HIF-1α及其靶基因VEGF在双胎输血综合征患者胎盘组织中的表达

Expressions of HIF-1α and target gene VEGF in placental tissue of patients with twin-twin transfusion syndrome

目的：探讨双胎输血综合征（TTTS）患者胎盘组织中缺氧诱导因子-1（HIF-1）及其靶基因血管内皮细胞生长因子（VEGF）的表达情况。方法：选取2010年1月-2014年7月在该院分娩的单绒毛膜双胎妊娠产妇68例,其中TTTS患者18例作为观察组,未发生TTTS患者50例作为对照组,对胎盘组织HIF-1α及其靶基因VEGF进行定位检测,并检测HIF-1α及其靶基因VEGF蛋白以及mRNA表达情况。结果：HIF-1α主要分布在胎盘的合体滋养细胞以及细胞滋养细胞,而VEGF主要分布在滋养细胞、血管内皮细胞、绒毛间质细胞胞核和胞质中;观察组胎盘组织HIF-1α表达平均面积、平均灰度和IOD值（面积×平均灰度）分别为（0.36±0.11）m2、（147.35±7.54）和（51.74±12.34）,VEGF表达平均面积、平均灰度和IOD值分别为（0.47±0.13）m2、（141.27±8.24）和（49.67±11.38）,均明显高于对照组（P〈0.05）;观察组HIF-1、mRNA和VEGF mRNA表达量分别为（0.41±0.04）和（0.38±0.06）,明显高于对照组（P〈0.05）。结论：HIF-1α和VEGF表达增强可能影响单绒毛膜双胎妊娠胎盘血管生成,从而致双胎输血综合征发生。

Objective： To explore the expressions of hypoxia inducible factor - 1α （ HIF -1α） and target gene vascular endothelial growth factor （VEGF） in placental tissue of patients with twin - twin transfusion syndrome （TITS） . Methods： Sixty - eight pregnant women of monochorionic twin pregnancy who gave birth to their babies in the hospital from January 2010 to July 2014 were selected, then they were divided into observation group （ 18 patients with TTTS） and control group （50 patients without TITS） . HIF -1α and VEGF expressions in placental tissue were located and detected; the expression levels of HIF-1α and VEGF proteins and mRNA in the two groups were detected. Results： HIF - 1α mainly distributed in placental syncytiotrophoblast and cytotrophoblast, while VEGF mainly distributed in the trophoblast, vascular endothelial cells and nucleus and cytoplasm of villous stromal cells; in placental tissue of observation group, the average expression area, average gray value and IOD value of HIF -1α were （0. 36 ±0. 11 ） m^2, （ 147.35 ±7.54） and （51.74 ± 12. 34）, respectively, the average expression area, average gray value and IOD value of VEGF were （ 0.47 ± 0. 13 ） m^2 , （ 141.27 ±8.24 ） and （49. 67 ±11.38 ）, respectively, which were statistically significantly higher than those in control group （P 〈 0.05 ） . The expression levels of HIF- 1 mRNA and VEGF mRNA in observation group were （0. 41 ± 0. 04 ） and （0. 38 ± 0. 06）, respectively, which were statistically significantly higher than those in control group （P 〈0. 05） . Conclusion： Up - regulations of HIF- 1α and VEGF may affect placental angiogenesis of patients with monochofionic twin pregnancy, then TITS is induced.