血管内皮生长因子及其受体在妊娠期肝内胆汁淤积症患者胎盘中的表达及其意义

Expression and Significance of Vascular Endothelial Growth Factor and Its Receptor Fms-Like Tyrosine Kinase-1 in Placenta for Patients With Intrahepatic Cholestasis of Pregnancy

目的探讨血管内皮生长因子(VEGF)及其受体fms样酪氨酸激酶-l(Flt-1)在妊娠期肝内胆汁淤积症(ICP)患者胎盘中的表达及意义。方法选取2009年6月至2010年5月于本院剖宫产分娩的单胎妊娠ICP患者30例为研究对象,纳入ICP组(n=30)。随机选择同期于本院剖宫产分娩的正常单胎妊娠妇女30例为对照组(n=30)。采用免疫组织化学方法测定两组受试者胎盘组织中VEGF及其Flt-1的表达,并进行统计学分析(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象本人的知情同意,并与之签署临床研究知情同意书)。两组受试者平均年龄、平均孕周、孕次、产次及分娩方式等比较,差异无统计学意义(P>0.05)。结果 VEGF及其受体Flt-1在两组受试者胎盘组织中分布基本一致,主要分布于合体滋养细胞、细胞滋养细胞、血管内皮细胞和绒毛间质细胞。ICP组胎盘VEGF及其受体Flt-1表达强度显著低于对照组,两组比较,差异有统计学意义(P<0.01)。结论 VEGF及其受体Flt-1表达水平显著下降,可能与胎盘血管生成减少及胎盘滋养叶细胞侵入异常有关,可能系ICP发病机制的重要因素之一。

Objective To investigate the expression and significance of vascular endothelial growth factor （VEGF） and its receptor fms-like tyrosine kinase-l（Flt-1） in placenta for patients with intrahepatic cholestasis of pregnancy （ICP）. Methods From June 2009 to May 2010,30 ICP patients （ICP group） and 30 normal third trimester pregnant women （control group） were included in the study. There had no significant differences in age, gestational age, gravidity, parity and modes of delivery between two groups （P〉0.05）. The expressions of VEGF and Flt-1 in placentas were detected by immunohistochemistry. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Wuxi Hospital for Maternal and Child Health Care. Informed consent was obtained from all participants. Results The distribution of VEGF and Flt-1 in placenta were found in villous trophoblast, placental blood vessels, and villous stroma in both groups. The expression levels of VEGF and Flt-1 in placenta in ICP group were significantly lower than those in control group （P 〈 0. 01）. Conclusion The significant decrease of expression levels of VEGF and Flt-1 might be related to inadequate blood vessel formation and the abnormal invasions of trophoblast and might play an important role in the pathogenic mechanism of ICP.