肝细胞生长因子、晚期糖基化终产物受体在妊娠期糖尿病胎盘中的表达及与母儿预后的关系

HGF and RAGE expressed in placentas of patients with gestational diabetes mellitus and its relationship with maternal and neonatal prognosis

目的：探讨妊娠期糖尿病（ GDM）胎盘中肝细胞生长因子（ HGF）、晚期糖基化终产物受体（ RAGE）的表达及与母儿预后的关系。方法选择晚孕GDM孕妇63例，依据是否规律降血糖治疗分为治疗组40例，未治疗组23例，另选择同期产检并分娩的健康孕妇30例为对照组。采用免疫组织化学方法测定三组胎盘中HGF和RAGE的表达，并比较其母儿预后的差异。结果 HGF和RAGE在三组胎盘组织中均有表达，HGF在未治疗组、治疗组、对照组胎盘中表达逐渐增强，阳性单位（PU值）分别为（5．03±1．05）、（7．83±1．62）、（11．54±2．62），组间比较差异有统计学意义（F＝7．56，P＜0．05）；RAGE在未治疗组、治疗组、对照组胎盘组织中表达逐渐减弱，PU值分别为（14．56±2．70）、（12．87±2．63）、（8．39±1．56），组间比较差异有统计学意义（F＝11．62，P＜0．05）；未治疗组母、儿并发症发生率（178．26％、121.73％）均明显高于治疗组（65.00％、32.50％）和对照组（13．33％、3．33％），组间比较差异均有统计学意义（χ2＝7．34、13．21、9．75、6.67、15．23、12．53，均P＜0．05）。结论 HGF、RAGE可能参与了GDM的发生发展，与母儿预后关系密切，规律治疗可改善母儿预后。

Objective To study the expression of HGF , RAGE in placentas of patients with gestational diabetes mellitus and its relationship with maternal and neonatal prognosis .Methods The complete clinical datas of late pregnancy,GDM treated group 40 cases,GDM untreated group 23 cases,the control group 30 cases.Immunohisto-chemical method was used to detect HGF and RAGE in the placentas of three groups ,the maternal and neonatal prog-nosis were recorded.Results In GDM untreated group,GDM treated group and the controlled group placenta ,HGF and RAGE expressed.The expression of HGF was gradually increased ,and any comparative differences between two groups were statistically significant （ F =7.56, P 〈0.05 ）;the expression of RAGE in placentas was gradually declined ,the differences among the control group and GDM untreated ,GDM treated group were statistically significant （F=11.62,P〈0.05）.The rates of maternal and neonatal complications in the GDM untreated group were signifi-cantly higher than that of the GDM treated group and the control group （χ2 =7.34,13.21,9.75,6.67,15.23, 12.53,all P〈0.05）.Conclusion HGF and RAGE may participate in the occurrence and development of GDM and maternal and neonatal prognosis closely ,regular treatment can improve the prognosis of mothers and infants .