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胎盘巨噬细胞和滋养细胞凋亡与重度子痫前期的相关研究
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DOI:
作者:
吴震溟、 狄文
Wu Zhen-ming, Di Wen
作者单位:
上海交通大学医学院附属仁济医院妇产科
Ren-Ji Hospital of Shanghai Jiaotong University, School of Medicine,Shanghai
关键词:
重度子痫前期 巨噬细胞 滋养细胞凋亡 组织特异性多肽抗原
Severe Pre-eclampsia, Macrophage, Trophoblast Apoptosis, TPS
摘要:
目的 研究人胎盘中巨噬细胞数量和滋养细胞凋亡的发生与重度子痫前期发病的相关性 方法 收集住院分娩的重度子痫前期病例22例、轻度子痫前期孕妇12例、正常妊娠妇女18例,采用免疫荧光法检测胎盘中巨噬细胞、TUNEL法检测胎盘中滋养细胞凋亡、ELISA检测孕妇血清中TPS、eNOS的表达。 结果 (1)子痫前期孕妇和对照组的年龄无明显差异,重度子痫前期孕妇的终止孕周明显早于轻度子痫前期和正常孕妇,新生儿的出生体重也小于正常孕妇(P<0.05)。(2)重度子痫前期胎盘中巨噬细胞的数量显著多于轻度子痫前期和正常妊娠胎盘(P<0.05)。(3)重度子痫前期胎盘中,滋养细胞的凋亡发生(21.4±2.2%)显著高于轻度子痫前期(9.3±1.8%)和正常孕妇(7.2±1.0%)(P<0.05),与巨噬细胞增加呈正相关(r=0.498)。(4)重度子痫前期孕妇血清中TPS表达(27.20±2.49ng/ml)高于轻度子痫前期(17.08±1.53ng/ml)和正常妊娠妇女(13.48±0.98ng/ml)(P<0.05),TPS的上升与滋养细胞凋亡增加成正相关(r=0.52),与eNOS表达成负相关(r=-0.364) 结论 胎盘中滋养细胞的过度凋亡,与巨噬细胞在子痫前期胎盘面的增多呈正相关,与母血循环中的组织特异性多肽抗原的表达水平上升成正相关,可能是子痫前期发病的一个重要因素。
Objective: To study the correlation between the macrophage in placenta and the apoptosis of trophoblast in severe preeclampsia women. Methods: We collected severe preeclampsia 22 cases, 12 cases of mild preeclampsia and normal pregnancy 18 cases who delivered in our hospital. The expression of macrophage in placenta was measured with immuno-fluorescent staining, the apoptosis of trophoblast was detected with TUNEL method, and the expression of tissue polypeptide specific antigen (TPS) and endothelial nitric oxide synthase (eNOS) in maternal circulation were tested with ELISA. Results: (1) There was no difference between the maternal age in preeclampsia and the control group, the terminal gestational weeks in severe preeclampsia is earlier than mild preeclampsia women and the normal pregnant women, the newborn weight of severe preeclampsia mother is far less than the normal born baby(P<0.05). (2) The expression of macrophage in placenta in severe preeclampsia women is higher than mild preeclampsia women and the normal pregnant women(P<0.05). (3) There are more apoptosis of trophoblast cell happened in severe preeclampsia women (21.4±2.2%)compared with mild preeclampsia(9.3±1.8%) and normal pregnant women(7.2±1.0%)(P<0.05). The enhancement of the trophoblast apoptosis is correlated with the increase of macrophage in placenta. (4) The expression of TPS in maternal serum of severe preeclampsia(27.20±2.49ng/ml) is higher than that in mild preeclampsia(17.08±1.53ng/ml)and normal pregnant women(13.48±0.98ng/ml). The increase of TPS in maternal serum is correlated with the enhancement of trophoblast apoptosis(r=0.52) and negative-correlated with the expression of eNOS in maternal circulation(r=-0.364)(P<0.05). Conclusion: The over-expression of trophoblast apoptosis is correlated with the increase of macrophage in placenta and the enhancement of TPS expression in maternal serum, maybe the pathogenesis of the onset of severe preeclamsia.
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