母胎界面血管内皮生长因子水平在妊娠高血压综合征中的意义

Significance of vascular endothelial growth factor level in maternal/fetal interface of pregnant women with pregnancy-induced hypertension

目的:血管内皮生长因子是一种对血管内皮细胞有特异高效的促有丝分裂因子,试验通过检测血管内皮生长因子在母血、脐带血以及胎盘母面和子面的水平,探索妊娠高血压综合征的发病因素和胎儿宫内发育迟缓发生的机制。方法:①试验对象:选取2006-10/2007-03在深圳市沙井医院就诊的正常孕妇及患有妊娠高血压综合征的孕妇各30人分别作为正常孕妇组和妊娠高血压综合征组,均为初产妇,两组孕妇年龄、孕周及体质量差异无显著性。纳入标准:正常孕妇及妊娠高血压综合征孕妇均无其他妊娠合并症或疾患,年龄24～35岁。患者对试验知情同意。②试验方法及评估:取母亲外周静脉血、新生儿脐带血及胎盘母面、子面标本各一块,酶联免疫吸附法检测母血、脐带血、胎盘母面及子面组织匀浆中的血管内皮生长因子含量,免疫组织化学染色及荧光染色观察血管内皮生长因子的表达。实验结果采用Excel2003软件进行两独立样本的t检验和Pearson相关分析。结果:纳入正常孕妇及患有妊娠高血压综合征的孕妇各30人,均进入结果分析。①免疫组织化学染色及荧光染色显示正常产妇胎盘子面内皮生长因子表达强阳性。②酶联免疫吸附结果显示,两组受试者胎盘母面、母血血管内皮生长因子含量差异无显著性(P>0.05);妊娠高血压综合征组胎盘子面、脐带血血管内皮生长因子含量与正常妊娠胎盘子面、脐带血相比较,差异显著(P<0.05)。结论:妊娠高血压综合征患者胎盘子面血管内皮生长因子水平下降,脐带血中血管内皮生长因子水平升高,提示母胎界面的异常可能与妊娠高血压综合征的发生有关。

AIM： Vascular endothelial growth factor （VEGF） is one specific and effective mitogenic factor for vascular endothelial cells. This study explored the etiologic factors for pregnancy-induced hypertension （PIH） and the pathophysiologic mechanism for intrauterine growth retardation by detecting the concentrations of VEGF in maternal blood, cord blood, uteroplacental and fetoplacental tissue homogenate. METHODS： Thirty normal pregnant women and thirty with PIH were selected from Shenzhen Shajing Hospital between October 2006 and March 2007 as normal group and PIH group. All subjects were of pnmipara, and their ages, gestational weeks and body mass showed no statistical difference. Pregnant women with no other pregnancy-induced complications or diseases, aged 24-35 years were selected. The informed consent was obtained from all subjects. （2）ELISA method was adopted to detect the concentration of VEGF in maternal blood, cord blood, uteroplacental and fetoplacental tissue homogenate. The expression of VEGF was observed by immunohistochemical and fluorescent staining. Two-independent-sarnpte ! test and Pearson correlation test were performed by the Excel2003 software. RESULTS： Thirty normal and thirty PIH pregnant women were all involved in the result analysis. （1）Immunohistochemical and fluorescent staining showed that the expression of VEGF in fetoplacental tissue without PIH showed dramatically positive. （2）There was no significant difference in the concentration of VEGF in uteroplacental tissue homogenate and maternal blood of two groups （P 〉 0.05）. The differences were statistically significant in the concentration of VEGF in fetoplacental tissue homogenate, and cord blood between two groups （P 〈 0.05）. CONCLUSION： In the pregnant women with PIH, the concentration of VEGF in fetoplacental tissue is decreased, but in cord blood increased, indicating the abnormity in maternal/fetal interface may be correlated with PIH.