长链脂肪酸氧化酶LCHAD胎盘表达与早发型重度先兆子痫的研究

Study on long chain fatty acid oxidative enzyme LCHAD and early onset of severe preeclampsia.

目的：探讨线粒体长链脂肪酸氧化酶-长链-3-羟酰基辅酶A脱氢酶（10ngchain3-hydroxyacyl-CoAdehydrogenase，LCHAD）在重度先兆子痫（severepreeclampsia，S-PE）不同发病时期中的作用。方法：用免疫组化SP法，检测70例重度先兆子痫不同发病时期的伴或不伴有肝损害的胎盘组织中LCHAD蛋白的表达特点，并与54例正常妊娠早、中、晚期的绒毛和胎盘组织比较。统计学方法采用t检验。结果：正常妊娠和重度先兆子痫胎盘组织均有LCHAD表达。正常胎盘组织LCHAD表达强度随妊娠孕周的增加逐渐降低，妊娠晚期的表达强度较妊娠早期明显降低，差异有显著性（P〈0．05）。发病孕周小于28周的重度先兆子痫组LCHAD表达强度明显低于对照组，差异有显著性（P=0．019）。孕28～32周发病的重度先兆子痫伴有肝损害组LCHAD的表达强度明显低于对照组，差异有显著性（P=0．010）；无肝损害组LCHAD表达强度降低，但与相同孕周对照组比较，差异无显著性（P=0．093）。大于32孕周发病的重度先兆子痫各组LCHAD表达强度与对照组比较无明显变化。结论：LCHAD在正常妊娠及重度先兆子痫胎盘组织中均有明确表达，进一步揭示胎盘的发生和发展需要脂肪酸氧化供能，对维持胎盘正常功能和保证胎儿正常生长发育可能起重要作用。脂肪酸氧化代谢异常与早发型重度先兆子痫尤其是伴有肝损害有关。

Objective：To explore the relationship between long chain 3-hydroxyacyl-CoA dehydrogenase （LCHAD） and severe preeclampsia （ week with or without liver damage. Methods：Placenta tissu PE onset in different gestational week with or without liver S-PE） onset in different gestational e were sampling from 70 cases of S- damage. The expression of LCHAD protein was analyzed using immunohistochemistry. Fifty samples from normal pregnancy in first, second and third trimester were collected as controls. Data were statistically treated with t-test. Results：Protein of LCHAD was expressed in placenta of normal pregnancy and S-PE. Expres- sion of LCHAD protein in normal pregnant placenta decreased as gestational age increased. The expression in first trimester was much higher than that in third trimeter with statistically signifi- cance （ P 〈 0.05 ）. Expression of LCHAD in cases of S-PE onset before 28 gestational weeks was much lower than controls with statistically significance （P = 0.019 ）. Expression of LCHADin cases of S-PE onset between 28 - 32 gestational weeks complicated with liver damage was much lower than controls with statistically significance （P = 0. 010）. Expression of LCHAD in cases of S-PE onset between 28 - 32 gestational weeks without liver damage was lower than controis but without statistically significance （ P = O. 093 ）. No differences were found between other S-PE groups and controls. Conclusion：The expression of LCHAD in human placental and in S- PE suggested that fatty acids oxidation （FAO） as a significant metabolic fuel and energy source is essential for placenta formation and development. FAO play an important role in maintenance of the normal function of placenta and fetal development. There is a strict correlation between abnormal FAO and early-onset preeclampsia, especially in cases with liver damage.