中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
Chinese Journal of Obstetrics and Gynecology
2015年
10期
752-756
,共5页
朱锦明%李蕾%李敏%何苗
硃錦明%李蕾%李敏%何苗
주금명%리뢰%리민%하묘
先兆子痫%血栓调节蛋白%胎盘
先兆子癇%血栓調節蛋白%胎盤
선조자간%혈전조절단백%태반
Pre-eclampsia%Thrombomodulin%Placenta
目的 探讨孕妇血浆和胎盘组织中的血栓调节蛋白(TM)表达与早发型重度子痫前期发病的关系.方法 选择2012年6月至2014年2月在徐州医学院附属徐州市妇幼保健院住院分娩的重度子痫前期孕妇60例.其中,早发型重度子痫前期孕妇30例为早发型组,晚发型重度子痫前期孕妇30例为晚发型组,选择同期健康孕妇并根据其孕周不同分为早发型对照组(孕周28~33周+6)23例和晚发型对照组(孕周≥34周)30例.采用ELISA法检测各组孕妇血浆中TM的水平,免疫组化SP法检测胎盘组织中TM蛋白的表达,逆转录(RT)-PCR技术检测胎盘组织中TM mRNA的表达.结果(1)早发型组孕妇血浆TM水平为(90.8 ± 6.9)μg/L,晚发型组为(87.5 ± 7.0)μg/L,早发型对照组为(37.7±2.3)μg/L,晚发型对照组为(37.7±2.5)μg/L.早发型组孕妇血浆TM水平分别高于其他3组,但早发型组与晚发型组比较,差异无统计学意义(P>0.05);早发型组与早发型对照组比较,差异有统计学意义(P<0.05);晚发型组高于晚发型对照组,差异有统计学意义(P<0.05).(2)TM蛋白主要定位于胎盘合体滋养细胞和血管内皮细胞的胞膜及胞质中,早发型组胎盘组织中TM蛋白的阳性表达率(47%,14/30)显著低于晚发型组(90%,27/30)、早发型对照组(91%,21/23)及晚发型对照组(93%,28/30),分别比较,差异均有统计学意义(P<0.05);晚发型组与晚发型对照组比较,差异无统计学意义(P>0.05);早发型对照组与晚发型对照组比较,差异无统计学意义(P>0.05).(3)早发型组胎盘组织中TM mRNA的表达水平为0.14±0.06,晚发型组为0.89±0.23,早发型对照组为0.88±0.22,晚发型对照组为0.93±0.19,早发型组胎盘组织中TM mRNA表达水平显著低于对其他3组,差异均有统计学意义(P<0.05);晚发型组与晚发型对照组比较,差异无统计学意义(P>0.05);早发型对照组与晚发型对照组比较,差异无统计学意义(P>0.05).结论 孕妇胎盘组织中TM表达水平降低可能与早发型重度子痫前期的进展有关;早发型重度子痫前期的发病机制可能与晚发型有所不同.
目的 探討孕婦血漿和胎盤組織中的血栓調節蛋白(TM)錶達與早髮型重度子癇前期髮病的關繫.方法 選擇2012年6月至2014年2月在徐州醫學院附屬徐州市婦幼保健院住院分娩的重度子癇前期孕婦60例.其中,早髮型重度子癇前期孕婦30例為早髮型組,晚髮型重度子癇前期孕婦30例為晚髮型組,選擇同期健康孕婦併根據其孕週不同分為早髮型對照組(孕週28~33週+6)23例和晚髮型對照組(孕週≥34週)30例.採用ELISA法檢測各組孕婦血漿中TM的水平,免疫組化SP法檢測胎盤組織中TM蛋白的錶達,逆轉錄(RT)-PCR技術檢測胎盤組織中TM mRNA的錶達.結果(1)早髮型組孕婦血漿TM水平為(90.8 ± 6.9)μg/L,晚髮型組為(87.5 ± 7.0)μg/L,早髮型對照組為(37.7±2.3)μg/L,晚髮型對照組為(37.7±2.5)μg/L.早髮型組孕婦血漿TM水平分彆高于其他3組,但早髮型組與晚髮型組比較,差異無統計學意義(P>0.05);早髮型組與早髮型對照組比較,差異有統計學意義(P<0.05);晚髮型組高于晚髮型對照組,差異有統計學意義(P<0.05).(2)TM蛋白主要定位于胎盤閤體滋養細胞和血管內皮細胞的胞膜及胞質中,早髮型組胎盤組織中TM蛋白的暘性錶達率(47%,14/30)顯著低于晚髮型組(90%,27/30)、早髮型對照組(91%,21/23)及晚髮型對照組(93%,28/30),分彆比較,差異均有統計學意義(P<0.05);晚髮型組與晚髮型對照組比較,差異無統計學意義(P>0.05);早髮型對照組與晚髮型對照組比較,差異無統計學意義(P>0.05).(3)早髮型組胎盤組織中TM mRNA的錶達水平為0.14±0.06,晚髮型組為0.89±0.23,早髮型對照組為0.88±0.22,晚髮型對照組為0.93±0.19,早髮型組胎盤組織中TM mRNA錶達水平顯著低于對其他3組,差異均有統計學意義(P<0.05);晚髮型組與晚髮型對照組比較,差異無統計學意義(P>0.05);早髮型對照組與晚髮型對照組比較,差異無統計學意義(P>0.05).結論 孕婦胎盤組織中TM錶達水平降低可能與早髮型重度子癇前期的進展有關;早髮型重度子癇前期的髮病機製可能與晚髮型有所不同.
