绒毛膜促性腺激素α与β不平衡合成在妊高征发病中的意义

Relationship between imbalanced synthesis of human chorionic gonadotropin α & β subunits and pregnancy induced hypertension

目的 :研究绒毛膜促性腺激素 (h CG) α与 β两亚单位是否不平衡合成及其在妊高征发病中的意义。方法 :用放射免疫法测定 6 0例妊高征 (研究组 )和 30例正常妊娠 (对照组 )的血清游离 αh CG,(Freeαh CG) ,总 h CG,βh CG水平 ;分析两组的各 h CG成分 ;统计总 h CG/ βh CG比值 ,(Fαh CG+ βh CG) / βh CG比值 ;用免疫组化法半定量测定两组胎盘的 Fαh CG,βh CG表达的差异性。结果 :妊高征组的 Fαh CG、总 h CG和 βh CG均高于对照组 (5 2 8± 4 2 1vs 2 2 2± 12 9) IU/ L,(39396± 6 412 vs 2 4 2 6 5± 5 5 75 ) IU/ L ,(6 6 5 79± 92 94 vs 36 0 78± 4 76 7) IU/ L ,均 P<0 .0 0 1;而两组的总 h CG/βh CG比值 (1.80 2± 0 .339vs 1.80 7± 0 .2 5 8,P>0 .0 5 )和 (Fαh CG+βh CG) /βh CG比值 (1.0 2 2± 0 .0 2 6vs 1.0 15± 0 .0 11,P>0 .0 5 )均无差异 ;但妊高征组的βh CG/ Fαh CG比值低于对照组 (91.2 3± 5 3.38vs 119.4 4±80 .1,P<0 .0 5 )。免疫组化结果显示 ,妊高征组的βh CG及 Fαh CG的表达均强于对照组。结论 :妊高征患者滋养细胞合成β亚单位亢进 ,导致α亚单位的绝对值升高 ,引起激素生物学效应增强 ,导致妊高征的发病。

Objective: To study the relationship between imbalanced synthesis of human chorionic gonadotropin (hCG) α & β subunits and the pathology of pregnancy induced hypertension (PIH). Methods: Total hCG, free αhCG and βhCG were measured in serum samples collected from 60 cases of PIH and 30 normal gravid women by radioimmunoassay.The ratio of total hCG/βhCG,βhCG/FαhCG,(FαhCG+βhCG)/βhCG were calculated.Immunohistochemical staining was performed in 13 placenta from each group. Results: In PIH group the levels of FαhCG,total hCG and βhCG were significantly higher than those of normal group (FαhCG:528±421 IU/L vs 222±129 IU/L; βhCG:39396±6412 IU/L vs 24265±5575 IU/L; total hCG:66597±9294 IU/L vs 36078±4767 IU/L,all P <0.001).The βhCG/FαhCG ratio in PIH was lower than that of normal group(91.23±53.38 vs 119.4±80.1, P <0.05); (FαhCG+βhCG)/βhCG ratio and total hCG/βhCG ratio in two groups were (1.022±0.026 vs 1.015±0 011;1.802±0.339 vs 1.807±0.258,respectively P >0.05).The immunohistochemical intensity of βhCG and FαhCG in syncytiotrophoblast was significantly increased in 13 PIH compared with the control. Conclusion: These data suggested that the imbalanced synthesis of hCG α & β subunits may cause hypertension. [