血清游离绒毛膜促性腺激素α与妊娠高血压综合征发病及脏器损害的关系

A Study on the Relationship between Serum Free α-subunit of Human Chorionic Gonadotropin and Pregnancy Induced Hypertension

目的 探讨妊娠高血压综合征 (妊高征 )患者血清游离绒毛膜促性腺激素α亚单位 (Fα hCG)水平与妊高征的严重程度及脏器损害的关系。方法 采用单克隆放射免疫法检测 6 6例妊高征患者 (妊高征组 ,其中轻度 5例 ,中度 8例 ,重度 5 3例 ) ;30例同期无妊高征合并症的妊娠妇女 (对照组 )的血清Fα hCG水平 ,并行尿蛋白检测。用免疫组化半定量法测定两组孕妇中各 13例胎盘组织上Fα hCG的表达。结果 妊高征组Fα hCG均值为 (5 2 8± 42 1)IU/L ;对照组均值为 (2 2 2± 12 9)IU/L。两组比较 ,差异有极显著性 (P <0 .0 0 1)。其中 ,(1)重度妊高征患者Fα hCG水平均值为 (5 6 9± 45 5 )IU/L ,显著高于轻、中度患者的 (36 3± 15 9)IU/L ;(2 )尿蛋白≥ (+++)患者的血清Fα hCG水平为(5 98± 474)IU/L ,高于尿蛋白 <(+++)患者的 (42 5± 2 91)IU/L(P >0 .0 5 )。 13例妊高征胎盘Fα hCG强阳性表达率 (10 / 13) ,显著高于 13例正常妊娠妇女胎盘的表达 (3/ 13) ,两者比较 ,差异有显著性(P <0 .0 5 )。结论 妊高征患者血清Fα hCG水平显著升高 ,且随妊高征严重程度及脏器损伤的加重而呈高水平。血清Fα hCG升高有胎盘病理学的基础。

Objective To determine the correlation of free alpha subunit of human chorionic gonadotropin (F α hCG) with pregnancy induced hypertension(PIH), and to observe the immunohistochemical expression of α hCG in placentae from PIH. Methods Serum was obtained from 66 successive pregnant women diagnosed with PIH (5 mild, 8 middle and 53 severe) at 21～43 weeks′ gestation. A group of 30 non PIH gravid women were used as controls. The serum was assayed for F α hCG by monoclonal technology and human prolactin was assayed for correcting the blood contraction. Immunolocalization and the intensity of the immunohistochemical stained in the placentae from 13 PIH and 13 nomal pregnacies. Results Significant difference was noted between the two groups mean of F α hCG (the control group VS PIH group was 528±421 IU/L VS 222±129 IU/L, P <0.001); no significant between two groups of hPL. The mean value of F α hCG of severe PIH revealed significantly higher than the mild and moderate (569±455 IU/L VS 363±159 IU/L, P <0.01); The leve of F α hCG in group of proteinuria ≥ +++ was higher than that of proteinuria < +++ (598±474 IU/L VS 425±291 IU/L, P > 0.05) . The intensity of α hCG immunostaining in syncytiotrophoblast was significantly increased in 13 PIH compared with the control group (the strong positive rate 10/13 VS 3/13 P <0.025). Conclusions The level of F α hCG are significantly higher in PIH compared with controls. The more severe the higher level of F α hCG is in PIH. The higher level of α hCG has the basement of placentae pathology.