脂联素、Apelin、抵抗素在子痫前期发病中的作用及相关性分析

发布时间：2018-03-29 06:25

  本文选题：子痫前期　切入点：抵抗素　出处：《河北医科大学》2014年硕士论文

【摘要】：子痫前期为妊娠期特有的合并症,威胁着母婴健康,其发病率约为5%-12%,初产妇中约为3%-7%,而经产妇则为1%-3%。研究表明血管内皮受损、胰岛素抵抗、胎盘浅着床、氧化应激以及胎盘缺血等多种因素均可导致子痫前期的发生。现一致认为该病主要的病理生理改变为全身小血管痉挛,内皮损伤及局部缺血。研究资料表明血管内皮细胞的炎性反应、胰岛素抵抗(insulin resistance, IR)以及脂肪细胞的降脂作用都与血管内皮功能紊乱相关。而脂肪细胞分泌的抵抗素(resistin)、脂联素(adiponectin)和Apelin与血管内皮的炎症反应及胰岛素抵抗密切关联。胰岛素抵抗、细胞内皮损伤均促进或加重了妊娠期高血压疾病的发生发展。Apelin作为-种炎症因子,参与机体的炎症反应及细胞生长发育,凋亡等过程。脂联素可通过激活TNF-α、NF-κB途径以及对炎症细胞的直接反应发挥抗炎作用。抵抗素可激活P38MAPK与磷脂酶C信号通路等途径进而参与炎症过程。目的：检测Apelin、脂联素以及抵抗素在子痫前期患者的表达情况,以分析三者与妊娠高血压疾病的关系,进而探讨三者在子痫前期发病中的作用与机制,为子痫前期的预防及治疗提供参考。方法：1研究对象：(1)实验组：选取于2013年3月-2014年2月在我院(沧州市人民医院)住院分娩的确诊子痫前期患者60例,其中子痫前期轻度患者和子痫前期重度患者各30例；(2)对照组：随机选择同期在本院住院分娩的正常孕晚期孕妇30例。两组孕妇均无糖尿病、慢性高血压、慢性肝病、肾病及免疫系统疾病等内外科疾病。2实验方法：留取清晨空腹肘静脉血4 ml,离心(2000 r/min)10 min,分离血清,-70℃冰箱保存备用。酶联免疫吸附法测定抵抗素、脂联素以及Apelin的水平。3统计学处理：采用统计软件SPSS 13.0对所有数据结果进行统计学分析,①计量资料采用单因素方差分析,②两组间比较用t检验,③两变量间的相关性分析用Spearman等级相关分析。各组对照结果以P0.05作为差异显著性标准。结果：1重度子痫前期孕妇的Apelin水平显著高于轻度子痫前期孕妇与对照组孕妇,分别为92.40±7.99、68.56±6.29和51.21±6.01 ng/L；三组中Apelin水平有明显差异,均有统计学意义(P0.05)。2重度子痫前期孕妇的血清脂联素水平显著低于轻度子痫前期孕妇与对照组孕妇,分别为4.61±2.12、7.12±2.65和12.14±3.56pg/ml;三组间血清脂联素水平有明显差异,均有统计学意义(P0.05)。3重度子痫前期孕妇的血清抵抗素水平显著高于轻度子痫前期孕妇与对照组孕妇,分别为28.75±5.01、21.69±5.12和14.02±4.41 ug/L；三组间血清抵抗素水平有明显差异,均有统计学意义(P0.05)。4三组血清Apelin水平和脂联素水平均成负相关(r=-0.597,P0.01; r=-0.786,PO.01;r=-0.636,P0.01);三组抵抗素水平与脂联素水平均成负相关(r=-0.764,P0.05；r=-0.528,P0.05;r=-0.540,P0.05)。结论：1在本次研究的三组患者的血清中抵抗素、脂联素以及Apelin均有表达,而且子痫前期病情越重,抵抗素和Apelin的表达水平越高；脂联素的表达水平越低。抵抗素、脂联素以及Apelin均参与了子痫前期的发生发展。2子痫前期患者血清中的脂联素与Apelin和抵抗素均为负相关,三者相互作用,共同影响着子痫前期的发生和发展。。
[Abstract]:Preeclampsia is a pregnancy specific complications, threatening the health of mother and infant, the incidence rate is about 5%-12%, at about 3%-7% of pregnant women, and for the 1%-3%. study showed that maternal vascular endothelial damage, insulin resistance, shallow placental implantation, many factors can lead to oxidative stress and placental ischemia pre eclampsia. Agreed that the pathophysiology of the disease mainly changed into small systemic vascular spasm, endothelial injury and ischemia. Research data show that the inflammatory response of vascular endothelial cells, insulin resistance (insulin resistance, IR) and fat cells have lipid-lowering effect and vascular endothelial dysfunction. The fat cells secrete resistin (resistin). Adiponectin (adiponectin) and inflammatory reaction and insulin resistance Apelin and vascular endothelial cells is closely related to insulin resistance, both promote endothelial injury or heavy pregnancy high blood The pressure of disease occurrence and development of.Apelin as an inflammatory factor, inflammatory reaction and cells involved in the body's growth and development, apoptosis. Adiponectin can activate TNF- alpha, the anti-inflammatory effect of NF- kappa B pathway and a direct response to inflammatory cells. Resistin can activate P38MAPK and phospholipase C signaling pathways and pathways involved in the inflammatory process objective: to detect Apelin, adiponectin and resistin expression in preeclampsia patients, to analyze the relationship