CAJ | 학술논문

目的：探讨胎盘中血管内皮生长因子（VEGF）及其可溶性受体1（sFlt-1）的变化与妊娠期高血压疾病的关系。方法采用半定量逆转录 PCR 法和免疫组织化学染色法检测20例正常人工流产绒毛组织、40例正常妊娠晚期、40例轻度子痫前期及40例重度子痫前期孕妇胎盘组织中VEGF 及 sFlt-1的表达及胎盘微血管密度（MVD）。结果子痫前期和正常妊娠孕妇绒毛或胎盘中均有VEGF、sFlt-1 mRNA 和蛋白的表达。正常妊娠早期组、正常妊娠晚期组、轻度子痫前期组及重度子痫前期组 VEGF、sFlt mRNA 及蛋白表达水平两两比较差异均具有统计学意义（P 均＜0.01）。随着妊娠的进展，胎盘 MVD 逐渐增加，而在子痫前期孕妇中逐渐减少，组间两两比较差异均有统计学意义（P 均＜0.01）。轻、中度子痫前期胎盘组织中 VEGF 与 sFlt-1 mRNA 和蛋白表达水平均呈负相关（P均＜0.05）。各组绒毛或胎盘组织中 MVD 与 VEGF mRNA 和蛋白表达水平均呈正相关（P 均＜0.05），而与 sFlt-1 mRNA 和蛋白质表达呈负相关（P 均＜0.05）。结论VEGF 和 sFlt-1参与妊娠期高血压疾病的发生、发展，VEGF 和 sFlt-1在妊娠期高血压疾病的发病过程中可能存在着相反的关系，也就是VEGF 对妊娠期高血压疾病的发生具有保护作用而 sFlt-1则对其具有促进作用。
목적：탐토태반중혈관내피생장인자（VEGF）급기가용성수체1（sFlt-1）적변화여임신기고혈압질병적관계。방법채용반정량역전록 PCR 법화면역조직화학염색법검측20례정상인공유산융모조직、40례정상임신만기、40례경도자간전기급40례중도자간전기잉부태반조직중VEGF 급 sFlt-1적표체급태반미혈관밀도（MVD）。결과자간전기화정상임신잉부융모혹태반중균유VEGF、sFlt-1 mRNA 화단백적표체。정상임신조기조、정상임신만기조、경도자간전기조급중도자간전기조 VEGF、sFlt mRNA 급단백표체수평량량비교차이균구유통계학의의（P 균＜0.01）。수착임신적진전，태반 MVD 축점증가，이재자간전기잉부중축점감소，조간량량비교차이균유통계학의의（P 균＜0.01）。경、중도자간전기태반조직중 VEGF 여 sFlt-1 mRNA 화단백표체수평균정부상관（P균＜0.05）。각조융모혹태반조직중 MVD 여 VEGF mRNA 화단백표체수평균정정상관（P 균＜0.05），이여 sFlt-1 mRNA 화단백질표체정부상관（P 균＜0.05）。결론VEGF 화 sFlt-1삼여임신기고혈압질병적발생、발전，VEGF 화 sFlt-1재임신기고혈압질병적발병과정중가능존재착상반적관계，야취시VEGF 대임신기고혈압질병적발생구유보호작용이 sFlt-1칙대기구유촉진작용。
Objective To investigate the relationship between the alterations in placental vascular endothelial growth factor (VEGF)and soluble receptor 1 (sFlt-1 )and hypertension during gestation period.Methods The expression of VEGF and sFlt-1 and microvascular density (MVD)in the villi of twenty healthy women with normal induced abortion and the placental tissues of 40 with late pregnancy,40 with mild pre-eclampsia and 40 with severe preeclampsia were measured using semi-quantitative reverse transcription PCR and immunohistochemical staining.Results At both protein and mRNA levels,VEGF and sFlt-1 were ex-pressed in the villi or placenta from healthy pregnant women and those with preeclampsia.The expression of VEGF and sFlt at both protein and mRNA levels significantly differed between any two groups among early and late pregnancy,mild and severe preeclampsia groups (all P <0.01 ).Along with the development of pregnan-cy,the placental MVD was gradually increased,whereas steadily decreased in pregnant women with preeclamp-sia with statistical significance between any two groups (all P <0.01 ).In the mild and moderate preeclampsia groups,the expression of placental VEGF mRNA and protein was negatively correlated with those of sFlt-1 (all P <0.05).In each group,MVD was positively correlated with expression of VEGF mRNA and protein (all P<0.05).However,MVD was negatively correlated with the expression of sFlt-1 mRNA and protein (all P <0.05).Conclusions VEGF and sFlt-1 participate in the incidence and progression of hypertension during gestation period.These two factors probably play different roles in the process.VEGF is help to prevent the in-cidence of gestational hypertension,whereas sFlt-1 exerts a promoting effect.