人血白蛋白联合小剂量肝素治疗重度子痫前期的临床疗效及其对胎盘组织中Endoglin、VEGF、Flt-1表达的影响

Clinical efficacy of human blood albumin and small dose heparin in treatment of severe preeclampsia and their effect on Endoglin,VEGF and Flt-1 expression in placenta tissues

目的：研究人血白蛋白联合小剂量肝素治疗重度子痫前期的临床疗效及其对胎盘组织Endoglin，血管内皮细胞生长因子（vascular endothelial growth factor，VEGF）及其受体蛋白（Flt-1）表达的影响。方法选取2012年10月～2014年1月在潍坊市益都中心医院产科收治的重度子痫前期患者60例，随机分为实验组与对照组，每组各30例。对照组予降压、扩容、利尿等常规治疗；实验组在治疗组的基础上，每日予肝素25 mg静脉滴注，5％人血白蛋白10 g静脉滴注，每天1次，连续治疗7 d。另选取本院同期住院行剖宫产分娩的正常足月妊娠孕妇30例作为空白组。疗程结束后，对比治疗前后实验组与对照组患者的平均动脉压（Kpa）及24 h尿蛋白定量，观察临床疗效；镜下观察治疗后空白组、对照组及实验组胎盘组织中 Endoglin、VEGF、Flt-1的表达情况，比较 Endoglin、VEGF、Flt-1在子痫前期患者体内的阳性表达率。结果治疗后2组平均动脉压、尿蛋白均有所改善，与对照组相比，实验组患者平均动脉压、尿蛋白改善更明显，差异有统计学意义（P＜0.05）。治疗后镜下观察空白组、对照组及实验组中，Endoglin、VEGF与Flt-1的表达部位大致相同；与空白组比较，对照组及实验组胎盘组织中Endoglin、VEGF蛋白、Flt-1的阳性表达率较高，差异有统计学差异（P＜0.05）；与对照组比较，实验组中Endoglin、VEGF蛋白、Flt-1的阳性表达率更高，差异有统计学意义（P＜0.05）。结论人血白蛋白联合小剂量肝素治疗重度子痫前能有效改善患者Kpa、24 h尿蛋白定量，降低胎盘组织中Endoglin VEGF和Flt-1蛋白表达。

Objective To study the clinical efficacy of human blood albumin and small dose heparin in treatment of severe preeclampsia and its effect on the expression of Endoglin,vascular endothelial growth factor (VEGF)and its receptors (Flt)in placental tissue.Methods 60 cases of severe preeclampsia collected in weifang yidu central hospital from October 2012 to January 2014 were randomly divided into experimental group and control group,each had 30 cases.Control group were given oral antihypertensive,expansion and diuretic treatment.Experiment group were received injection with 500 mL 5% glucose,60 mL 25% magnesium sulfate and 25 mg heparin on the basis of control group,one time each day,for successive seven days.Another 30 cases of normal full-term pregnancy for cesarean section delivery collected in our hospital during the same period were as blank group.Mean arterial pressure (Kpa)and 24 h urine protein quantitative and clinical efficacy were observed and compared between experimental group and control group before and after treatment.curative effect. Microscopically observed treatment after Endoglin in blank group, control group and experimental group placenta tissue,The expression of Endoglin,VEGF and Flt 1 in placental tissue among three groups were observed by microscope, and their positive expression rate were compared. Results The mean arterial pressure and urine protein were all improved after treatment in control group,and experimental group,but the latter was more obvious than the former(P<0.05 ).The expression location of Endoglin,VEGF and PLT-1 in three groups were the same with microscopic observation.Compared with blank group,the positive expression rate of Endoglin,VEGF protein and PLT-1 in placenta of other two groups were higher(P<0.05),and those in experimental group were more higher than control group(P<0.05).Conclusion Human blood albu min and small dose heparin can effectively improve the indexes of quantitative Kpa and 24 h urine protein in severe preeclampsia, reduce the expression of Endoglin,VEGF and Flt 1 protein in placental tissue.