnancy group. After delivery, serum FSH level in pregnancy induced hypertension group was significantly lower. Retinal vascular lesions correlated highly with serum progesterone and estradiol levels. Conclusion: Levels of estrogens and progestins in the serum have good correlativity to the severity of retinal vascular lesions in patients with pregnancy induced hypertension. It is suggested that estrogens and progestins levels in the serum may play an important role in the occurrence and development of retinal vascular lesions in pregnancy induced hypertension.