孕妇血清中Chemerin水平变化与子痫前期发病的关系与临床意义

Changes in serum chemerin level in pregnant women with severe pre-eclampsia and eclampsia

摘要:

目的：探讨孕妇血清中脂肪因子chemerin水平变化与重度子痫前期（severe preeclampsia，SPE）及子痫发病的关系及临床意义。方法：2011年至2012年在本院分娩的SPE孕妇50例及子痫2例为研究组：早发型SPE32例，晚发型SPE18例，其中并发胎儿生长受限（fetal growth restriction，FGR）12例；选择同期妊娠结局正常孕妇 30例作为对照组。采用酶联免疫吸附法检测各组血清chemerin蛋白表达，分析血清chemerin蛋白水平变化与发病的关系。结果：研究组孕妇血清chemerin水平为（422.30±60.72） ng/L明显高于正常妊娠组（316.2±47.87） ng/L，2组比较差异有统计学意义（P=0.000）；研究组中早发型SPE孕妇血清中chemerin水平为（420.94±69.71） ng/L，晚发型SPE孕妇为（424.89±40.22） ng/L，两者比较差异无统计学意义（P=0.812）。新生儿出生体质量研究组明显低于同期正常妊娠组，差异有统计学意义（P=0.000），研究组中并发FGR孕妇血清中chemerin水平为（482.17±52.93） ng/L，无FGR孕妇为（404.35±50.97） ng/L，两者比较差异有统计学意义（P=0.000）。相关分析结果显示，血清chemerin与收缩压、舒张压、尿素氮、肌酐、甘油三酯、低密度脂蛋白呈正相关（r=0.698、0.654、0.277、0.235、0.288、0.475，P=0.000、0.000、0.012、0.034、0.009、0.000），而与高密度脂蛋白呈负相关（r=-0.396，P=0.000），与胆固醇无相关（r=0.178、P=0.110）。结论：孕妇血清中chemerin水平升高，可能与SPE及子痫发病有关，并可能影响胎儿的生长发育。

Abstract:

Objective：To discuss the serum chemerin level in pregnant women with severe pre-eclampsia and eclampsia and to ex－plore their relationship． Methods：Fifty patients with severe pre-eclampsia and 2 with eclampsia in Second Affiliated Hospital of Chongqing Medical University from 2011 to 2012 were enrolled. There were 32 cases of early onset pre-eclampsia and 18 cases of late onset pre-eclampsia including 12 cases of fetal growth restriction（FGR）． Thirty normal pregnant women during the same period were taken as control group. Serum chemerin level was determined by ELISA in each group． Results：Serum chemerin level of severe pre-eclampsia and eclampsia group（422.30±60.72） ng/L was higher than that in normal group（316.2±47.87） ng/L（P=0.000）． Serum chemerin level of early onset group（420.94±69.71） ng/L did not differ from that in late onset group（424.89±40.22） ng/L（P=0.812）. Serum chemerin level of FGR sub group（482.17±52.93） ng/L was higher than that in non-FGR sub group（404.35±50.97） ng/L（P=0.000）． Correlation analysis showed that serum chemerin level significantly and positively correlated with systolic blood pressure，diastolic blood pressure，blood urea nitrogen，creatinine，triglycerides and low density lipoprotein（r=0.698，0.654，0.277，0.235，0.288，0.475；P=0.000，0.000，0.012，0.034，0.009，0.000），and negative correlated with high density lipoprotein（r=-0.396，P=0.000）. There was no correlation between serum chemerin level and cholesterol（r=0.178，P=0.110）. Conclusion：The elevated serum chemerin level may contribute to the pathogenesis of severe pre-eclampsia，eclampsia and FGR，and may influence the fetal growth．