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目的:探讨妊娠期高血压疾病患者C反应蛋白(CRP)的变化以及与ET-1、NO的相关性。方法:选择2009年2月～6月在我院住院妊娠期高血压疾病(HDCP)患者40例,根据病情分为妊娠期高血压组(GH)13例,轻度子痫前期组(MP)10例,重度子痫前期组(SP)17例;以同期妊娠末期健康妇女20例为对照组。用酶联免疫吸附法检测血清CRP和ET-1浓度;硝酸还原酶法测定血清NO浓度;将CRP浓度与ET-1、NO做相关性分析。结果:(1)妊娠期高血压疾病组血清CRP(8416.48±3646.64ng/ml),ET-1(340.30±127.16μg/ml)浓度水平均显著高于对照组(1573.60±722.45ng/ml),(61.20±29.44ng/ml);NO(82.69±17.12μmol/L)浓度水平显著低于对照组(105.18±7.12μmol/L),差异有显著的统计学意义(P<0.001);(2)HDCP各组血清CRP(GH:5634.62±1445.57ng/ml)(MP:8027.90±2593.46ng/ml)(SP:10772.35±3845.01ng/ml),ET-1(GH:245.46±62.20μg/ml)(MP:354.30±86.87μg/ml)(SP:404.59±142.41μg/ml)浓度水平较对照组升高,差异有显著的统计学意义(P<0.001)(P<0.001);MP组血清CRP,ET-1浓度水平较GH组升高,差异有统计学意义(P<0.05)(P<0.01);SP组血清CRP,ET-1浓度水平较GH组升高,差异有显著的统计学意义(P<0.001)(P<0.01);SP组血清CRP浓度水平也较MP组高,差异有显著的统计学意义(P<0.01),ET-1浓度水平较MP组有升高趋势,差异无统计学意义(P=0.168);(3)GH血清NO(101.03±4.79μmol/L)浓度水平较对照组(105.18±7.12μmol/L)降低,差异无统计学意义(P=0.197);MP组血清NO(83.47±12.72μmol/L)浓度水平较对照组降低,差异有统计学意义(P<0.001);MP组血清NO浓度水平也较GH组低,差异有统计学意义(P<0.001);SP组血清NO(68.21±10.48μmol/L)浓度水平较对照组、GH组、MP组也降低,差异有显著的统计学意义(P<0.001);(4)CRP浓度与ET-1浓度呈正相关(r=0.805,P=0.000);与NO浓度呈负相关(r=-0.637,P=0.000)。结论:妊娠期高血压疾病患者CRP,ET-1浓度水平升高,NO浓度水平降低,且CRP与ET-1、NO有一定的相关性,临床上可通过检测CRP、ET-1、NO,综合判断病情的发展与预后。
Objective: To investigate the changes of C-reactive protein (CRP) and the relationship with ET-1, NO in patients with hypertensive disorders during pregnancy. Methods: Forty patients with hypertensive disorder complicating pregnancy (HDCP) hospitalized in our hospital from February 2009 to June were divided into three groups: hypertensive pregnancy group (GH) in 13 cases, mild preeclampsia group (MP) 10 cases, severe preeclampsia group (SP) 17 cases; with the same period of pregnancy, 20 healthy women as control group. Serum levels of CRP and ET-1 were detected by enzyme-linked immunosorbent assay (ELISA); Nitric acid reductase method was used to determine serum NO concentration; correlation analysis between CRP concentration and ET-1, NO was done. Results: (1) Serum levels of CRP (8416.48 ± 3646.64ng / ml) and ET-1 (340.30 ± 127.16μg / ml) in gestational hypertension group were significantly higher than those in control group (1573.60 ± 722.45ng / ml) (61.20 ± 29.44ng / ml); NO (82.69 ± 17.12μmol / L) was significantly lower than that of the control group (105.18 ± 7.12μmol / L) Serum CRP (GH: 5634.62 ± 1445.57 ng / ml) (MP: 8027.90 ± 2593.46 ng / ml) (SP: 10772.35 ± 3845.01 ng / ml), ET-1 (GH: 245.46 ± 62.20 μg / ml) MP: 354.30 ± 86.87μg / ml) (SP: 404.59 ± 142.41μg / ml) was significantly higher than that of the control group (P <0.001) The concentration of ET-1 in serum of group SP was higher than that of group GH (P <0.05) (P <0.01). The level of serum CRP and ET-1 in group SP was higher than that of group GH, the difference was statistically significant (P <0.001) (P <0.01). The level of serum CRP in SP group was also significantly higher than that in MP group (P <0.01). The concentration of ET-1 in ET group was higher than that in MP group There was no statistical significance (P = 0.168). (3) The concentration of serum NO in serum of 101.03 ± 4.79μmol / L was lower than that of the control group (105.18 ± 7.12μmol / L) (P = 0.197). The concentration of serum NO in MP group was lower than that in control group (P <0.001), and the level of serum NO in MP group was also lower than that in GH group (P <0.001). The level of serum NO (68.21 ± 10.48μmol / L) in SP group was also lower than that in control group, GH group and MP group (P <0.001), and the difference was statistically significant (4) The concentration of CRP was positively correlated with the concentration of ET-1 (r = 0.805, P = 0.000) and negatively correlated with the concentration of NO (r = -0.637, P = 0.000). Conclusion: CRP, ET-1 levels and NO levels in patients with gestational hypertension are lower than those in patients with gestational hypertension, and there is a correlation between CRP and ET-1 and NO. Clinically, CRP, ET-1, NO, Comprehensive judgment of disease development and prognosis.