本文選題：子癇前期　切入點(diǎn)：抵抗素　出處：《河北醫(yī)科大學(xué)》2014年碩士論文

【摘要】：子癇前期為妊娠期特有的合并癥,威脅著母嬰健康,其發(fā)病率約為5%-12%,初產(chǎn)婦中約為3%-7%,而經(jīng)產(chǎn)婦則為1%-3%。研究表明血管內(nèi)皮受損、胰島素抵抗、胎盤(pán)淺著床、氧化應(yīng)激以及胎盤(pán)缺血等多種因素均可導(dǎo)致子癇前期的發(fā)生�，F(xiàn)一致認(rèn)為該病主要的病理生理改變?yōu)槿硇⊙墀d攣,內(nèi)皮損傷及局部缺血。研究資料表明血管內(nèi)皮細(xì)胞的炎性反應(yīng)、胰島素抵抗(insulin resistance, IR)以及脂肪細(xì)胞的降脂作用都與血管內(nèi)皮功能紊亂相關(guān)。而脂肪細(xì)胞分泌的抵抗素(resistin)、脂聯(lián)素(adiponectin)和Apelin與血管內(nèi)皮的炎癥反應(yīng)及胰島素抵抗密切關(guān)聯(lián)。胰島素抵抗、細(xì)胞內(nèi)皮損傷均促進(jìn)或加重了妊娠期高血壓疾病的發(fā)生發(fā)展。Apelin作為-種炎癥因子,參與機(jī)體的炎癥反應(yīng)及細(xì)胞生長(zhǎng)發(fā)育,凋亡等過(guò)程。脂聯(lián)素可通過(guò)激活TNF-α、NF-κB途徑以及對(duì)炎癥細(xì)胞的直接反應(yīng)發(fā)揮抗炎作用。抵抗素可激活P38MAPK與磷脂酶C信號(hào)通路等途徑進(jìn)而參與炎癥過(guò)程。目的：檢測(cè)Apelin、脂聯(lián)素以及抵抗素在子癇前期患者的表達(dá)情況,以分析三者與妊娠高血壓疾病的關(guān)系,進(jìn)而探討三者在子癇前期發(fā)病中的作用與機(jī)制,為子癇前期的預(yù)防及治療提供參考。方法：1研究對(duì)象：(1)實(shí)驗(yàn)組：選取于2013年3月-2014年2月在我院(滄州市人民醫(yī)院)住院分娩的確診子癇前期患者60例,其中子癇前期輕度患者和子癇前期重度患者各30例；(2)對(duì)照組：隨機(jī)選擇同期在本院住院分娩的正常孕晚期孕婦30例。兩組孕婦均無(wú)糖尿病、慢性高血壓、慢性肝病、腎病及免疫系統(tǒng)疾病等內(nèi)外科疾病。2實(shí)驗(yàn)方法：留取清晨空腹肘靜脈血4 ml,離心(2000 r/min)10 min,分離血清,-70℃冰箱保存?zhèn)溆�。酶�?lián)免疫吸附法測(cè)定抵抗素、脂聯(lián)素以及Apelin的水平。3統(tǒng)計(jì)學(xué)處理：采用統(tǒng)計(jì)軟件SPSS 13.0對(duì)所有數(shù)據(jù)結(jié)果進(jìn)行統(tǒng)計(jì)學(xué)分析,①計(jì)量資料采用單因素方差分析,②兩組間比較用t檢驗(yàn),③兩變量間的相關(guān)性分析用Spearman等級(jí)相關(guān)分析。各組對(duì)照結(jié)果以P0.05作為差異顯著性標(biāo)準(zhǔn)。結(jié)果：1重度子癇前期孕婦的Apelin水平顯著高于輕度子癇前期孕婦與對(duì)照組孕婦,分別為92.40±7.99、68.56±6.29和51.21±6.01 ng/L；三組中Apelin水平有明顯差異,均有統(tǒng)計(jì)學(xué)意義(P0.05)。2重度子癇前期孕婦的血清脂聯(lián)素水平顯著低于輕度子癇前期孕婦與對(duì)照組孕婦,分別為4.61±2.12、7.12±2.65和12.14±3.56pg/ml;三組間血清脂聯(lián)素水平有明顯差異,均有統(tǒng)計(jì)學(xué)意義(P0.05)。3重度子癇前期孕婦的血清抵抗素水平顯著高于輕度子癇前期孕婦與對(duì)照組孕婦,分別為28.75±5.01、21.69±5.12和14.02±4.41 ug/L；三組間血清抵抗素水平有明顯差異,均有統(tǒng)計(jì)學(xué)意義(P0.05)。4三組血清Apelin水平和脂聯(lián)素水平均成負(fù)相關(guān)(r=-0.597,P0.01; r=-0.786,PO.01;r=-0.636,P0.01);三組抵抗素水平與脂聯(lián)素水平均成負(fù)相關(guān)(r=-0.764,P0.05；r=-0.528,P0.05;r=-0.540,P0.05)。結(jié)論：1在本次研究的三組患者的血清中抵抗素、脂聯(lián)素以及Apelin均有表達(dá),而且子癇前期病情越重,抵抗素和Apelin的表達(dá)水平越高；脂聯(lián)素的表達(dá)水平越低。抵抗素、脂聯(lián)素以及Apelin均參與了子癇前期的發(fā)生發(fā)展。2子癇前期患者血清中的脂聯(lián)素與Apelin和抵抗素均為負(fù)相關(guān),三者相互作用,共同影響著子癇前期的發(fā)生和發(fā)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.

【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R714.244
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本文編號(hào)：1679927