子痫前期患者子宫动脉多普勒与血清chemerin的变化及意义
|
摘要
目的:讨论妊娠期高血压孕妇和正常妊娠妇女妊娠早、中、晚期子宫动脉血流变化及血清chemerin变化的规律及意义。方法:选取潍坊市妇幼保健院系统产前检查的孕妇共300例作为研究对象,分别于妊娠14周、24周、34周收集和测量两组孕妇的血液样本和子宫动脉多普勒信息。比较两组孕妇血清chemerin浓度,子宫动脉舒张末期流速(S/D)、搏动指数(PI)、阻力指数(RI)。结果:1)子痫前期患者血清中chemerin浓度明显高于对照组(P<0.05),且重度子痫前期组明显高于轻度子痫前期组(P<0.05)。2)子宫动脉血流动态变化:正常妊娠组孕妇随妊娠进展,子宫动脉RI、PI、S/D 3项指标逐渐降低,妊娠早、中、晚期分别比较,均有统计学差异(P<0.01)。子痫前期组孕妇子宫动脉RI、PI、S/D 3项指标以孕晚期最高,妊娠早、中、晚期分别比较,均有统计学差异(P<0.01)。子痫前期组孕妇妊娠中、晚期子宫动脉3项指标均高于正常妊娠组,有统计学差异(P<0.01)。3)子痫前期患者血清中chemerin浓度在孕早期与子宫动脉血流无明显相关性,在妊娠中晚期呈明显正相关。结论:随着妊娠进展,子痫前期患者血清中chemerin浓度逐渐升高,正常妊娠妇女子宫动脉的血流阻力逐渐下降;而子痫前期组孕妇随妊娠进展子宫动脉的血流阻力明显升高。两者共同参与妊娠期高血压的发病。
Objective:To discuss the regularity and significance of the changes of uterine artery blood flow and serum Chemerin in pregnant women with pregnancy induced hypertension and normal pregnant women.Methods:A total of 300 pregnant women in Weifang maternal and child health care system were selected as the research objects.Blood samples and uterine artery Doppler in two groups were collected and measured at 14 weeks,24 weeks and 34 weeks.The concentrations of Chemerin in the two groups of pregnant women,the end diastolic flow rate(S/D),the pulsatile index(PI)and the resistance index(RI)of the uterine artery were compared.Results:1)the serum Chemerin concentration in preeclampsia patients was significantly higher than that in the control group(P <0.05),and the severe preeclampsia group was significantly higher than that in the mild preeclampsia group(P <0.05).2)the dynamic changes of uterine artery blood flow showed that 3 indexes of RI,PI and S/D of uterine artery decreased gradually in pregnant women in normal pregnancy group,and the difference was statistically significant in early,middle and late pregnancy(P <0.01).3 indexes of RI,PI and S/D of uterine artery in preeclampsia group,The highest in the late pregnancy,the difference of early,middle and late pregnancy were statistically significant(P <0.01).Pregnant and late preeclampsia pregnant women,The 3 indexes of uterine artery were all higher than those of normal pregnancy group,and the difference was statistically significant(P <0.01).3)The serum concentration of Chemerin in preeclampsia had no significant correlation with the uterine artery blood flow in the early pregnancy,and there was a significant positive correlation in the middle and late pregnancy.Conclusion:As the pregnancy progresses,the serum levels of Chemerin in preeclampsia patients increase gradually.The blood flow resistance of uterine artery decreased gradually in normal pregnant women.In the preeclampsia group,the blood flow resistance of the uterine arteries increased significantly with the progressing of pregnancy.Both are involved in the onset of pregnancy induced hypertension.
Objective:To discuss the regularity and significance of the changes of uterine artery blood flow and serum Chemerin in pregnant women with pregnancy induced hypertension and normal pregnant women.Methods:A total of 300 pregnant women in Weifang maternal and child health care system were selected as the research objects.Blood samples and uterine artery Doppler in two groups were collected and measured at 14 weeks,24 weeks and 34 weeks.The concentrations of Chemerin in the two groups of pregnant women,the end diastolic flow rate(S/D),the pulsatile index(PI)and the resistance index(RI)of the uterine artery were compared.Results:1)the serum Chemerin concentration in preeclampsia patients was significantly higher than that in the control group(P <0.05),and the severe preeclampsia group was significantly higher than that in the mild preeclampsia group(P <0.05).2)the dynamic changes of uterine artery blood flow showed that 3 indexes of RI,PI and S/D of uterine artery decreased gradually in pregnant women in normal pregnancy group,and the difference was statistically significant in early,middle and late pregnancy(P <0.01).3 indexes of RI,PI and S/D of uterine artery in preeclampsia group,The highest in the late pregnancy,the difference of early,middle and late pregnancy were statistically significant(P <0.01).Pregnant and late preeclampsia pregnant women,The 3 indexes of uterine artery were all higher than those of normal pregnancy group,and the difference was statistically significant(P <0.01).3)The serum concentration of Chemerin in preeclampsia had no significant correlation with the uterine artery blood flow in the early pregnancy,and there was a significant positive correlation in the middle and late pregnancy.Conclusion:As the pregnancy progresses,the serum levels of Chemerin in preeclampsia patients increase gradually.The blood flow resistance of uterine artery decreased gradually in normal pregnant women.In the preeclampsia group,the blood flow resistance of the uterine arteries increased significantly with the progressing of pregnancy.Both are involved in the onset of pregnancy induced hypertension.
引文
[1] Emst M C.Chemerin exacerbates glucose intolerance in mouse models of obesity and diabetes[J].Endocrinology,2013,151(05):1998-2007.
[2] 张志杰,刘惠琴,王芳,等.脂肪细胞因子Chemerin表达水平对妊娠期高血压的影响分析[J].中国卫生标准管理,2018,09(04):39-41
[3] Xu Q L.The predictive value of the first-trimester maternal serum chemerin level for pre-eclampsia[J].Peptides,2014,(62):150-154.
[4] Stepan H,Philipp A,Roth I,et al.Serum levels of the adipokine chemerin are increased in preeclampsia during and 6 months after pregnancy[J].Regul Pept,2015,168(1-3):69-72.
[5] 温玉玲,郁丁.妊娠期高血压疾病患者子宫螺旋动脉特征的超声评估及其与胎盘缺氧损伤的相关性[J].海南医学院学报,2017,23(23):3259-3262,3266.
[2] 张志杰,刘惠琴,王芳,等.脂肪细胞因子Chemerin表达水平对妊娠期高血压的影响分析[J].中国卫生标准管理,2018,09(04):39-41
[3] Xu Q L.The predictive value of the first-trimester maternal serum chemerin level for pre-eclampsia[J].Peptides,2014,(62):150-154.
[4] Stepan H,Philipp A,Roth I,et al.Serum levels of the adipokine chemerin are increased in preeclampsia during and 6 months after pregnancy[J].Regul Pept,2015,168(1-3):69-72.
[5] 温玉玲,郁丁.妊娠期高血压疾病患者子宫螺旋动脉特征的超声评估及其与胎盘缺氧损伤的相关性[J].海南医学院学报,2017,23(23):3259-3262,3266.