妊娠高血压综合征患者胎盘血管内皮生长因子的表达及其意义

Expression and role of placental vascular endothelial growth factor in patients with pregnancy induced hypertension

目的 探讨胎盘血管内皮生长因子 (VEGF)在妊娠高血压综合征 (妊高征 )患者中的表达及其与胎盘血管网络构建、胎盘重量及新生儿体重的关系。方法 采用蛋白免疫印迹技术测定 2 5例正常妊娠妇女 (正常妊娠组 )及 2 5例妊高征患者 (妊高征组 )的胎盘组织中VEGF的表达。采用免疫组织化学法 ,用抗F8因子抗体标记两组孕妇胎盘中的血管密度。两组孕妇分娩后 ,测量新生儿身长、体重 ,并胎盘称重。结果 (1)妊高征组和正常妊娠组孕妇胎盘VEGF积分吸光度值分别为2 4793± 6 5 79、4190 3± 110 0 9;胎盘血管密度分别为 (6 1± 11)和 (78± 11)个 / 40 0×视野。两组比较 ,差异均有极显著性 (P <0 0 1) ,且与妊高征患者病情严重程度相关。 (2 )妊高征组胎盘重量 [(4 6 0±5 9)g]较正常妊娠组 [(5 73± 99)g]显著下降 (P <0 0 1)。 (3)妊高征组新生儿体重为 (3176± 5 0 3)g,较正常妊娠组的 (34 6 8± 493)g显著下降 (P <0 0 5 ) ;而新生儿身长在两组间比较 ,差异无显著性(P >0 0 5 )。(4 )正常妊娠组中 ,胎盘VEGF的表达与血管密度、胎盘重量和新生儿体重的相关系数分别为 0 82 3、0 6 71、0 888;妊高征组分别为 0 90 5、0 85 9、0 732 ,两者均呈显著正相关 (P <0 0 1)。

Objective To investigate the expression of placental vascular endothelial growth factor (VEGF) and its relationship with construction of placental vascular network, placental weight and the newborns′ weight in patients with pregnancy induced hypertension (PIH). Methods Twenty-five patients with PIH and twenty-five normal late pregnant (NLP) women in the third trimester were observed in this study. The expression of VEGF protein in placental, the placental vascular density were determined by Western blot and immunohistochemical F8 staining respectively. Results The VEGF values in patients with PIH and NLP were 24 793± 6 579 and 41 903± 11 009, and the vascular densities were (61±11) and (78±11) counts/400 ×vision respectively. They were both significantly different in both groups and were closely related to the severity of PIH (P<0.01). Placental weight and the newborns′ weight in patients with PIH [(460±59) g, (3 176± 503) g respectively] were also significantly decreased compared with NLP [(573±99) g, (3 468±493) g respectively], but the new newborns′ length had no significant difference between the two groups (P>0.05). In NLP group, placental vascular density, placental weight and the newborns′ weight all had a significantly positive correlation with VEGF (P<0.01,r= 0.823? 0.671? 0.888 respectively) and in PIH group, the situation was the same (P<0.01,r= 0.905? 0.859? 0.732 respectively), but the new newborns′ length had no correlation with VEGF (P>0.05). Conclusion It shows that the reduced expression of VEGF in placenta of patients with PIH may be one of the important factors responsible for decreased placental vascular density and fetal intrauterine growth restriction.