VEGF在妊娠期糖尿病巨大儿胎盘及脐带中的变化及意义

Differential expression of vascular endothelial growth factor in placenta and corn in macrosomia of gestational diabete mellitus

目的探讨血管内皮生长因子(VEGF)在妊娠期糖尿病巨大儿脐带动脉血及静脉血中水平及其在胎盘、脐带血管的表达情况及意义。方法选取2014年5月至2015年5月该院妇产科住院分娩的确认为妊娠期糖尿病并分娩巨大儿的初产妇为巨大儿组(n=30),同期分娩的正常体质量新生儿初产妇为对照组(n=30)。用放射免疫分析法分别测定巨大儿组及对照组脐静脉血及脐动脉血中VEGF水平,用免疫组化法分别测定VEGF在巨大儿组及对照组胎盘及脐动脉、脐静脉的表达情况。结果巨大儿组脐静脉血和脐动脉血清中VEGF水平分别为(30.74±4.82)pg/mL和(22.67±5.65)pg/mL,明显高于对照组(P<0.01)。VEGF在巨大儿组胎盘、脐动脉及脐静脉表达A值分别为0.454±0.024、0.381±0.023、0.367±0.049,较对照组明显升高(P<0.01)。结论妊娠期糖尿病巨大儿脐血中VEGF水平增高,VEGF在妊娠期糖尿病巨大儿脐带及胎盘组织中表达增强。

Objective To investigate the value of vascular endothelial growth factor（VEGF） in umbilical venous and arterial blood and the changes of VEGF in placenta and corn of macrosomia delivered by gestational diabetes mellitus mothers so that we can explore the role of vascular endothelial growth factor in the development of macrosomia. Methods We studied 60 cases between May 2014 and May 2015 ,including 30 cases of macrosomias who＇s mothers were gestational diabetes mellitus patients as observa- tion group and 30 cases of normal weight newborns whors mothers were healthy as control group. The umbilical venous and arterial blood from all cases were collected for detecting the level of VEGF by the radioimmunoassay method.The method of immunohisto- chemstry was used to explore the expression of VEGF in which were placenta,umbilical venous and umbilical arterial in all cases. Results The levels of VEGF in umbilical vein and umbilical arterial in observation group were （30. 74±4.82）pg/mL and （22. 67± 5.65） pg/mL, respectively. Those were significantly higher than that in the control group （P〈0.01 ） . The expressing of VEGF in placenta,umbilical vein and umbilical artery in observation group were（0. 454 ± 0. 024）, （0. 381 ± 0. 023）, and（0. 367 ±0. 049）, Which were significantly higher than the control group（P〈0.01）. Conclusion The change of VEGF has strong relationship with the development of macrosornia in gestation diabete mellitus. The increased VEGF in umbilical vein blood and umbilical arterial blood can lead to the induction of maerosomia;the VEGF over expression in placenta and cord vessel are important factor to accelerate fetal overgrowth.