between the three with hypertensive disorders of pregnancy, and to explore the mechanism and the three in the pathogenesis of preeclampsia, and provide reference for the prevention and treatment of preeclampsia. Methods: 1 subjects: (1) experimental group: selected in March 2013 February -2014 in our hospital (Cangzhou People's Hospital) diagnosed 60 patients with preeclampsia pregnant patients, including mild pre eclampsia and preeclampsia severe patients In 30 cases; (2): the control group were randomly selected in normal pregnancy childbirth in our hospital in 30 cases. Two groups of pregnant women without diabetes, chronic hypertension, chronic liver disease,.2 nephropathy experimental method of surgical diseases and diseases of the immune system such as: take2ml venous blood of all 4 ml, centrifuged (2000 r/min) 10 min, separation of serum, -70 C refrigerator spare. Determination of resistin ELISA, adiponectin and Apelin level.3 statistics: using SPSS 13 statistical software to all of the data were statistically analyzed by one-way ANOVA of the measurement data, the two groups using t test, correlation the two variables analyzed by Spearman rank correlation analysis. The results were controlled by P0.05 as the difference standard. Results: 1 severe preeclampsia Apelin level was significantly higher than that of mild pre eclampsia and control Groups of pregnant women were 92.40 + 7.99,68.56 + 6.29 and 51.21 + 6.01 ng/L; Apelin levels in the three groups have obvious differences, statistically significant (P0.05) the level of serum adiponectin in.2 severe preeclampsia was significantly lower than mild preeclampsia in pregnant women and pregnant women in the control group, were 4.61 + 2.12,7.12 + 2.65 and 12.14 + three 3.56pg/ml; group the serum adiponectin levels were significantly different, statistically significant (P0.05) the serum resistin level in.3 severe preeclampsia was significantly higher than that of mild preeclampsia in pregnant women and pregnant women in the control group, were 28.75 + 5.01,21.69 + 5.12 and 14.02 + 4.41 ug/L; serum resistin levels between the three groups have obvious differences were statistically significant (P0.05)..4 three serum Apelin levels and adiponectin levels were negatively correlated (r=-0.597, P0.01; r=-0.786, PO.01; r=-0.636, P0.01); the three group resistance levels and adiponectin levels were negatively. Close (r=-0.764, P0.05; r=-0.528, P0.05; r=-0.540, P0.05). Conclusion: 1 in serum of three groups of patients in this study, the expression of adiponectin and resistin, Apelin and preeclampsia were more severe, the expression level of resistin and Apelin is higher; the expression level of adiponectin is lower. Resistin, adiponectin and Apelin are involved in the occurrence and development of preeclampsia.2 in patients with preeclampsia in serum adiponectin and resistin and Apelin were negatively correlated, the interaction between the three, affect the occurrence and development of preeclampsia.

【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.244
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本文编号：1679927