子痫前期孕妇血清及胎盘组织血管内皮生长因子受体1表达及与脂代谢的关系

Expression and significance of vascular endothelial growth factor receptor-1 in placenta,serum and their role in pathogenesis of preeclampsia

目的探讨孕妇血清及胎盘组织中血管内皮生长因子受体1(sFlt-1)表达变化在子痫前期(PE)发病中的作用,及与脂代谢异常、胰岛素抵抗(IR)的关系。方法选择2009年10月至2011年5月我院产科住院分娩的PE孕妇及同期正常对照组各60例,采用ELISA方法检测孕妇血清sFlt-1,采用RT-PCR技术检测胎盘组织中sFlt-1mRNA的表达。结果 1)早发型及晚发型PE组孕妇血清中sFlt-1水平分别为(3 608±1 210)及(2 609±865)ng/L,均高于对照组(P<0.05)。2)早发型及晚发型PE组孕妇血清FINS、胰岛素抵抗指数(HOMA-IR)水平分别为(25.0±4.2)mU/L、5.4±1.0及(24.7±4.3)mU/L、4.9±1.3,均高于对照组(P<0.05);早发型与晚发型PE组FINS及HOMA-IR比较,差异均无统计学意义(P>0.05)。3)早发型和晚发型PE组孕妇胎盘组织中sFlt-1mRNA的表达水平分别为3.30±1.70及2.28±1.07,均高于孕周≥34周对照组(P<0.05),且早发型PE组高于晚发型PE组(P<0.05)。4)孕妇血清中sFlt-1水平与胎盘组织中sFlt-1mRNA表达水平呈正相关(P<0.05);孕妇血清sFlt-1水平与血TG、TC、FINS、HOMA-IR、UA、SP、DP、MAP、孕时BMI均呈正相关(P<0.05),与血HDL-C无明显相关。结论 PE孕妇血清sFlt-1水平及胎盘组织中sFlt-1mRNA表达水平明显升高,两者呈正相关。PE孕妇存在IR、高胰岛素血症、高脂血症,该变化可能与PE的发病有关。

Objective To investigate the change of sFlt-1in maternal serum and sFlt-1mRNA placental expression in patients with preeclampsia（PE）,and the relationship with lipid metabolism and insulin resistance（IR）.Methods A total of 60 women with PE and 60 normal pregnant women（control group）participated in this study.All were admitted to Fujian Maternity and Children Health Hospital for delivery from October 2009 to May 2011.ELISA was used to detect sFlt-1in matemal serum.RT-PCR was used to detect placental sFlt-1mRNA expression.Results 1）Maternal serum sFlt-1was（3 608±1 210）ng/L in early-onset PE group and（2609±865）ng/L in late-onset PE group,significantly elevated as compared to control group（P〈0.05）.2）Mean maternal FINS,HOMA-IR were significantly elevated in PE group as compared to control group（P〈0.05）,and the difference was not the early-onset and late-onset PE group（P〉0.05）.3）Mean placental sFlt-1mRNA expression was significantly elevated in PE group as compared to late control group,and were significantly elevated in the early-onset PE group as compared to late-onset PE groups（P〈0.05）.4）Mean maternal serum sFlt-1concentration was correlated positively with placental sFlt-1mRNA expression,TG,TC,FINS,HOMA-IR,UA,SP,DP,MAP,BMI（P〈0.05）,and not significantly correlated with HDL-C.Conclusion Increased sFlt-1expression in maternal serum and placenta may be involved in the pathogenesis of preeclampsia.PE patients always accompany by IR,hyperinsulinemia and hyperlipidemia,that maybe relate to the pathogenesis of preeclampsia.