小剂量低分子肝素联合硫酸镁治疗重度子痫前期对血清和胎盘中病情相关分子的调节作用

Regulation effect of small doses of low molecular weight heparin combined magnesium sulfate treatment on serum and placental disease-related molecules of severe preeclampsia patients

目的分析小剂量低分子肝素联合硫酸镁治疗重度子痫前期对血清和胎盘中病情相关分子的调节作用。方法选取2012年7月-2014年7月于本院收治的重度子痫前期患者68例作为研究对象,随机分为观察组及对照组。对照组患者接受单纯硫酸镁治疗,观察组患者接受小剂量低分子肝素联合硫酸镁治疗,对比两组患者的血清及胎盘组织中激肽释放酶表达、妊娠相关血浆蛋白A(PAPP-A)、妊娠特异性β_1糖蛋白(SPI)、胎盘生长因子(PLGF)、人胎盘催乳素(HPL)水平、转化生长因子β_1(TGF-β_1)、血管细胞黏附分子1(VCAM-1)及E选择素水平等差异。结果观察组患者的治疗后血清及胎盘组织中激肽酶表达量均高于对照组患者,差异有统计学意义(P<0.05);血清及胎盘组织中PAPP-A水平低于对照组患者,差异有统计学意义(P<0.05);血清及胎盘组织中,TGF-β_1水平高于对照组,VCAM-1及E选择素水平低于对照组患者,差异有统计学意义(P<0.05)。结论重度子痫前期患者接受小剂量低分子肝素联合硫酸镁治疗,可以促进内源性激肽释放酶表达,降低妊娠期高血压相关预测因子水平,减弱细胞滋养细胞的浸润能力。

Objective To analyze the regulation effect of small doses of low molecular weight heparin combined magnesium sulfate treatment on serum and pl acental disease-related molecules of severe preeclampsia patients. Methods Sixty-eight cases of severe preeclampsia patients between July 2012 to July 2014 in our hospital were chosen as research subjects and randomly divided into observation group and control group. The control group patients received magnesium sulfate treatment alone, the observation group patients received small doses of low molecular weight heparin combined magnesium sulfate treatment. The serum and placental levels of kallikrein expression, PAPP-A, SPI, PLGF, HPL, TGF-β1, VCAM-1 and E-selectin were compared between the two groups. Results The serum and placental kallikrein and TGF-β1 levels of the observation group were significantly higher than those of the control group （P〈0.05）; while the serum and placental PAPP-A, VCAM-1 and E-selectin levels were lower than those of the control group （P〈0.05）. Conclusions In severe preeclampsia patients, treatment with pancreatic kallikrein and magnesium sulfate can promote endogenous kallikrein expression, reduce the levels of gestational hypertension-related predictive factors, weaken the invasive capacity of cytotrophoblast cells.