妊娠期糖尿病胎盘细胞凋亡及其与围产结局的关系

The Study of Placental Apoptosis in Correlation between Apoptosis and Perinatal Outcome in Gestational Diabetes Mellitus

目的 :研究胎盘细胞凋亡在妊娠期糖尿病发生及其与临床结局的关系 .方法 :对 4 0例妊娠期糖尿病 (GDM )患者和 4 0例正常对照孕妇的胎盘组织进行检测 ,用DNA缺口原位末端标记 (TUNE)技术检测细胞凋亡 ,电镜观察凋亡细胞的超微结构 ,免疫组织化学方法 (S -P)检测促 (抑 )凋亡基因Bax/Bcl- 2表达水平 .结果 :妊娠期糖尿病组胎盘细胞凋亡指数及Bax、Bcl - 2阳性率、Bax/Bcl- 2的比率均高于对照组 (P <0 0 5 ) ,妊娠期糖尿病组胎盘细胞凋亡指数与孕妇血糖值和新生儿体重呈正相关 ,对照组胎盘细胞凋亡指数与孕妇血糖值和新生儿体重无相关 .结论 :妊娠期糖尿病组和对照组胎盘中均有一定量的细胞凋亡和Bax ,Bcl- 2的表达 ,妊娠期糖尿病组胎盘细胞凋亡明显增加 ,Bax/Bcl- 2的比值增加 .胎盘细胞凋亡及其调节基因的表达间具有一致性 。

Objective: To investigate what role placental apoptosis is playing and correlation with perinatal outcome in gestational diabetes melllitus(GDM).Methods: Placental samples were obtained from 40 GDM and uncomplicated term pregnancies(control group).TUNEL(terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling)stain was used to confirm the occurrence and quantify the incidence of apoptosis.Immunohistochemistry(S-P)was performed to detect expression of Bax and Bcl-2 in paraffin-embeded section of human placenta from GDM and control group . Results: There were apoptosis and expression of Bax and Bcl-2 in placenta in both GDM group and control group,but significantly higher in GDM group.It is suggested that the higher ratio of Bax / Bcl-2 prompts placental apoptosis in GDM,so placental apoptosis and its related gene expression were simultaneous.Placental AI was a significantly positive correlation with adverse neonatal outcome of GDM. Placental apoptosis may be involved in pathophysiologic process in GDM.