中性粒细胞激活在妊娠高血压综合征发病中的作用

Neutrophil Activation in Pathogenesis of Preeclampsia

目的 探讨中性粒细胞激活在妊娠高血压综合征 (妊高征 )发病中的作用。方法 应用流式细胞术 (flowcytometry ,FCM) ,检测 2 2例妊高征患者 (妊高征组 )和 2 1例正常妊娠妇女 (对照组 )的外周血中性粒细胞CD11b的表达。同时采用放射免疫非平衡法和Griess法 ,检测两组孕妇外周血血浆内皮素 1(endothelin 1,ET 1)浓度和血清一氧化氮 (NO)代谢终产物———亚硝酸盐 (NO-2 )浓度。结果 妊高征组外周血CD11b的平均对数荧光强度指数、血浆ET 1及血清NO-2 浓度 [分别为(439 1± 16 9 1)、(6 1 4± 48 2 )ng/L和 (2 0 4± 5 2 ) μmol/L]均显著高于对照组 [分别为 (32 1 2±16 6 3)、(2 9 3± 2 0 9)ng/L和 (15 5± 4 8) μmol/L],(P分别 <0 0 5、<0 0 1和 <0 0 1)。CD11b与NO-2和ET 1均具有显著相关性 (r分别为 0 312和 0 382 ,P <0 0 5 ) ,而ET 1与NO-2 之间无显著相关性 (r=0 2 2 7,P >0 0 5 )。结论 妊高征患者中性粒细胞CD11b的表达明显增强 ,可能与内皮细胞损伤有关 ,并引起内皮细胞代偿性释放NO增加 ,提示中性粒细胞激活在妊高征发病中起着重要作用。

Objective To investigate the effect of neutrophil activation on pathogenesis of preeclampsia. Methods In 22 pregnant women with preeclampsia and 21 normal pregnant women at third trimester, neutrophil activation was examined by flow cytometry to assess the CD11b expression,and the levels of plasma endothelin 1(ET 1) and serum NO - 2 were also measured with no equilibrium radio immunoassay and with Griess assay respectively. Results The expression of neutrophil CD11b was significantly elevated in women with preeclampsia compared with that of normal pregnant women at third trimester [the mean fluorescence index of CD11b were 439 1± 169 1 and 321 2±166 3 respectively, P<0 05], the plasma ET 1 level and serum NO - 2 concentration in preeclampsic women [(61 4±48 2) ng/L and (20 4±5 2)μmol/L, respectively] were both significantly increased compared with those in the normal pregnancy women [(29 3±20 9) ng/L and (15 5± 4 8)μmol/L, respectively], (P<0 01) The mean fluorescence index of CD11b was significantly correlated with plasma ET 1 level and serum NO - 2 concentration (r=0 312 and 0 382,respectively, P<0 05). But the correlation between the plasma ET 1 level and serum NO - 2 concentration was not found (r=0 227, P>0 05). Conclusions The neutrophil CD11b expression is significantly elevated in preeclampsia. The increased neutrophil activation may cause the damage of vascular endothelium and result in compensatory increase of NO release in endothelial cells. It suggests that the neutrophil activation may play a key role in pathogenesis of preeclampsia.