可溶性血管细胞粘附分子1、白细胞介素6及肿瘤坏死因子α在妊高征发病中的作用

Role of soluble vascular cell adhesion molecole 1, interleukin 6 and tumor necrosis factor-αin the pathogenesis of pregnancy induced hypertension syndrome

目的:研究可溶性血管细胞粘附分子1(solublevascularcelladhesionmolecule-l,sVCAM-1)、白细胞介素6(interleukin-6,IL-6)及肿瘤坏死因子α(tumornecrosisfactor-α,TNF-α)在妊高征发病中的作用。方法:测定67例孕妇血清中sVCAM-1、IL-6、TNF-α水平,其中正常妊娠组15例,妊高征组52例,包括轻度14例、中度18例、重度20例。用酶联免疫吸附法(ELISA)测定sVCAM-1,用放射免疫法(RIA)测定IL-6及TNF-α。结果:中、重度妊高征患者血中sVCAM-1、IL-6、TNF-α水平均显著高于正常妊娠组(P<0.01),轻度妊高征患者与正常妊娠组相比,虽无统计学差异,但有升高趋势。妊高征组产后各项指标下降与正常妊娠组差异无显著性(P>0.05)。sVCAM-1与平均动脉压呈正相关(r=0.542,P<0.01),IL-6、TNF-α与sVCAM-1也呈正相关(r=0.435,P<0.01及r=0.532,P<0.01)。结论:妊高征患者血中sVCAM-1水平升高表明内皮细胞损伤在妊高征的发病中起重要作用。IL-6、TNF-α可诱导sVCAM-1的表达。

Objective To investigate the role of soluble vascular cell adhesion molecule l(sVCAM 1), interleukin 6 (IL 6) and tumor necrosis factor α(TNFα)in the pathogenesis of pregnancy induced hypertension (PIH). Methods Maternal serum sVCAM 1, IL 6 and TNF αlevel were determined in 67 women of whom 15 were normal pregnant women and 52 with PIH. The PIH group were divided into 14 women with mild, 18 with moderate, 20 with severe PIH. sVCAM 1 was measured by ELISA, IL 6 and TNF αby RIA. Results The levels of serum sVCAM 1, IL 6 and TNF αwere significantly elevated in women with moderate and severe PIH compared with control subjects (P< 0.01). The difference was not significant in all indexes to be lowered after delivery between PIH and normal pregnant women (P >0.05). The sVCAM 1 levels were positively correlated with mean blood pressure(r=0.542, P< 0.01), the IL 6 and TNF αlevels were positively correlated with sVCAM 1(r=0.435,P< 0.01; r=0.532,P< 0.01). Conclusion Elevated levels of sVCAM 1 indicate that a primary endothelial cell dysfunction plays an important role in the pathogenesis of PIH. Elevated sVCAM 1 is associated with IL 6 and TNF αlevels increased.