血清TPA、sVCAM-1与子痫前期发病关系的初步探讨

Correlation between serum TPA and sVCAM-1 and pathogenesis of pre-eclampsia

目的:探讨组织多肽抗原(tissue polypeptide antigen,TPA)、可溶性血管细胞粘附分子-1(solublevascular cell adhesion molecule-1,sVCAM-1)与子痫前期发病的关系。方法:采用酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)测定子痫前期患者(实验组)和正常晚孕妇女(对照组)外周血中TPA、sVCAM-1的浓度,并与子痫前期患者病情及新生儿体重进行相关分析。结果:①轻、重度子痫前期患者外周血TPA浓度均高于正常孕妇,两者比较差异有统计学意义(P重<0.01,P轻<0.05),其中重度患者升高尤为明显;②重度患者外周血sVCAM-1浓度高于轻度患者和正常孕妇,差异有统计学意义(P重<0.01);③外周血中TPA浓度和sVCAM-1浓度呈正相关(r=0.419);④外周血TAP、sVCAM-1浓度与患者舒张压及24h尿蛋白定量呈正相关(r分别为0.521、0.374);与新生儿体重呈负相关(r=-0.614)。结论:随着子痫前期患者病情的加重,母血中TPA、sVCAM-1浓度均明显升高,提示胎盘滋养细胞凋亡增多、血管内皮细胞损伤加重。

Objective： To explore the correlation of serum tissue polypeptide antigen（TPA）and the soluble vascular cell adhesion molecule-l（sVCAM-1） and pathogenesis of pre-eclampsia. Methods： ELISA was used to determine the serum of TPA and sVCAM-1 in pre-eclamptie（the experimental group） and normotensive pregnant（ the control group） women, and the correlation of pre-eclampsia （PE） and neonatal outcomes was analyzed by rank correlation. Results： （1） Concentration of serum TPA in the experimental group was obviously higher than that in the control group （P 〈 0.05） and it was the highest in patients with serious pre-eclampsia（ P 〈 0.01）. （2） Concentration of serum sVCAM-1 in the severe experimental group was obviously higher than that in the mild experimental and the control groups （P 〈0.01）. （3） There was a significantly positive correlation between the TPA and the sVCAM-1 in the experimental and control groups. （4） There were a significantly positive correlation between the TPA and sVCAM-1 and the DBP and urine protein in the experimental group, and a significantly negative correlation between the TPA and the sVCAM-1 and the weight of newborns. Conclusion： With the state of. the disease worsening, serum TPA and sVCAM-1 is increased, indicating that the apoptosis of the trophoblast cells and the dysfunction of the vascular endothelial cells are aggravated.