穿孔素在重度子痫前期发病中的作用

Role of perforin in severe preeclampsia

目的探讨穿孔素（PFN）在重度子痫前期发病中作用。方法选择2007年12月-2009年6月在中国医科大学附属盛京医院产科住院分娩的重度子痫前期孕妇32例（重度子痫前期组）；选取同期健康孕妇32例作为健康妊娠组。应用逆转录（RT）PCR技术检测两组孕妇外周血单个核细胞中PFNmRNA表达水平，并与平均动脉压进行相关性分析。免疫组化方法检测两组孕妇蜕膜组织中PFN蛋白的表达。结果（1）PFNmRNA表达：重度子痫前期组孕妇外周血单个核细胞中PFNmRNA表达水平为1．19±0．31，健康妊娠组为0．82±0．28，重度子痫前期组PFNmRNA表达水平明显高于健康妊娠组，两组比较，差异有统计学意义（P〈0．01）。（2）相关性分析：重度子痫前期组孕妇平均动脉压为（133±5）mmHg（1mmHg=0．133kPa），重度子痫前期组孕妇外周血单个核细胞中PFNmRNA表达水平与平均动脉压呈显著正相关（r=0．701，P=0．000）。（3）PFN蛋白表达：PFN蛋白主要表达于蜕膜组织淋巴细胞及蜕膜间质细胞的胞质中。重度子痫前期组孕妇PFN蛋白阳性表达率（84％，27／32）明显高于健康妊娠组（53％，17／32）。两组比较，差异有统计学意义（P〈0．01）。结论重度子痫前期孕妇外周血及蜕膜组织中PFN表达水平明显升高，PFNmRNA表达水平与平均动脉压呈显著正相关，提示PFN可能参与了重度子痫前期的发病过程。

Objectives To investigate the possible role of perforin （PFN） in the pathogenesis of severe preeclampsia. Methods Thirty-two cases of severe preeclampsia were included in the study. Thirtytwo cases of normal pregnancy were selected as control group in random. The expression of PFN mRNA in the peripheral blood mononuclear cells （PBMC） was detected by reverse transcription （RT）-PCR, and its correlation with mean arterial pressure was analyzed in severe preeclamptic patients. The expression of PFN protein in the decidua was detected by immunohistochemistry. Results （ 1 ） The expression of PFN mRNA in PBMC：the PFN mRNA level in severe preeclamptic group was 1.19 ± 0. 31, and that in normal pregnancy group is 0. 82 ± 0. 28. The PFN mRNA level in severe preeclamptic group was significantly higher than that of control group （P 〈 0. 01 ）. （2）Correlation analysis： the mean blood pressure in severe preeclampsia group was （ 133 ±5） mm Hg（ 1 mm Hg = 0. 133 kPa）. There was significant positive correlation between level of PFN mRNA in PBMC and mean blood pressure in severe preeclamptic patients（ r = 0. 701, P = 0. 000）. （3） Decidual PFN protein expression： PFN protein was mainly expressed in lymphocytes and the cytoplasm of decidual stromal cells. The positive ratio of PFN in the decidua of severe preeclamptic patients was 84% （27/ 32）, significantly higher than that of control group （53%, 17/32, P 〈 0. 01 ）. Conclusions Expression of PFN was significantly increased in severe preeclampsia, and it was of significant positive correlation with mean blood pressure. PFN may participate in the pathogenesis of severe preeclampsia.