重度子痫前期患者胎盘绒毛外滋养细胞VCAM-1、E-selectin的表达及意义

VCAM-1 and E-selectin Expression in Extravillous Cytotrophoblasts of Severe Preeclampsia

目的探讨子宫胎盘界面绒毛外滋养细胞(EVCT)上血管细胞粘附分子(VCAM-1)及E-选择素(E-selectin)的表达特点以及与妊娠期高血压疾病的关系。方法采用免疫组织化学法观察20例重度子痫前期胎盘(妊高征组)以及孕周相配的20例正常妊娠胎盘(对照组)子宫胎盘界面蜕膜中绒毛外滋养细胞VCAM-1、E-selectin的表达;光镜下计算EVCT阳性染色强度,并用医学图象分析软件测定EVCT阳性染色的平均光密度值(MOD)。结果与正常对照比较,子痫前期患者子宫胎盘界面EVCT上VCAM-1、E-selectin的染色强度及MOD值均降低,差异有统计学意义(P<0.05、P<0.01)。结论子痫前期子宫胎盘界面EVCT上血管内皮细胞特性的粘附分子VCAM-1、E-selectin的表达减少,可能引起滋养细胞对子宫壁和血管的浸润性降低,导致子宫胎盘血管形成障碍。

Objective To investigate the expression pattern of vascular cell adhesion moleeule-1（VCAM-1） and endothelial seleetin （E-seleetin） in the placental bed extravillous eytotrophoblast （EVCT） as well as its relationship with preeclampsia. Methods Placentas from severe preeclampsia （n=20） and gestional age-matched normal pregnancies （n=20） were studied. The staining intensity and the Mean Optical Density （MOD） of VCAM- 1 and E-seleetin in EVCT of placental bed deeiduas were measured by immunohistoehemistry. Results The staining intensity and MOD of VCAM-1 and E-seleetin on placental bed EVCT in severe preeelampsia were significantly lower than those in the control group respectively （P〈0. 05, P〈0. 01）, Conclusion The decreased EVCT expression of vascular adhesion phenotype VCAM-1 and E-seleetin may account for the shallow trophoblast invasion in preeelampsia, which is the major pathological change of this disease.