内皮糖蛋白、血管内皮生长因子及其受体1在子痫前期中的表达和临床意义

Expression and clinical implication of endothelial glycoprotein,vascular endothelial growth factor and its receptor 1 in preeclampsia

目的：探讨内皮糖蛋白（Endoglin）、血管内皮生长因子（VEGF）及其受体1（Flt﹣1）在子痫前期外周血清及胎盘组织中的表达和临床意义。方法选取轻度子痫前期患者15例、重度子痫前期患者30例及正常足月妊娠孕妇20例（对照组），取外周静脉血，以ELISA试剂盒测定Endoglin、VEGF及Flt﹣1的血清含量；并于胎盘娩出后取全层胎盘组织，以免疫组化实验观察Endoglin、VEGF及Flt﹣1的分布与表达。结果对照组、轻度和重度子痫前期组血清中的Endoglin水平分别为（0．9±0．1）ng／ml、（1．1 ±0．2）ng／ml、（1．4±0．3）ng／ml，对照组、轻度和重度子痫前期组血清中Flt﹣1含量分别为（204．0±33．4）ng／L、（562．0±60．7）ng／L、（756．0±71．3）ng／L，Endoglin与Flt﹣1含量均逐渐升高；对照组、轻度和重度子痫前期组血清中VEGF含量分别为（151．0±13．1）ng／L、（81．4± 6．3）ng／L、（63．2±5．2）ng／L，VEGF含量逐渐降低，差异均有统计学意义；对照组、轻度和重度子痫前期组胎盘组织中Endoglin的阳性表达率分别为36．0％、61．3％、79．3％，表达量分别为（86．72±6．35）、（97．46±6．91）、（113．57±7．04），Flt﹣1的阳性表达率分别为48．0％、70．7％、84．0％，表达量分别为（126．12±7．80）、（141．86±7．17）、（154．32±8．01），Endoglin及Flt﹣1均逐渐升高，差异均有统计学意义；对照组、轻度和重度子痫前期组胎盘组织中VEGF阳性表达率分别为57．0％、86．7％、91．3％，表达量分别为（133．50±7．14）、（117．28±6．46）、（103．69±6．84），阳性表达率逐渐升高、表达量逐渐降低，差异均有统计学意义。胎盘组织中Endoglin与VEGF、Flt﹣1的表达无关，VEGF与Flt﹣1的表达呈负相关（R2＝0．7168）。结论 Endoglin、VEGF、Flt﹣1与子痫前期发病和进展密切相关，可作为临床诊断和预后评估的辅助指标。

Objective Tocharacterizetheexpressionofinternalprotein（endoglin）,vascularendothelialgrowth factor （VEGF）and its receptor 1 （Flt﹣1 ）in serum and placenta tissue of patients with preeclampsia,and to examine the clinical implications. Methods Fifteen cases of patients with mild preeclampsia,30 cases of patients with severe preeclampsia and 20 cases of normal term pregnant women （control group）were selected.Concentrations of endoglin, VEGF,and Flt﹣1 in serum were determined by ELISA kit.At delivery,placental samples were collected,and the expression and distribution of endoglin,VEGF,and Flt﹣1 were determined by immunohistochemistry. Results Endoglin level in serum of the control,mild,and severe preeclampsia group was （0. 9 ±0. 1）ng/ml,（1. 1 ±0. 2）ng/ml,（1. 4 ±0. 3） ng/ml,respectively.Serum Flt﹣1 concentration in the control,mild and severe preeclampsia group was （204. 0 ±33. 4） ng/L,（562. 0 ±60. 7）ng/L,（756. 0 ±71. 3）ng/L,respectively.Serum VEGF concentration in the control,mild,and severe preeclampsia group was （151. 0 ±13. 1）ng/L,（81. 4 ±6. 3）]ng/L,（63. 2 ±5. 2）ng/L,respectively.Positive expression rate of endoglin in placenta tissue of the control,mild,and severe preeclampsia was 36. 0%,61. 3%,and 79.3%,respectively,with expression quantities of （86.72 ±6.35）,（97.46 ±6.91）,and （113.57 ±7.04）, respectively.The positive expression rate of Flt﹣1 was 48. 0%,70. 7%,and 84. 0%,respectively,with expression quantities of （126. 12 ±7. 80）,（141. 86 ±7. 17）,and （154. 32 ±8. 01）,respectively.The positive expression rate of VEGF in the control, mild, and severe preeclampsia placenta tissue was 57.0%, 86.7%, and 91.3%, respectively, with expression quantities of 133.50 ± 7. 14, 117.28± 6.46, and 103.69 ±6. 84, respectively. In placenta tissue, the expression of endoglin, VEGF, and Flt-1 was not correlated; the expression of VEGF and Fit-1 was negatively correlated. Conclusion Endoglin, VEGF, and Fh-1 were closely related to the occurrence and progression of preeclampsia, and therefore may be used as auxiliary indicator to evaluate the clinical diagnosis and prognosis.