목적 탐토잉부혈장화태반조직중적혈전조절단백(TM)표체여조발형중도자간전기발병적관계.방법 선택2012년6월지2014년2월재서주의학원부속서주시부유보건원주원분면적중도자간전기잉부60례.기중,조발형중도자간전기잉부30례위조발형조,만발형중도자간전기잉부30례위만발형조,선택동기건강잉부병근거기잉주불동분위조발형대조조(잉주28~33주+6)23례화만발형대조조(잉주≥34주)30례.채용ELISA법검측각조잉부혈장중TM적수평,면역조화SP법검측태반조직중TM단백적표체,역전록(RT)-PCR기술검측태반조직중TM mRNA적표체.결과(1)조발형조잉부혈장TM수평위(90.8 ± 6.9)μg/L,만발형조위(87.5 ± 7.0)μg/L,조발형대조조위(37.7±2.3)μg/L,만발형대조조위(37.7±2.5)μg/L.조발형조잉부혈장TM수평분별고우기타3조,단조발형조여만발형조비교,차이무통계학의의(P>0.05);조발형조여조발형대조조비교,차이유통계학의의(P<0.05);만발형조고우만발형대조조,차이유통계학의의(P<0.05).(2)TM단백주요정위우태반합체자양세포화혈관내피세포적포막급포질중,조발형조태반조직중TM단백적양성표체솔(47%,14/30)현저저우만발형조(90%,27/30)、조발형대조조(91%,21/23)급만발형대조조(93%,28/30),분별비교,차이균유통계학의의(P<0.05);만발형조여만발형대조조비교,차이무통계학의의(P>0.05);조발형대조조여만발형대조조비교,차이무통계학의의(P>0.05).(3)조발형조태반조직중TM mRNA적표체수평위0.14±0.06,만발형조위0.89±0.23,조발형대조조위0.88±0.22,만발형대조조위0.93±0.19,조발형조태반조직중TM mRNA표체수평현저저우대기타3조,차이균유통계학의의(P<0.05);만발형조여만발형대조조비교,차이무통계학의의(P>0.05);조발형대조조여만발형대조조비교,차이무통계학의의(P>0.05).결론 잉부태반조직중TM표체수평강저가능여조발형중도자간전기적진전유관;조발형중도자간전기적발병궤제가능여만발형유소불동.
Objective To explore the thrombomodulin(TM) expreesion levels changes in plasma and placenta in patients with early onset severe preeclampsia. Methods Sixty cases of severe preeclampsia women who delivered in the affiliated Xuzhou Maternity and Child Health Care Hospital of Xuzhou Medical College were enrolled in the study from June 2012 to February 2014, including 30 patients with early onset severe preeclampsia (early onset group), and 30 patients with late onset severe preeclampsia (late onset group). Healthy pregnant women were divided into two control groups according to gestational weeks at delivery: early control group ( n=23, at 28-33+6 weeks), and late control group (n=30, delivered after 34 weeks). ELISA was used to detect the levels of TM in plasma. Immunohistochemistry SP was applied to detect the TM protein expression on placenta. TM mRNA was determined by reverse transcription polymerase chain reaction (RT)-PCR technique. Results (1) TM level in plasma in early onset group and late onset group were (90.8±6.9) and (87.5±7.0)μg/L, and TM level in plasma in early control group and late control group were (37.7 ± 2.3) and (37.7 ± 2.5)μg/L. Plasma TM level in early onset group was higher than that in late onset group, early control group and late control group. The TM level had no statistically significant compare of early-onset group to late onset group.(P>0.05). The plasma TM level in early onset group was significantly higher than that in early control group (P<0.05), and the plasma TM level in late onset group was significantly higher than that in late control group (P<0.05). (2)TM expressed mainly in the membrane and cytoplasm of placental syncytiotrophoblasts and endothelial cells. The expression of TM protein in early onset group was 47%(14/30), significantly lower than that in late onset group, early control group and late control group (P<0.05), in which the positive rate were 90%(27/30), 91%(21/23) and 93%(28/30) respectively (P<0.05).There was no difference between late onset group and late control group (P>0.05). There was no difference between early control group and late control group (P>0.05). (3) TM mRNA expression in early onset group, late onset group, early control group and late control group were 0.14±0.06, 0.89 ± 0.23, 0.88 ± 0.22 and 0.93 ± 0.19, respectively. The expression of TM mRNA in early onset group was significantly lower than that in late onset group, early control group and late control group (P<0.05), and the difference between early control group and late control group was not statistically significant (P>0.05). There was no difference between late onset group and late control group (P>0.05). There was no difference between early control group and late control group (P>0.05). Conclusions Decreased expression of TM in placenta may be associated with the pathogenesis of early onset severe preeclampsia, there may be different pathogenesis in early onset and late onset severe preeclampsia.
