妊娠期高血压疾病患者胎盘黏附分子的表达与意义

Expression of adhesion molecule in placenta in patients with hypertensive disorders in pregnancy and its significance

目的观察妊娠期高血压疾病患者胎盘组织中细胞间黏附分子-1（ICAM-1）、血管内皮黏附分子-1（VCAM-1）的表达，探讨它们与妊娠期高血压疾病的关系及意义。方法收集妊娠期高血压疾病患者52例（疾病组），其中妊娠期高血压11例、轻度子痫前期18例和重度子痫前期23例；正常孕妇26例作为对照组。采用HE染色和免疫组化SP法对胎盘组织进行检测并用图像分析测量软件观察、分析ICAM-1、VCAM-1阳性表达情况。结果疾病组胎盘绒毛毛细血管内皮细胞ICAM-1和VCAM-1阳性表达率[78．85％（41／52）和75．00％（39／52）]均明显高于对照组[26．92％（7／26）和23．08％（6／26）]（P〈0．01）；重度子痫前期患者[100．00％（23／23）和100．00％（23／23）]明显高于轻度子痫前期患者[77．78％（14／18）和72．22％（13／18）]和妊娠期高血压患者[36．36％（4／11）和27．27％（3／11）]（P〈0．05或〈0．01），轻度子痫前期患者明显高于妊娠期高血压患者（P〈0．05）。疾病组胎盘绒毛合体滋养细胞ICAM-1和VCAM-1的阳性表达率[38．46％（20／52）和44．23％（23／52）]明显低于对照组[100．00％（26／26）和96．15％（25／26）]（P〈0．01）；重度子痫前期患者[8．70％（2／23）和13．04％（3／23）]明显低于轻度子痫前期患者[44．44％（8／18）和50．00％（9／18）]和妊娠期高血压患者[90．91％（10／11）和100．00％（11／11）]（P〈0．05或〈O．01），轻度子痫前期患者明显低于妊娠期高血压患者（P〈0．05）。结论胎盘绒毛毛细血管内皮细胞及绒毛合体滋养细胞ICAM-1、VCAM-1的异常表达参与了妊娠期高血压疾病血管内皮损伤的病理生理过程。

Objective To observe the expression of intercellular adhesion molecule 1 （ICAM-1） and vascular cellular adhesion molecule 1 （VCAM-1） in placenta in pafients with hypertensive disorders in pregnancy, investigate their roles in patients with hypertensive disorders in pregnancy and correlation. Methods Fifty-two patients with hypertensive disorders in pregnancy （disease group） were collected, including 11 cases with gestational hypertension（ GH ）, 18 cases with mild pre-eclampsia（MP） and 23 cases with severe pre-eclampsia（SP）, 26 cases of normal pregnant women as control group. Immunohistochemistry and image analytical technique were employed to show the expression of ICAM-1 and VCAM-1. Results The quantities of ICAM-I and VCAM-1 expressed in the placental vascular endothelial ceil were 78.85% （41/52 ） and 75.00% （ 39/52 ） in disease group., 26.92% （ 7/26 ） and 23.08% （ 6/26 ） in control group, there was a significant difference between the two groups（P 〈 0.01 ）, and those in SP patients [ 100.00%（23/23） and 100.00%（23/23）] were higher than those in MP patients [77.78%（14/18） and 72.22%（13/18）] and GH patients [36.36% （4/11） and 27.27% （3/11） ] （P 〈 0.05 or 〈 0.01 ）. The quantities of ICAM-1 and VCAM-1 expressed in the placental villous syneytiotrophobtast were cell 38.46% （20/52） and 44.23% （ 23/52 ） in disease group, 100.00% （ 26/26 ）and 96.15% （ 25/26 ） in control group, there was a significant difference between the two groups （P 〈 0.01 ）, and those in SP patients [ 8.70% （2/23）and 13.04% （3/23）] were lower than those in MP patients [44.44% （8/18） and 50.00% （9/18）] and GH patients [90.91% （10/11） and 100.00%（11/11）]（P〈0.05 or 〈0.01）. Conclusion Abnormalexpression of ICAM-I and VCAM-I in the placental vascular endothelial and villous syneytiotrophoblast cell in patients with hypertensive disorders in pregnancy may participate in pathogenic process of vascular endothelial damage of hypertensive disorders in pregnancy.