妊娠高血压疾病胎盘组织ACE2和ACE的表达及其临床意义

Expressions of ACE and ACE2 in placenta in patients with pregnancy Induced hypertension and their clinical significance

目的探讨血管紧张素转换酶2(ACE2)以及血管紧张素转换酶(ACE)在妊娠高血压疾病中的表达及其临床意义。方法用逆转录酶-聚合酶链反应(RT-PCR)测定2010年6月—2011年12月入住我院的50例妊娠高血压疾病、30例无妊娠高血压疾病病史的足月妊娠孕妇,手术取材其胎盘组织检测其胎盘组织中ACE2 mRNA和ACE mRNA表达水平。结果妊娠高血压疾病患者胎盘组织的ACE2 mRNA和ACE mRNA表达均较对照组明显升高,差异有显著统计学意义(P<0.01),妊娠高血压疾病患者胎盘组织的ACE2 mRNA和ACE mRNA随病情的加重而升高,重度妊娠高血压疾病患者升高更为显著(P<0.01);轻中度妊娠高血压疾病患者胎盘组织ACE2 mRNA/ACE mRNA比值较正常组升高,而重度患者其比值较正常组降低。结论妊娠高血压疾病患者组织ACE2和ACE基因表达明显增强;轻中度妊娠高血压疾病患者胎盘组织ACE2 mRNA/ACE mRNA比值升高可能是一种代偿机制,导致AngⅡ的降解,促进AngⅠ-7合成,降低血压及改善胎盘功能,而重度妊娠高血压疾病导致代偿功能减退,最终加剧病情恶化。

Objective TO explore the expressions of placenta ACE and ACE2 in patients with pregnancy induced hypertension and their clinical significance. Methods ACE and ACE2 were measured via RT-PCR in 50 women with pregnancy induced hypertension and 30 ones without hypertension admitted to our hospital from June 2010 to December 2011. Results The expressions of ACE2 and ACE mRNA were significantly higher in the patients with pregnancy induced hypertension than in the controls （ P 〈 0. O1 ） , especially in those with severe pregnancy induced hypertension （P 〈 0.01 ）. The ACE2/ACE mRNA ratio increased in the patients with mild-middle pregnancy induced hypertension and decreased in those with severe pregnancy induced hypertension, when com- pare with the controls. Conclusion The expressions of ACE2 and ACE were up-regulated in patients with pregnancy induced hy- pertension. The increased ACE2/ACE mRNA ratio in the patients with mild-middle pregnancy induced hypertension may be due to compensation, indicating the promotion of Ang Ⅱ degradation and Ang 1-7 synthesis. The decreased ACE2/ACE mRNA ratio in the patients with severe pregnancy induced hypertension suggested that Ang Ⅱ level accelerated the disease progression.