肿瘤坏死因子α与妊娠高血压综合征发病关系的研究

Role of tumor necrosis factor -α in the pathogenesis of pregnancy-induced hypertension

目的 探讨肿瘤坏死因子α(TNFα)在妊娠高血压综合征 (简称妊高征 )发病中的作用。方法 对 41例妊高征患者 (妊高征组 )和 17例正常妊娠妇女 (正常妊娠组 )进行了下列研究 :(1)测定血浆中TNFα水平 ,观察胎盘血管内皮细胞的形态学变化 ;(2 )利用其血清对离体培养的脐血管内皮细胞作用 ,观察其损伤性表现 ;(3)利用 40 0U/ml的人重组TNFα (rTNFα)对离体培养的脐血管内皮细胞作用 ,比较TNFα和妊高征孕妇血清对内皮细胞的损伤作用。结果 (1)妊高征组孕妇血浆TNFα为2 .2 9μg/L± 0 .5 1μg/L ,正常妊娠组血浆TNFα为 1.73μg/L± 0 .2 5 μg/L ,两组差异有显著意义 (t =5 6 0 ,P <0 .0 1) ;胎盘血管内皮细胞有损伤性改变 ,主要表现为细胞肿胀、增生、内质网扩张及细胞连接疏松等 ;(2 )正常孕妇血清对培养的脐血管内皮细胞无损伤作用 ,而妊高征患者血清及rTNFα对培养的脐血管内皮细胞有同样的损伤作用 ,表现为细胞增殖抑制和细胞形态及结构改变等。结论 (1)妊高征患者胎盘血管内皮细胞损伤与血中TNFα水平增高有关 ;(2 )妊高征患者血清对培养的血管内皮细胞有损伤作用 ,且这种作用与TNFα有关。提示TNFα可能作为血管内皮细胞损伤的一种免疫因子 ,参与妊高征的发病。

Objective To investigate the role of tumor necrosis factor α(TNFα) in the pathogenesis of pregnancy induced hypertension (PIH) by damaging endothelial cells. Methods 41 patients with PIH and 17 healthy pregnant women were studied. The concentration of TNFα in maternal plasma was measured by sensitive radioimmunoassay. The morphology of endothelial cells of placental blood vessels was observed. Endothelial cells were incubated in the presence of TNFα (400 U/ml) and sera (30% vol/vol) from PIH women and normal pregnant women to observe their growth and shape. Results Maternal plasma TNFα level in PIH was 2.29 μg/L±0.51 μg/L, higher than that in normal pregnancy (the latter was 1.73 μg/L±0.25 μg/L, t =5.60, P <0 01). The endothelial cells of placental blood vessels in PIH revealed morphologic damages. Both sera of PIH women and TNFα were cytotoxic to endothelial cells in culture, including inhibition of the proliferation and morphologic changes of the cells. Conclusion Damage of the endothelial cells of placental blood vessels is associated with the abnormal increase in the maternal blood TNFα. Sera of PIH women can damage the endothelial cells in culture and this effect is also associated with TNFα.