探讨妊娠期高血压疾病(hypertensive disorder complicating pregnancy，HDCP)患者血清脂联素(adiponectin)、内皮素(endothelin，ET)–1和一氧化氮(nitrogen monoxide，NO)水平变化及其与该疾病发生的关系。

将2007年6月至2008年5月在天津医科大学第二医院妇产科确诊为妊娠期高血压疾病，并住院治疗后手术分娩的82例孕妇中同意接受试验的62例孕妇纳入研究组(n＝62), 包括HDCP组(n＝20)，轻度PE组(n＝20)，重度PE组(n＝19)，子痫组(n＝3)；同期住院手术分娩的正常足月妊娠孕妇纳入对照组(n＝20) (本研究遵循的程序符合天津医科大学第二医院人体试验委员会所制定的伦理学标准，得到该委员会批准，取得受试对象的知情同意，并与其签署临床研究知情同意书)，采用酶联免疫吸附测定(enzyme linked immunosorbent assay，ELISA)法检测定上述各组血清脂联素、内皮素–1水平；用硝酸还原法测定一氧化氮水平。

研究组中，轻、重度PE组和子痫组孕妇的血清脂联素水平及一氧化氮水平呈下降趋势，内皮素–1水平呈上升趋势。轻、重度PE组及子痫组与HDCP组及对照组脂联素水平、内皮素–1及一氧化氮水平比较，差异有显著意义(P<0.05，P<0.01，P<0.01)；重度PE组与轻度PE组比较，差异有显著意义(P<0.05)；子痫组与重度PE组比较，血清脂联素水平呈下降趋势，差异无显著意义(P>0.05)；内皮素–1及一氧化氮水平比较，差异有显著意义(P<0.05; P<0.05)；HDCP组与对照组比较，差异无显著意义(P>0.05)。PE组血清脂联素水平与一氧化氮呈正相关(r＝0.619，P<0.01)，与内皮素–1呈负相关(r＝–0.571, P<0.01)；血清脂联素水平与血压呈显著负相关(r＝–0.516，P<0.01；r＝–0.474, P<0.01)。

脂联素水平降低，可影响血管内皮功能，在妊娠期高血压疾病的发生发展过程中，起一定作用。

To discuss the relationships between gestational women serum levels of adiponectin, endothelin (ET)-1 and nitrogen monoxide (NO) and hypertensive disorder complicating pregnancy(HDCP).

From June 2007 to May 2008, blood samples were obtained from 62 pregnant women with hypertensive disorder complicating pregnancy (20 gestational hypertension, 20 mild preeclampsia, 19 severe preeclampsia, and 3 eclampsia) and 20 normal pregnant women served as control. Informed consent was obtained from all participates. The serum levels of adiponectin, endothelin-1 were analyzed by enzyme-linked immunosorbent assay (ELISA) and the level of nitrogen monoxide was determined by the method of nitric acid recovery.

The serum levels of adiponectin, nitrogen monoxide in normal, gestational hypertension, mild preeclampsia, severe preeclampsia and eclampsia groups were gradually declined, but the serum levels of endothelin-1 in those groups were gradually increased. There had significant difference of the serum levels of adiponectin, endothelin-1 and nitrogen monoxide between preeclampsia, eclampsia group and gestational hypertension, control group (P<0.05, P<0.01). There had significant difference between serve preeclampsia group and mild preeclampsia group (P<0.05). There had no significant difference of serum level of adiponectin between eclampsia group and serve preeclampsia group (P>0.05), but had significant difference of endothelin-1 and nitrogen monoxide. However, no significant difference was found between the gestational hypertension and control group (P>0.05). There was positive correlation between the serum level of adiponectin and nitrogen monoxide (r=0.619, P<0.01), and there was inverse correlation between the serum level of adiponectin and endothelin-1(r=-0.571, P<0.01) in the preeclampsia and eclampsia group. There was inverse correlation between the serum level of adiponectin and blood pressure(r=-0.516, P<0.01; r=-0.474, P<0.01).

The decrease of serum level of adiponectin may effect the vasomotor functions and play a role in the genesis of hypertensive disorder complicating pregnancy.