妊娠期高血压疾病患者胎盘组织中HGF、MMP-9的表达及意义

The expressions of HGF and MMP-9 in placenta tissue of the patients with gestational hypertension and their significance

目的:通过分析子痫前期患者胎盘与正常晚孕妇女胎盘组织中肝细胞生长因子(HGF)、基质金属蛋白酶-9(MMP-9)的表达,探讨其在妊娠期高血压疾病(HDCP)发病中的作用。方法:选择晚孕期正常组孕妇35例、子痫前期组71例(包括轻度子痫前期组37例;重度子痫前期组34例)作为研究对象。两组均在临产前行剖宫产术,胎盘娩出后30 min内取胎盘母面中央绒毛组织块约1×1×1 cm,避开钙化区及坏死区,留取胎盘组织。生理盐水充分清洗,10%中性福尔马林溶液固定24 h以上,常规石蜡包埋4μm连续切片。免疫组织化学SP法检测胎盘组织中HGF、MMP-9的表达强度,根据细胞内染色强度和阳性细胞数分级。应用SPSS12.0统计软件进行数据处理。结果:①正常晚孕组胎盘组织中HGF、MMP-9表达均呈强阳性,阳性表达率分别为71.43%、80.00%;轻度子痫前期组胎盘组织中HGF、MMP-9表达均呈阳性,阳性表达率分别为64.86%、72.97%;重度子痫前期组胎盘组织中HGF、MMP-9阳性颗粒均明显减少,阳性表达率为35.29%、32.35%。②子痫前期组胎盘组织中HGF、MMP-9表达与正常晚孕组比较均有明显差异(P<0.05);重度子痫前期组胎盘组织HGF、MMP-9表达与对照组比较均有显著差异(P<0.01);轻度子痫前期组胎盘组织HGF、MMP-9表达与重度子痫前期组比较也有显著差异(P<0.05);轻度子痫前期组胎盘组织HGF、MMP-9表达与对照组比较无明显差异(P>0.05)。③重度子痫前期组HGF和MMP-9的表达水平存在正相关性(r=0.5663P<0.01)。结论:正常妊娠胎盘绒毛表达HGF及MMP-9子痫前期病情严重程度和此两种因子的表达密切相关,提示可能因HGF和(或)MMP-9表达减少、滋养细胞侵袭受限而引起胎盘生理性血管重铸障碍,导致胎盘缺血,引起一系列子痫前期临床症状发生。

Objective： To investigate the pathogenesis of preeclampsia by analyzing the expression of HGF and MMP - 9 in placental of women with preeclampsia and normal pregnancy. Methods： Placental samples were obtained in 30 minutes after delivery from 35 normal pregnancy women and 37 patients with mild preeclamptic pregnancies, 34 with severe preeclampsia. The villi were taken from them. All placentas were obtained from women undergoing spontaneous labor when they took on caesarean surgery. All tissues were routinely fixed in 10 percent formalin and embedded in paraffin. Four - μm - thickness tissue sections of all samples were stained by immunohistochemical analysis. Statistical analyses were performed with the use of the SPSS 12. 0. Results： The expressions of HGF and MMP -9 on control group were both the strongest, positive rate was 71. 43% and 80. 00% ; mild preeclampsia had weaker expression, positive rate was 64. 86% and 72. 97% ; that of severe precclampsia was almost negative, positive rate was 35. 29% and 32. 35%. The expression of HGF and MMP - 9 between the normal placenta and preeclamptie placenta was both statistically different （P 〈 0. 05） ; significant differences was found between the normal placenta and severe preeclamptie placenta （P 〈0. 01 ） ; The same result was found between severe and mild preeclampsia placenta too （P 〈 0. 05） ; But there was no significant difference between normal and mild preeclampsia placenta （ P 〉 0. 05） . 3. Positive correlation was found between HGF and MMP - 9 expressions in severe preeclampsia groups （ r = 0. 5663, P 〈 0. 01 ）. Conclusion： Placental villi can express HGF and MMP- 9. Villous core mesenchymal cells produce HGF whereas MMP -9 is demonstrated mainly on trophoblast. HGF and MMP - 9 may play an important role in placental trophoblast invasion. Decreased expression of HGF and （or） MMP -9 may affect acquisition of an invasive by trophoblasts, resulting in the abnormal shallow trophoblast invasion of the uterus that is associated with preeclampsia.