子痫前期患者血清VEGF与TNFα水平及其与临床特征的关系

Clinical significance of VEGF and TNFα in serum of normal pregnancies and patients with Preelaclampsia

目的:探讨血清血管内皮生长因子(VEGF)、肿瘤坏死因子α(TNFα)在子痫前期发病中的作用和二者在子痫前期发病中的相互关系以及与临床特征的关系。方法:采用放射免疫方法和酶联免疫法分别测定40例正常妊娠妇女(正常妊娠组)及50例子痫前期(轻度20例,重度30例)患者(子痫前期组)分娩前血清TNFɑ与VEGF水平,同时分析其与临床特征的关系。结果:①子痫前期组孕妇血VEGF为(15.90±1.13)μg/L,正常妊娠组孕妇血VEGF为(17.12±1.81)μg/L,子痫前期组与正常妊娠组比较差异有显著性(P<0.05);轻度及重度子痫前期患者血VEGF分别为(16.33±1.02)μg/L、(15.61±1.13)μg/L,VEGF水平与子痫前期病情严重程度呈负相关(r=-0.446,P<0.05)。②子痫前期组血TNFα为(1.57±0.17)μg/L,明显高于正常妊娠组(1.39±0.13)μg/L,差异有显著性(P<0.05);且重度子痫前期患者血TNFα(1.64±0.18)μg/L,明显高于轻度(1.48±0.12)μg/L(P<0.05)。③两组患者血清VEGF与TNFα之间存在负相关(r=-0.448,P<0.05)。④子痫前期患者血清TNFα、VEGF水平与其临床特征有密切的关系。结论:孕妇血清TNFα、VEGF水平可反映子痫前期病情的严重程度,可成为子痫前期的检测指标之一;TNFα与VEGF在子痫前期的发生发展过程中可能存在调节抑制。

Objective： To examine the level of TNFα and vascular endothelial growth factor （VEGF） in maternal serum of normal pregnancies and patients with preeclampsia and to study the clinical significance and effects of them on the pathogenesis of the disease. Methods： Serum levels of TNFα and VEGF of 40 normal pregnant women and 50 patients with preeclampsia （ mild 20, severe 30） were determined respectively by radioimmunoassay and ELISA. Results： ① Serum levels of VEGF in all preeclampsia subgroups （ 16. 33 ± 1. 02） μg/L, （ 15. 61 ± 1. 13） μg/L in mild and severe were significantly lower than those in the normal pregnant group （ 17. 12 ± 1. 81 ） μg/L （ P 〈 0. 05 ）. There was negative correlation between levels of VEGF and degrees of preeclampsia （r = - 0. 446, P 〈 0. 05 ）. ②Sernm levels of TNFα in preeclampsia （1. 57 ± 0. 17） μg/L were significantly higher than that of normal pregnant group （1. 39 ± 0. 13） μg/L. ③There was negative correlation between levels of VEGF and TNFα （r = -0. 448, P 〈0. 05） in preeclampsia and normal pregnant women. ④There were close relationship in serum levels of VEGF and TNFα in patients of preeclampsia and their clinical characters. Conclusion： The levels of VEGF and TNFα maybe suggest the degree of preeclampsia, be one of the indicator of preeclampsia; VEGF may be correlated with TNFα in development of preeclampsia.