雌、孕激素和血管内皮生长因子在子痫前期胎盘中的表达

Expressions of estrogen,progesterone and vascular endothelial growth factor in placenta of patients with preeclampsia

目的通过检测子痫前期患者和正常孕妇胎盘组织中雌、孕激素和血管内皮生长因子的表达,探讨子痫前期的发病机制。方法选取2013年5月至2014年5月入住我院分娩并被确诊为子痫前期的患者50例作为观察组,同时选取同期入住我院分娩的正常孕妇50例作为对照组。分别采用化学荧光免疫法和免疫组化法检测两组胎盘组织中雌、孕激素水平和血管内皮生长因子的表达情况,采用HE染色法观察两组胎盘组织的组织形态学变化。结果 (1)两组胎盘组织雌二醇(E2)水平分别为(40.81±6.88)pmol/L和(79.20±7.23)pmol/L,观察组显著低于对照组(P<0.05);两组孕激素(Pg)水平分别为(595.77±66.59)nmol/L和(328.40±59.56)nmol/L,观察组显著高于对照组(P<0.05);且观察组E2/Pg比值小于对照组(P<0.05)。(2)观察组和对照组胎盘组织中血管内皮生长因子蛋白阳性表达分别为96%和46%,观察组显著高于对照组(P<0.05)。(3)对照组胎盘组织绒毛形态完整,间质和血管正常;而观察组绒毛形态不规则,胎盘血管出现损伤,间质出现水肿和增生,血管减少并伴有淤血。结论子痫前期患者胎盘组织雌激素水平下降,孕激素水平上升,血管内皮生长因子表达上调;可能由于激素水平变化和血管内皮功能的损伤导致了子痫前期的发生。

Objective： To detect the expression of estrogen, progesterone and vascular endothelial growth factor （VEGF）in patients with preeclampsia,and explore the pathogenesis of preeclampsia. Methods： Fifty patients with preeclampsia were recruited as observation group;meanwhile,50 normal pregnant women were selected as control group in our hospital from May 2013 to May 2014. The levels and expression of estrogen（E2）,progesterone（P）and VEGF were detected by chemical immunofluorescent and immunohistochemieal method respectively. Morphological changes were observed by HE methods. Results： Estradiol levels in the observation group（40.81＋6.88 pmol/L）were significantly lower than those in the control group（79.20±7.23 pmol/L） （P〈0.05） ,while progesterone levels in the observation group（595.77 ±66.59 nmol/L）were significantly higher than those in the control group（328.40 ± 59.56 nmol/L（P〈0.05）. Therefore,E2/P ratio in the observation group was significantly lower than those in the control group（P〈0.05）. The positive expression rate of VEGF protein in the observation group （96%）was also significantly higher than that in the control group（46%）（P〈0.05）. The villous morphology was intact, and stroma and blood vessels were normal in placenta of the control group.However,many abnormal phenomena were found in the placenta of the observation group, which included irregular villous morphology,vascular damage,reduction and congestion,stromal edema and hyperplasia. Conclusions： Declined estrogen and elevated progesterone levels, and up-regulated expression of VEGF were found in patients with preeclampsia. The changes of hormone levels and injury of vascular endothelial function could lead to the occurrence of preeclampsia.