妊娠期高血压疾病母体血清及胎盘组织中hCG的表达

The hCG levels in maternal serum and human placentas on Hypertensive Disorders Complicating Pregnancy

目的:研究hCG表达水平与妊娠期高血压疾病之间的关联。方法:利用前瞻性对照的研究方法,研究了10例子痫前期(轻度6例、重度4例)、12例妊娠期高血压和22例正常妊娠。①利用酶联免疫吸附试验(ELISA)检测孕10～14、20～24、30～34周3个不同时间段3组对象母体血浆β-hCG值;②运用免疫组织化学染色的方法检测胎盘组织中hCG的表达,并通过计算机成像技术分析表达的强度;③荧光定量(QF)RT-PCR方法检测胎盘组织中β-hCG mRNA的表达,分析目的基因与β-actin拷贝数(荧光强度)比值。结果:①子痫前期患者孕10～14、20～24、30～34周母体血浆中β-hCG值与正常妊娠组比较,其值明显上升(P=0.000、0.01、0.048);而妊娠期高血压组与正常妊娠组比较虽有上升的趋势,但无统计学差异(P=0.787、0.937、0.838)。②胎盘合体滋养细胞表达强度按正常妊娠、妊娠期高血压、子痫前期依次递增,子痫前期较前正常妊娠明显增强(P=0.000),而妊娠期高血压与正常妊娠之间无明显差异(P=0.24)。③β-hCG mRNAQF-PCR表达强度按正常妊娠、妊娠期高血压、子痫前期依次增强,子痫前期较前正常妊娠明显表达增加(P=0.000),妊娠期高血压与正常妊娠之间无明显差异(P=0.214)。结论:子痫前期患者母体血清β-hCG值在妊娠较早阶段就有明显改变,并伴随整个孕期,胎盘中hCGmRNA、蛋白表达亦明显增加,证实hCG与子痫前期疾病之间有密切联系。

Objective： To investigate the association of human Chorionic Gonadotrophin levels with Hypertensive Disorders Complicating Pregnancy. Methods： The levels of hCG were contrasted by perspective and control study among three groups on 10 cases of preeclampsia （6 mild and 4 severy） and 12 cases of Gestational Hypertension and 22 cases of normal pregnancies. ①The levels of maternal blood plasma β- hCG were detected at 10-14 and 20-24 and 30-34 gestational weeks by enzyme linked immunosorbent assay.②We used the immunohistoehemistry technique to locate hCG among three groups. Quantification of immunohistochemistry intensity was done by computer image analysis. ③The levels of β-hCGmRNA were detected by Quantitative Fluorescent Reverse Transcription PCR technique and the relative quantification of β-hCGmRNA （β-hCG/β-action） was analyzed. Results： ①The maternalβ-hCG levels of preeclampsia were significantly higher than normal pregnancies at 10-14, 20-24, 30-34 gestational weeks （P=0. 000、0.01, 0.048）, but there was no significant difference between Gestational Hypertension and normal pregnancies （P=0.787, 0.937, 0.838）.②The levels of hCG immunohistochemistry were specifically detected in the syncytiotrophoblast and heightened gradually from normal to gestational hypertension to preeclampsia. Microdensitometric analysis of the section from preeclampsia and normal placentas indicated that there was a statistically significant increase in immunohistoehemistry reaction intensity for hCG （P=0.000）, but no statistically difference between Gestational Hypertension and normal pregnancies （P=0.24）.③There was a statistically significant increase in relative quantification QF-PCR of hCGmRNA from preeclampsia and normal pregnancies （P=0.000）, but no statistically difference between Gestational Hypertension and normal pregnancies （P=0.214）.Conclusion： The levels of maternal blood plasma β-hCG obviously heighten on the early stage of pregnancy, and those changes follow the whole durations of pregnancies in preeclampsia groups and the increasing levels of hCGmRNA and protein on placenta validate that there is intimate relationship between preeclampsia and hCG.