氧化应激与子痫前期进展的相关性探讨

Correlation between oxidative stress and progression of preeclampsia

目的分析子痫前期患者血清中8-异前列腺素(8-isoprostane)、丙二醛(malondialdehyde,MDA)、超氧化物歧化酶(superoxide dismutase,SOD)、活性氧(reactive oxygen species,ROS)等氧化应激产物水平,探讨氧化应激在子痫前期中的表达及意义,为临床诊断和治疗提供新的研究方向。方法选择2012年1月—2013年12月住院治疗的子痫前期患者100例作为病例组,其中轻度子痫前期40例,重度子痫前期60例。并且随机选择相同年龄段同期进行产前检查的无妊娠合并症和并发症的正常孕妇60例作为对照组。所有研究对象均在入院后检测8-isoprostane、MDA、SOD、ROS水平。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果病例组体重指数(body mass index,BMI)[(30.19±4.41)kg/m2]明显高于对照组[(27.73±3.03)kg/m2],差异有统计学意义(均P<0.05);病例组终止妊娠的孕周[(36.28±3.80)周]明显小于对照组[(39.04±3.90)周],重度子痫前期终止妊娠的孕周[(35.80±4.12)周]小于轻度子痫前期[(37.15±3.19)周],差异有统计学意义(P<0.05)。病例组8-isoprostane、SOD水平、ROS水平[(164.86±14.78)μg/L、(89.78±11.42)、(19.81±8.67)U/L]与对照组[(156.32±13.86)μg/L、(105.64±12.86)、(11.32±6.86)U/L]比较,差异有统计学意义(均P<0.05);重度子痫前期8-isoprostane、SOD水平、ROS水平[(166.42±11.42)μg/L、(86.45±10.89)、(21.45±9.85)U/L]与轻度子痫前期[(161.63±13.64)μg/L、(91.22±13.74)、(15.65±9.67)U/L]比较,差异均有统计学意义(均P<0.05)。病例组剖宫产率(67.0%)明显高于对照组(20.0%),并且重度子痫前期(75.0%)高于轻度子痫前期(55.0%),比较差异均有统计学意义(均P<0.05);病例组低体重儿发生率(14.0%)明显高于对照组(0),并且重度子痫前期(21.7%)高于轻度子痫前期(2.5%),比较差异均有统计学意义(均P<0.05)。结论子痫前期不仅存在过度的氧化应激,而且随病情进展而加重。

Objective To analyze serum levels of 8-isoprostane, malondialdehyde（MDA）, superoxide dismutase（SOD） and reactive oxygen species（ROS）in patients with preeelampsia and to investigate the expression and significance of oxidative stress in patients with preeclampsia, so as to provide new research directions for clinical diagnosis and treatment.Methods From January 2012 to December 2013,100 hospitalized patients with preeclampsia were selected as case group,including 40 mild cases and 60 severe cases.Meanwhile,60 healthy pregnant women were randomly selected as the controls,which were of the same age and received prenatal examination without any complications.All the subjects were detected for the serum levels of 8-isoprostane,MDA,SOD and ROS.Measurement data were processed by t-test,count data by χ^2 test ,the result of P〈0.05 was considered statistically significant.Results BMI was significantly higher in cases group than in the control group [（30.19 ± 4.41） kg/m^2 vs （27.73 ± 3.03） kg/m^2], the difference was statistically signifieant（P〈0.05）;the gestational week for termination of pregnancy was significantly earlier in case group than in the control group [（36.28 ± 3.80） weeks vs （39.04 ± 3.90） weeks],the gestational week for termination of pregnancy was significantly earlier in severe preeclampsia than in mild preeclampsia [（35.80 ± 4.12） weeks vs （37.15 ± 3.19） weeks],the difference was statistically significant（P〈0.05）.In case group,the serum levels of 8-isoprostane,SOD and ROS were （164.86 ± 14.78）μg/L （89.78 ± 11.42）,and （19.81 ± 8.67）U/L respectively,which were statistically different from those in control group [（156.32 ± 13.86） μ g/L,（105.64 ± 12.86）,（11.32 ± 6.86）U/L]（P〈0.05）,the serum levels of 8-isoprostane,SOD and ROS were （166.42 ± 11.42）μg/L, （86.45 ± 10.89）,and （21.45 ± 9.85）U/L respectively in severe preeelampsia,which were statistically different from those in mild preeelampsia [（161.63 ± 13.64）μg/L,（91.22 ± 13.74）,（15.65 ± 9.67） U/L]（P〈0.05）.Cesarean section rate was significantly higher in case group than in the control group （67.0% vs 20.0%）,and it was significantly higher in severe preeclampsia than in mild preeclampsia （75.0% vs 55.0%）,showing statistically significant difference（P〈0.05）.The incidence of low birth weight infants was significantly higher in case group than in control group （14.0% vs 0）,and it was significantly higher in severe preeclampsia higher than in mild preeclampsia（21.7% vs 2.5%）,showing statistically significant differences（P〈0.05）.Conclusion Excessive oxidative stress exists in preeclampsia and progresses with disease severity.