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目的探讨血清中血管紧张素Ⅱ-Ⅰ型受体自身抗体水平与子痫前期的关系。方法选择2008年4月至2009年9月在河北唐山开滦医院、唐山妇幼保健院、张家口市张北县医院产科住院分娩的141例子痫前期患者作为病例组,选择同期114例正常妊娠妇女作为对照组,用ELISA法检测两组孕妇血清中血管紧张素Ⅱ-Ⅰ型受体自身抗体的水平,比较组间患者的一般情况,对子痫前期的危险因素进行单因素和多因素logistic回归分析。结果 (1)子痫前期患者的血管紧张素Ⅱ-Ⅰ型受体自身抗体水平高于对照组,差异有统计学意义(P<0.05)。子痫前期组年龄、高血压家族史、体质指数、腹围、低密度脂蛋白、甘油三酯水平均高于对照组,而受教育程度、经济收入水平低于对照组,差异有统计学意义(P<0.05)。(2)重度子痫前期组的血管紧张素Ⅱ-Ⅰ型受体自身抗体水平高于轻度子痫前期组,差异有统计学意义(P<0.05)。(3)多因素logistic回归分析结果显示:血管紧张素Ⅱ-Ⅰ型受体自身抗体、低密度脂蛋白、甘油三酯、空腹血糖是子痫前期独立的危险因素,OR值分别为3.397、2.201、4.167、1.638。结论 (1)血清中血管紧张素Ⅱ-Ⅰ型受体自身抗体水平增加是子痫前期的危险因素。(2)子痫前期患者有心血管疾病危险因素聚集现象。
Objective To investigate the relationship between the level of autoantibodies to angiotensin Ⅱ type Ⅰ receptor and preeclampsia in serum. Methods From April 2008 to September 2009, 141 preeclampsia patients were delivered in Kailuan Hospital, Tangshan MCH Hospital and Zhangbei Hospital of Zhangjiakou City, Hebei Province from April 2008 to September 2009. A total of 114 normal pregnant women In the control group, the serum levels of angiotensin Ⅱ type Ⅰ receptor autoantibodies were detected by ELISA in both groups. The general situation of patients in the two groups was compared. The risk factors of preeclampsia were analyzed by single factor and multivariate logistic regression analysis . Results (1) The levels of angiotensin Ⅱ type Ⅰ receptor autoantibodies in patients with preeclampsia were significantly higher than those in the control group (P <0.05). The pre-eclampsia group’s age, family history of hypertension, body mass index, abdominal circumference, low density lipoprotein, triglyceride levels were higher than those in the control group, while the level of education and economic income were lower than the control group, the difference was statistically significant (P <0.05). (2) The levels of angiotensin Ⅱ type Ⅰ receptor autoantibodies in severe preeclampsia group were higher than those in mild preeclampsia group (P <0.05). (3) Multivariate logistic regression analysis showed that the autoantibodies, the low density lipoprotein, the triglyceride and the fasting blood glucose of the angiotensin Ⅱ type Ⅰ receptor were independent risk factors of preeclampsia, the OR values were 3.397 and 2.201 respectively , 4.167,1.638. Conclusions (1) The increase of autoantibody level of serum angiotensin Ⅱ type Ⅰ receptor is a risk factor of preeclampsia. (2) patients with preeclampsia have cardiovascular disease risk factors aggregation phenomenon.