血红蛋白氧合酶在妊娠期高血压疾病发病中的作用

Study on the Role of Hemeoxygenase in the Pathogenesis of Hypertensive Disorder Complicating Pregnancy

目的探讨血红蛋白氧合酶(hemeoxygenase,HO)的生理状态下主要存在形式血红蛋白氧合酶-1、血红蛋白氧合酶-2在妊娠期高血压疾病(hypertensive disorder complicating pregnancy)患者与正常晚孕妇女胎盘中的表达规律,以及其产物一氧化碳(carbon monoxide,CO)在外周血的变化,研究血红蛋白氧合酶在妊娠期高血压疾病发病中的作用。方法选取2005年5月至2005年12月在山西医科大学第一医院剖宫产分娩的56例孕妇为研究对象,采用原位杂交技术和免疫组化法检测30例妊娠期高血压疾病患者(观察组,其中,观察组A患者为8例,观察组B为22例)与26例正常晚孕妇女(对照组)胎盘组织中HO-1 mRNA,HO-2 mRNA的表达和定位,并应用血气仪检测外周血中碳氧血红蛋白(COHb)的变化。结果①HO-1 mRNA和HO-2 mRNA在观察组胎盘滋养细胞及血管内皮细胞中的表达与对照组比较,差异无显著意义(P>0.05)。②血红蛋白氧合酶-1在观察组胎盘滋养细胞中的表达,明显低于对照组,两组比较,差异有显著意义(P<0.05);血红蛋白氧合酶-2在观察组胎盘滋养细胞和血管内皮细胞中表达,均明显低于对照组,与对照组比较,差异有显著意义(P<0.05),并且随着妊娠期高血压疾病病情的加重,血红蛋白氧合酶-1和血红蛋白氧合酶-2表达逐渐减弱,与对照组比较,差异有显著意义(P<0.05)。③碳氧血红蛋白在观察组外周血中的水平明显低于对照组,两组比较,差异有显著意义(P<0.05)。结论血红蛋白氧合酶可能参与妊娠期高血压疾病的发生。

Objective To examine the expression of hemeoxygenase（HO） 1 and hemeoxygenase-2 in placenta tissue and changes of its byproduct carbon monoxide（CO） in peripheral blood between patients with the hypertensive disorder complicating pregnancy and women with normotensive late pregnancy, so as to explore the role of hemeoxygenase in the pathogenesis of hypertensive disorder complicating pregnancy. Methods The expression and localization of HO-1 mRNA and HO-2 mRNA in placenta tissue of the hypertensive disorder complicating pregnancy （the test group, n=30; the test group A had 8 cases of slight hypertensive disorder complicating pregnancy, the test group B had 22 cases of severe hypertensive disorder complicating pregnancy）and normotensive late pregnancy （the control group,n = 26） were detected hy in situ hybridization and immunohistochemistry. In addition, the level of carbon monoxide- hemoglobin（COHb） in peripheral blood was studied by medical image measure system. Results ①The expression of HO-1 mRNA and HO-2 mRNA in placental trophoblast cells and vascular endothelial cells in the test group had no significant difference compared with those in the control group （P〉0. 05）. ②The expression of hemeoxygenase-1 in placental trophoblast cells had a significantly reduced in placenta from the test group, compared with the control group（P〈0. 05）. The expression of hemeoxygenase 2 in placental trophoblast cells and vascular endothelium cells were significantly lower than those in the control group （P〈0.05）. The expression of hemeoxygenase-1 and hemeoxygenase-2 in the test group A were significantly higher than those in the test group B （P〈0.05）. ③The level of carbon monoxidehemoglobin in peripheral blood in the test group was significant lower than that in the control group （P〈0. 05）. Conclusion The hemeoxygenase may be involved in the pathogenesis of the hypertensive disorder complicating pregnancy.