血清可溶性晚期糖基化终末产物受体水平与妊娠期高血压疾病的相关性研究

Correlation study of serum soluble receptor for advanced glycation end products and hypertensive disorder in pregnancy

目的探讨妊娠期高血压疾病患者血清可溶性晚期糖基化终末产物受体（sRAGE）水平变化，分析sRAGE水平变化与妊娠期高血压疾病的关系。方法HE染色并在光镜下观察妊娠期高血压疾病孕妇胎盘组织的病理特征；采用双抗体夹心酶联免疫吸附法检测75例妊娠期高血压疾病孕妇（包括33例妊娠期高血压和42例子痫前期）及55例正常孕妇血清sRAGE水平。结果HE染色可见妊娠期高血压疾病孕妇胎盘细胞滋养细胞增生，合体滋养细胞结节增多，基底膜增厚，基底纤维素样坏死，绒毛间质水肿，绒毛内血管减少，蜕膜组织内螺旋动脉管壁增厚，管腔狭窄，蜕膜组织可见纤维素样坏死和炎细胞浸润。妊娠期高血压疾病孕妇血清sRAGE水平[（287．6±36．5）ng／L]明显低于正常孕妇[（312．8±53．7）ng／L]（P〈0．01），子痫前期孕妇血清sRAGE水平[（281．9±19．7）ng／L]明显低于妊娠期高血压孕妇[（293．6±20．3）ng／L]（P〈0．05）。结论HE染色病理诊断证实妊娠期高血压疾病存在血管内皮细胞损伤。妊娠期高血压疾病孕妇血清sRAGE水平明显降低，可能参与了妊娠期高血压疾病血管内皮损伤的病理生理过程，测定血清sRAGE水平有可能作为预测妊娠期高血压疾病的临床指标之一。

Objective To investigate the changes of serum soluble receptor for advanced glycation end products （sRAGE） in patients with hypertensive disorder in pregnancy,and analyze the relationship between serum sRAGE and hypertensive disorder in pregnancy. Methods Seventy-five patients with hypertensive disorder in pregnancy including 33 gestational hypertension cases and 42 eclampsism cases, 55 normal control were selected. Morphologic changes of placenta were analyzed by means of HE staining. ELISA method was used to determine the level of serum sRAGE. Results Placentomes of cytotrophoblastic cells, nodule of syneytiotrophoblast, thickening of basement membrane, fibrinoid necrosis, villus interstitial edema,reduction in vascularity of villus were much more frequently seen in hypertensive disorder in pregnancy. There were also fabric hyperplasy of helicine artery,narrow lumina, fibrinoid necrosi and inflammatory cell infiltrating in the uterine decidua in hypertensive disorder in pregnancy. The level of serum sRAGE was significantly decreased in patients with hypertensive disorder in pregnancy [ （287.6 ± 36.5） ng/L] when compared with normal controls [ （312.8 ±53.7 ） ng/L] （P 〈 0.01 ）. In hypertensive disorder in pregnancy,the level of serum sRAGE in patients accompanied with eclampsism [ （281.9 ±19.7） ng/L] was lower than that in patients accompanied with gestational hypertension [ （293.6 ±20.3 ） ng/L] （P 〈 0.05 ）. Conclusions HE staining of the placenta showed vascular endothelial damage is the pathogenic basis of hypertensive disorder in pregnancy. The level of serum sRAGE is significantly decreased in patients with hypertensive disorder in pregnancy,it may be contributed to the pathogenesis and development of hypertensive disorder in pregnancy. The level of serum sRAGE may be helpful in predicting hypertensive disorder in pregnancy.