血清、脐血中MPO水平变化及胎盘组织MPO mRNA表达与子痫前期发病的关系

Serum and placental myeloperoxidase in the pregnancies complicated by preeclampsia

目的:研究重度子痫前期(PE)患者血清MPO及胎盘组织中MPO mRNA表达水平变化与PE发病的关系,探讨糖脂代谢异常及氧化应激在PE病理生理机制中的可能作用。方法:选取60例重度PE孕妇,按发病时孕周不同分为早发型PE组(孕周<34周)和晚发型PE组(孕周≥34周)各30例。另选取同期健康晚期妊娠孕妇60例,分为对照1组(孕周<34周)和对照2组(孕周≥34周)各30例。采用实时荧光定量PCR技术检测胎盘组织中MPO mRNA表达水平;ELISA法检测血清MPO水平。检测患者血压、血脂、血糖、胰岛素水平等指标,进行相关性分析。结果:PE组的血清MPO水平高于对照组(P<0.05),且早发型高于晚发型PE组(P<0.05);但对照组间比较无差异(P>0.05)。PE组的血清TC、TG、LDL、FINS、HOMA-IR分别高于对照组(P<0.05),HDL水平低于对照组(P<0.05);但PE组间比较及对照组间比较,均无差异(P>0.05)。PE组的脐血MPO水平、胎盘组织中MPO mRNA表达水平均高于对照2组(P<0.05),且早发型高于晚发型组(P<0.05)。PE组的血清MPO水平与TG、HoMA-IR、FINS、胎盘组织MPO mRNA表达水平均呈正相关(r=0.557、0.615;0.694、0.511;0.766、0.717;0.696、0.695),与血HDL呈负相关(r=-0.697,-0.576);对照2组则无相关性。结论:MPO可能参与了PE的病理生理过程。胎盘组织中MPO mRNA表达水平升高可能是血清MPO水平升高的重要原因。PE患者血脂代谢异常及胰岛素抵抗增加与血清MPO水平升高有关,它们可能参与了血清MPO水平升高后促发PE的氧化应激的病理生理过程。

Objective ：To investigate MPO level in serum, umbilical cord blood and pla- centa of pregnancies complicated by preeelampsia. Discuss the possible pathophysiological mecha- nism of dyslipidemia and insulin resistance and oxidative stress in preeclampsia. Methods：This study included 60 pregnancies of PE and 60 normal pregnancies. Patients of PE were divided into early-onset group （n = 30, presented at〈34 weeks of gestation）, and late-onset group （n = 30, presented at≥34 weeks of gestation） ,with 30 normal pregnanies as control group1 （〈34 weeks of gestation） and group2 （≥34 weeks of gestation）. Real time fluorescence quantitative PCR was used to detect placental MPO mRNA. ELISA was used to detect serum MPO. Blood pressure, serum lipid, glucose and insulin levels were detected and made their correlation analysis. Results： Serum MPO level of PE were higher than their control groups （P〈0. 05 ）. There was significant difference between early and late-onset PE （ P〈0.05 ）, while no difference between the control groups. SerumTC ,TG, LDL, FINS, HOMA-IR of PE were higher than control groups （ P〈0.05 ）,while HDL was lower （P 〈 0. 05 ）. There was no difference between early and late-onset PE groups,or between the control groups. Serum MPO of umbilical cord blood and placental MPO mRNA of PE were higher than those of control group 2 （P〈0.05）. Early-onset were higher than late-onset PE group （P〈O. 05 ）. Serum MPO and TG, HOMA-IR, FINS and placental MPO mRNA of PE were positively correlated （r = 0.557 and 0.615,0.694 and 0. 511,0. 766 and 0. 717,0. 696 and 0.695 ）, while HDL were negatively correlated （r =-0.697,-0.576） ;No relationships were found in control group2. Conclusion：MPO may be involved in the pathophysiological process of preeclampsia. Placental MPO mRNA of PE may be the important reason of the high level of serum MPO. Dyslipidemia and increases of insulin resistance of PE were concerned with serum MPO levels,they may be involved in the oxidative stress process of PE.