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目的:探讨子痫前期患者血清维生素结合蛋白4(RBP4)水平变化及其与胰岛素抵抗的相关性。方法:选择在我院住院分娩的单胎妊娠妇女160例,根据有无妊娠并发症及妊娠并发症情况,分为无妊娠并发症组(对照组,A组)35例、妊娠期高血压组(B组)38例、轻度子痫前期组(C组)33例、早发型重度子痫前期组(D组)18例和晚发型重度子痫前期组(E组)36例共5组。采用酶联免疫吸附试验(ELISA)检测各组血清RBP4水平,同时测定血糖、血脂等指标,并计算胰岛素抵抗指数(HOMA-IR)。结果:(1)D、E组三酰甘油(TG)、总胆固醇(TC)水平显著高于A组(P<0.05);各组低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平比较,差异不显著(P>0.05);D组空腹血糖(FPG)、空腹胰岛素(FINS)、HOMA-IR及RBP4水平,均显著或非常显著高于其他组(P<0.05,P<0.01);C组FINS水平显著高于A组和B组(P<0.05);E组FPG水平非常显著高于A组(P<0.01),FINS水平显著高于A组和B组(P<0.05),HOMA-IR及RBP4水平非常显著高于A、B、C组(P<0.01)。(2)RBP4与妊娠期呈非常显著负相关(P<0.01),与收缩压、FPG、FINS、HOMA-IR呈显著或非常显著正相关(P<0.05,P<0.01)。(3)仅FPG、FINS及HOMA-IR进入RBP4的回归方程。结论:重度子痫前期妊娠妇女血清RBP4水平增高,且存在糖脂代谢异常及胰岛素抵抗,这些变化在早发型重度子痫前期妊娠妇女中更为显著,RBP4可能通过增加胰岛素抵抗在子痫前期发病中发挥一定作用。
Objective: To investigate the changes of serum vitamin Binding Protein 4 (RBP4) level in patients with preeclampsia and its relationship with insulin resistance. Methods: One hundred and sixty-one singleton pregnant women were selected for hospital delivery in our hospital. According to the presence or absence of pregnancy complications and pregnancy complications, 35 pregnant women with pregnancy-induced complications (control group, group A) (Group B) 38 cases, mild preeclampsia group (group C) 33 cases, early-onset severe preeclampsia group (group D) and late-onset severe preeclampsia group (group E) . Serum RBP4 levels were measured by enzyme-linked immunosorbent assay (ELISA), and blood glucose, blood lipid and other indicators were measured at the same time, and insulin resistance index (HOMA-IR) was calculated. Results: (1) The triglyceride (TG) and total cholesterol (TC) of group D and E were significantly higher than that of group A (P <0.05). The levels of LDL-C and high density lipoprotein The levels of fasting blood glucose (FPG), fasting insulin (FINS), HOMA-IR and RBP4 in group D were significantly higher than those in other groups (P <0.05) <0.05, P <0.01). The FINS level in group C was significantly higher than that in group A and B (P <0.05). The level of FPG in group E was significantly higher than that in group A (P <0.01) B group (P <0.05). The levels of HOMA-IR and RBP4 were significantly higher than those in A, B and C groups (P <0.01). (2) RBP4 had a significantly negative correlation with gestational age (P <0.01), and had a significant or very significant positive correlation with SBP, FPG, FINS and HOMA-IR (P <0.05, P <0.01). (3) Only regression equations of FPG, FINS and HOMA-IR into RBP4. CONCLUSIONS: Serum levels of RBP4 in pregnant women with severe preeclampsia increase and there are abnormalities of glucose and lipid metabolism and insulin resistance. These changes are more significant in pre-pregnant women with severe preeclampsia, and RBP4 may increase insulin resistance in preeclampsia In a certain role.