中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2013年
7期
490-493
,共4页
吴英%余艳红%钟梅%龚时鹏%李青%刘士三
吳英%餘豔紅%鐘梅%龔時鵬%李青%劉士三
오영%여염홍%종매%공시붕%리청%류사삼
先兆子痫%眼蛋白质类%神经生长因子类%舍平类%胎盘%新生血管化,病理性
先兆子癇%眼蛋白質類%神經生長因子類%捨平類%胎盤%新生血管化,病理性
선조자간%안단백질류%신경생장인자류%사평류%태반%신생혈관화,병이성
Pre-eclampsia%Eye proteins%Nerve growth factors%Serpins%Placenta%Neovascularization,pathologic
目的 探讨胎盘组织中色素上皮衍生因子(PEDF)蛋白表达及其与胎盘血管生成的机制在子痫前期发病中的作用.方法 选取2011年10月至2013年1月在南方医科大学南方医院妇产科住院分娩的子痫前期孕妇60例,分为子痫前期轻度组30例,子痫前期重度组30例；同期分娩的健康妊娠晚期孕妇40例作为对照组.采用蛋白印迹和免疫组化SP法测定各组孕妇胎盘组织中PEDF蛋白的表达,计数胎盘微血管密度(MVD),对胎盘组织中PEDF蛋白表达与MVD进行相关性分析.结果 (1)胎盘病理:子痫前期轻度组和重度组胎盘重量明显减轻,绒毛血管数量减少,管腔狭窄,滋养细胞基底膜增厚；合体滋养细胞结节状增生,伴灶性梗死、纤维素样坏死或血栓形成.而对照组胎盘组织则无上述病理改变.(2) PEDF蛋白表达:子痫前期轻度组、子痫前期重度组和对照组胎盘PEDF蛋白表达水平分别为0.63 ±0.09、0.93±0.07和0.47 ±0.04,子痫前期轻度组及子痫前期重度组胎盘PEDF蛋白表达水平显著高于对照组,分别比较,差异有统计学意义(P＜0.05)；且子痫前期重度组显著高于子痫前期轻度组,两组比较,差异有统计学意义(P＜0.05).(3)MVD检测:子痫前期轻度组、子痫前期重度组和对照组胎盘组织中MVD水平分别为106 ±9、93 ±8、136 ±9,子痫前期轻度组及重度组显著低于对照组,分别比较,差异有统计学意义(P＜0.05),且子痫前期重度组显著低于子痫前期轻度组,两组比较,差异有统计学意义(P＜0.05).(4)相关性分析:子痫前期轻度组及子痫前期重度组胎盘组织中PEDF蛋白表达与MVD均呈负相关(分别为r=-0.426,P ＜0.05;r=-0.646,P＜0.05),对照组胎盘组织中PEDF蛋白表达与MVD也呈负相关(r=-0.589,P＜0.05).结论 子痫前期孕妇胎盘组织中PEDF蛋白高表达,导致胎盘血管生成障碍和胎盘发生缺血缺氧性病理改变,从而参与子痫前期的发病与病情进展.
目的 探討胎盤組織中色素上皮衍生因子(PEDF)蛋白錶達及其與胎盤血管生成的機製在子癇前期髮病中的作用.方法 選取2011年10月至2013年1月在南方醫科大學南方醫院婦產科住院分娩的子癇前期孕婦60例,分為子癇前期輕度組30例,子癇前期重度組30例；同期分娩的健康妊娠晚期孕婦40例作為對照組.採用蛋白印跡和免疫組化SP法測定各組孕婦胎盤組織中PEDF蛋白的錶達,計數胎盤微血管密度(MVD),對胎盤組織中PEDF蛋白錶達與MVD進行相關性分析.結果 (1)胎盤病理:子癇前期輕度組和重度組胎盤重量明顯減輕,絨毛血管數量減少,管腔狹窄,滋養細胞基底膜增厚；閤體滋養細胞結節狀增生,伴竈性梗死、纖維素樣壞死或血栓形成.而對照組胎盤組織則無上述病理改變.(2) PEDF蛋白錶達:子癇前期輕度組、子癇前期重度組和對照組胎盤PEDF蛋白錶達水平分彆為0.63 ±0.09、0.93±0.07和0.47 ±0.04,子癇前期輕度組及子癇前期重度組胎盤PEDF蛋白錶達水平顯著高于對照組,分彆比較,差異有統計學意義(P＜0.05)；且子癇前期重度組顯著高于子癇前期輕度組,兩組比較,差異有統計學意義(P＜0.05).(3)MVD檢測:子癇前期輕度組、子癇前期重度組和對照組胎盤組織中MVD水平分彆為106 ±9、93 ±8、136 ±9,子癇前期輕度組及重度組顯著低于對照組,分彆比較,差異有統計學意義(P＜0.05),且子癇前期重度組顯著低于子癇前期輕度組,兩組比較,差異有統計學意義(P＜0.05).(4)相關性分析:子癇前期輕度組及子癇前期重度組胎盤組織中PEDF蛋白錶達與MVD均呈負相關(分彆為r=-0.426,P ＜0.05;r=-0.646,P＜0.05),對照組胎盤組織中PEDF蛋白錶達與MVD也呈負相關(r=-0.589,P＜0.05).結論 子癇前期孕婦胎盤組織中PEDF蛋白高錶達,導緻胎盤血管生成障礙和胎盤髮生缺血缺氧性病理改變,從而參與子癇前期的髮病與病情進展.
