稽留流产患者血清和绒毛中HIF-1α和VEGF表达水平及其相关性分析

Expression Levels of HIF-1α and VEGF in Serum and Villus in Patients with Missed Abortion

目的：探讨缺氧诱导因子-1α（HIF-1α）和血管内皮生长因子（VEGF）在稽留流产患者血清和绒毛中的表达水平及其相关性分析。方法：选择2014年8月至2015年8月我院妇产科76例稽留流产患者为观察组及行人工流产的60例正常早产孕妇为对照组;根据患者稽留流产时间将稽留流产患者分为稽留时间〈2周组（12例）,2～4周组（33例）,〉4周组（31例）;采用酶联免疫吸附（ELISA）和免疫组化SP法检测并分析患者血清与绒毛中HIF-1α与VEGF的表达水平。结果：观察组血清中HIF-1α与VEGF表达水平均显著低于对照组,差异有统计学意义（P〈0.05）;观察组和对照组绒毛VEGF和HIF-1α均表达,其中VEGF主要表达于滋养层细胞细胞质和细胞间质,HIF-1α主要表达于滋养层细胞的细胞核与细胞质,且观察组患者绒毛HIF-1α与VEGF表达水平均显著低于对照组,差异有统计学意义（P〈0.05）;不同稽留时间患者绒毛HIF-1α与VEGF表达水平间比较,差异均无统计学意义（P〉0.05）观察组患者血清HIF-1α与VEGF的表达水平呈现正相关关系（r=0.601;P〈0.05）;且绒毛HIF-1α与VEGF的表达水平也呈现正相关关系（r=0.401;P〈0.05）。结论：HIF-1α和VEGF在血清和绒毛中的低表达可能是稽留流产的发生的重要原因,临床上可以通过检测患者血清和绒毛组织中HIF-1α和VEGF的水平,有针对性的对患者进行监护和治疗,预防稽留流产的发生。

Objective： To explore the expression levels of hypoxia-inducible factor-1α （HIF-1 α） and vascular endothelial growth factor （VEGF） in patients with missed abortion and its correlation analysis. Methods： A total of 76 patients with missed abortion, who were admitted to Wuhan General Hospita of Guangzhou Military Region from August 2014 to August 2015, were chosen as observation group; and 60 cases of normal preterm pregnant woman with abortion, as control group. The patients with missed abortion were divided into 〈2 weeks group （n=12）, 2-4 weeks group （n=33）, and 〉4 weeks group （n=31） according to the time of missed abortion. The expression levels of HIF-1α and VEGF in the serum and villus of patients were detected and analyzed by enzyme-linked immuno sorbent assay （ELISA） and immunohistochemical SP method. Results： The expression levels of HIF-1α and VEGF in the serum of observation group were significantly lower than those in the control group, the differences were statistically significant（P〈0.05）. HIF-1α and VEGF in the villus were expressed both in observation group and control group, and VEGF was mainly expressed in the trophoblast cell of cytoplasm and intercellular substance, HIF-lot, in trophohlast cells of the nucleus and cytoplasm; the expression levels of HIF-1 ot and VEGF in the villus of observation group were significantly lower than those in he villus of control group, the differences were statistically significant （P〈0.05）. There were no statistical significance in the comparison between the expression levels of HIF-1 ot and VEGF in the serum and villus at different missed time （P〉0.05）. The expression level of HIF-1α in the serum was positively correlated with the expression level of VEGF in the observation group （r=0.601, P〈0.05）; and the expression level of HIF-1α in the villus was positively correlated with the expression level ofVEGF （r=0.401, P〈0.05）. Conclusion： The low expression of HIF-1α and VEGF in the serum and villus may be an important reason of the occurrence of missed abortion; so detecting the levels of of HIF-1α and VEGF in the serum and villus of paitients in clinic and pertinently monitoring and treating patients can prevent the occurrence of missed abortion.