妊高征胎盘绒毛eNos及mRNA表达血内皮素-1、硝酸盐、钙镁的关系

eNOS and eNOS mRNA Expression in Placental Villus and Changes in Plasma Endothelin 1, Nitric Oxide, Calcium, Magnesium, and Relationship of Calcium and Magnesium in Red Blood Cell in Patients with Pregnancy induced Hypertension

目的 探讨内皮素１（ＥＴ１）、一氧化氮（ＮＯ）、钙镁在妊高征发病中的作用。 方法 用硝酸盐还原酶还原法、放射免疫及原子吸收法，分别测定７０ 例妊高征（ 妊高征组） 孕妇和３０ 例正常妊娠（（ 正常组） 孕妇血浆ＮＯ 稳定代谢终产物硝酸盐（ＮＯ－３ ） 、ＥＴ１，钙镁和血红细胞内钙镁的浓度；用免疫组化，还原型辅酶ⅡＮＡＤＰＨ黄递酶组织化学染色及原位杂交法，了解内皮型ＮＯ 合成酶（ｅＮＯＳ） 及其ｍ ＲＮＡ 在胎盘绒毛组织的表达。 结果 （１） 妊高征组血浆ＮＯ－３ 水平明显低于正常组，病情越重其值越低，并与妊高征患者平均动脉压呈负相关；（２） 妊高征组血浆ＥＴ１ 水平明显高于正常组，病情越重其值越高，并与妊高征患者平均动脉压呈正相关；（３）妊高征组血钙降低，血红细胞内钙升高；（４） 胎盘绒毛合体滋养细胞及除毛细血管外的胎儿血管内皮细胞有ｅＮＯＳ及其ｍＲＮＡ 的表达，胎盘绒毛组织只有ｅＮＯＳ表达，ｅＮＯＳ在妊高征胎盘绒毛组织的表达明显低于正常组。 结论 妊高征发病与血管内皮损伤，ＥＴ１ 产生增加，血钙减少，血红细胞内钙含量增加，致ＮＯ

Objective To investigate whether the endothelin (ET 1), nitric oxide (NO), calcium and magnesium play a role in the pathogenesis of pregnancy induced hypertension (PIH). Methods The plasma concentration of ET 1, nitrate of the stable metabolic end products of NO, calcium, magnesium, and the concentration of calcium, magnesium in red blood cells were evaluated from 70 patients with PIH and 30 normal pregnancies respectively by nitrate reductase radioimmunoassay and atomic absorption spectrophotometry. The distribution of eNOS and eNOS mRNA in villi by immunohistochemistry, NADPH diaphorase histochemistry and in situ hybridization were studied. Results (1)The plasma concentration of nitrate decreased significantly in patients with PIH, and there was a negative correlation between the plasma nitrate and the mean arterial blood pressure in PIH. (2) In NP (normal pregnancies) the nitrate concentrations were significantly higher than moderate and severe PIH ( P <0.05, P <0.01),and there was a positive correlation between the plasma ET 1 and the mean arterial blood pressure in PIH. (3) Plasma concentration of calcium in NP was significantly higher than in severe PIH ( P <0.05). Erythrocytic concentration of calcium in NP was significantly lower than in severe PIH ( P <0.05). (4) eNOS and eNOS mRNA expressions in syncytiotrophoblast and endothelia cells of the fetal vessels except capillary vessel were observed. There was only endothelia isoform of nitric oxide synthase in the placental villous and other isoforms of NOS were not present in the villi, and the level of eNOS decreased significantly in placental villous of PIH. Conclusion The results show that increased plasma concentrations of ET 1, and erythrocytic concentration of calcium and decreased of NO and calcium are imbalance, and are due to the injury of endothelial cells and it may play an important role in the pathogenesis of PIH.