ADMA/NOS/NO/cGMP通路系统在子痫前期患者母胎界面的表达及意义

Expression and significance of ADMA/NOS/NO/cGMP pathway in maternal-fetal interface of patients with preeclampsia

目的:探讨ADMA/NOS/NO/c GMP通路系统在子痫前期患者母胎界面的表达及意义。方法:分别选取重度子痫前期、轻度子痫前期、妊娠期高血压患者各20例,另选同期行剖宫产的单胎初产健康妊娠妇女20例作为对照。检测并比较各组胎盘组织NO和c GMP水平、总NOS活性,免疫组化SP法检测胎盘组织e NOS和i NOS表达。高效液相色谱法检测各组脐静脉内皮细胞(Human umbilical vein endothelial cells,HUVECs)内ADMA水平。结果:重度、轻度子痫前期组胎盘组织NO水平分别为(7.6±3.6)μmol/g、(11.4±4.3)μmol/g,均显著低于对照组(均P<0.05);重度、轻度子痫前期组胎盘组织c GMP水平分别为(3.26±0.31)pmol/g、(4.53±0.42)pmol/g,均显著低于对照组(均P<0.05),且4组胎盘组织c GMP水平与NO水平呈正相关关系(r=0.672);重度、轻度子痫前期组胎盘组织总NOS活性分别为(10.4±3.0)、(14.8±1.6)U/mg蛋白质,显著低于对照组(均P<0.05),4组胎盘组织总NOS活性与NO水平呈正相关关系(r=0.785);重度、轻度子痫前期组胎盘组织e NOS表达显著低于对照组(均P<0.05),重度子痫前期组i NOS表达显著高于对照组(P<0.05);重度子痫前期、轻度子痫前期及妊娠期高血压3组HUVECs内ADMA水平均显著高于对照组(均P<0.05),且4组患者HUVECs内ADMA水平与胎盘组织NO水平呈负相关关系(r=-0.582)。结论:ADMA/NOS/NO/c GMP通路系统可能在子痫前期的发病中起重要作用。

Objective： To study the expression and significance of ADMA/NOS/NO/c GMP pathway in the maternal-fetal interface of patients with preeclampsia. Methods： 60 patients were selected and divided into severe preeclampsia group,mild preeclampsia group and gestational hypertensive group according to the disease condition,meanwhile 20 healthy pregnant women of singleton receiving cesarean section were chosen as control group. Levels of NO and c GMP in placenta of the four groups were detected and compared,and activities of total NOS in placenta were measured and compared. The expression of e NOS and i NOS in placental tissue was detected by immunohistochemistry SP method. High-performance liquid chromatography was used to detect the level of ADMA in HUVECs. Results：The levels of NO in placenta of severe and mild preclampsia groups were（ 7. 6 ± 3. 6） and（ 11. 4 ± 4. 3） μmol / g,which were statistically significantly lower than that in control group（ P〈0. 05）. The levels of c GMP in placenta of severe and mild preclampsia groups were（ 3. 26 ± 0. 31） and（ 4. 53 ± 0. 42） pmol / g,which were aslo significantly lower than that in control group（ P〈0. 05）. In the four groups,the level of c GMP in placenta was positively correlated with the level of NO in placenta（ r = 0. 672）. The activities of total NOS in placenta of severe and mild preeclampsia groups were（ 10. 4 ± 3. 0） and（ 14. 8 ± 1. 6） U / mg protein,which were statistically significantly lower than that in control group（ P〈0. 05）. In placenta of the four groups,the activity of total NOS was positively correlated with the level of NO（ r = 0. 785）. The expression of e NOS in placenta of severe and mild preeclampsia groups was statistically significantly lower than that in control group（ P〈0. 05）,the expression of i NOS in severe preeclampsia group was significantly higher than that in the control group（ P〈0. 05）. The levels of ADMA in HUVECs of severe preeclampsia group,mild preeclampsia group and gestational hypertensive group were statistically significantly higher than that in the control group（ P〈0. 05）. The level of ADMA in HUVECs was negatively correlated with the level of NO in placenta of the four groups（ r =- 0. 582）. Conclusion： ADMA / NOS / NO / c GMP pathway may play an important role in the pathogenesis of preeclampsia.