목적 탐토태반조직중색소상피연생인자(PEDF)단백표체급기여태반혈관생성적궤제재자간전기발병중적작용.방법 선취2011년10월지2013년1월재남방의과대학남방의원부산과주원분면적자간전기잉부60례,분위자간전기경도조30례,자간전기중도조30례；동기분면적건강임신만기잉부40례작위대조조.채용단백인적화면역조화SP법측정각조잉부태반조직중PEDF단백적표체,계수태반미혈관밀도(MVD),대태반조직중PEDF단백표체여MVD진행상관성분석.결과 (1)태반병리:자간전기경도조화중도조태반중량명현감경,융모혈관수량감소,관강협착,자양세포기저막증후；합체자양세포결절상증생,반조성경사、섬유소양배사혹혈전형성.이대조조태반조직칙무상술병리개변.(2) PEDF단백표체:자간전기경도조、자간전기중도조화대조조태반PEDF단백표체수평분별위0.63 ±0.09、0.93±0.07화0.47 ±0.04,자간전기경도조급자간전기중도조태반PEDF단백표체수평현저고우대조조,분별비교,차이유통계학의의(P＜0.05)；차자간전기중도조현저고우자간전기경도조,량조비교,차이유통계학의의(P＜0.05).(3)MVD검측:자간전기경도조、자간전기중도조화대조조태반조직중MVD수평분별위106 ±9、93 ±8、136 ±9,자간전기경도조급중도조현저저우대조조,분별비교,차이유통계학의의(P＜0.05),차자간전기중도조현저저우자간전기경도조,량조비교,차이유통계학의의(P＜0.05).(4)상관성분석:자간전기경도조급자간전기중도조태반조직중PEDF단백표체여MVD균정부상관(분별위r=-0.426,P ＜0.05;r=-0.646,P＜0.05),대조조태반조직중PEDF단백표체여MVD야정부상관(r=-0.589,P＜0.05).결론 자간전기잉부태반조직중PEDF단백고표체,도치태반혈관생성장애화태반발생결혈결양성병리개변,종이삼여자간전기적발병여병정진전.
Objective To investigate the effect of pigment epithelium-derived factor (PEDF) on the pathogenesis of preeclampsia disease,by detecting the expression of PEDF in the placentas,as well as the relationship between PEDF and the production of placental vessels.Methods A study was performed in 60 cases of pregnant women with preeclampsia in the obstetrical department of Nanfang Hospital affiliated to southern medical university from October 2011 to January 2013,in which 30 cases were patients with mild preeclampsia(mPE) and other 30 cases were those with severe preeclampsia (sPE).40 normal pregnant women who also been hospitalized and delivered were selected as control group.The expression of PEDF and micro-vessel density (MVD) in placentas were assayed by using western blot and SP immunohistochemical method,then the relationship between PEDF and MVD was analyzed.Results (1) The pathological changes of placentas:the placental weight were lightened obviously in the mild preeclampsia and severe preeclampsia groups,the reduced blood vessels and luminal stegnosis were found in chorionic villus,basement membrane of trophocytes were thickening.The hyperplasia syneytiotrophoblast were like nodosity,with focus infarction,fibrinoid necrosis,or thrombogenesis.While there was no the above mentioned pathological alteration in normal control group.(2)The levels of PEDF expression in mild and severe preeclampsia group were 0.63 ± 0.09,0.93 ± 0.07,while 0.47 ± 0.04 in control group,which in mild and sever preeclampsia groups were significantly higher than that in normal group (P ＜ 0.05).Compared to mild preeclampsia group,the expression of PEDF was significantly increased in severe preeclampsia group,there was statistical significance between the difference (P ＜ 0.05).(3) The amount of microvessel density (MVD) in mild and severe preeclampsia group were 106 ±9,93 ±8,while 136 ±9 in control group,which were significantly reduced in mild and severe preeclampsia group,compared to that in normal control group (P ＜ 0.05).And it was significantly lower in severe preeclampsia group than that in mild preeclampsia group (P ＜ 0.05).(4) The expression of PEDF was negatively correlated with the amount of MVD in mild and severe preeclampsia group (r =-0.426,P ＜ 0.05 ; and r =-0.646,P ＜ 0.05 respectively),which was also negative in control group (r =-0.589,P ＜ 0.05).Conclusion Increased PEDF expression in placentas of women with preeclampsia induce the dysfunction of the placental vascular reconstruction and the pathological alteration like ischemic and hypoxia in placentas,which may be involved in pathogenesis and pathogenic progress of preeclampsia.
