单核细胞趋化蛋白-1在胎儿生长受限患者胎盘的表达及其意义

Expression of monocyte chemoattractant protein-1 in placenta of patients with fetal growth restriction and its significance

目的通过检测胎儿生长受限(fetal growth restriction,FGR)患者胎盘、外周血中单核细胞趋化蛋白-1(monocyte chemoattractant protein-1,MCP-1)的表达水平,探讨MCP-1在FGR中的作用及可能机制。方法选择50例FGR患者为FGR组,正常晚期妊娠分娩孕妇50例为正常对照组,以酶联免疫吸附法检测两组孕妇胎盘、外周血MCP-1水平,并对胎盘组织切片进行病理形态学分析。结果 FGR组胎盘光镜下见不同程度的绒毛发育不良,合体结节增多,绒毛炎,其发生率高于正常对照组[64.0%(32/50)vs12.0%(6/50),P<0.05],其中合并绒毛炎的发生率31%(10/32);FGR组中胎盘病理异常组的胎盘MCP-1浓度高于正常对照组,差异有统计学意义[胎盘MCP-1:(136.97±10.24)vs(129.76±5.67)ng/m L,P<0.05],其中合并绒毛炎胎盘中MCP-1浓度高于正常对照组[(149.76±8.67)vs(129.76±5.67)ng/m L,P<0.05];而FGR组中胎盘病例异常组与正常对照组外周血MCP-1浓度比较差异无统计学意义[血清MCP-1(137.14±9.73)vs(140.16±10.34)ng/m L,P>0.05]。结论 MCP-1参与了FGR的发生,其作用机制可能通过过度炎症反应,导致胎盘灌注不足。

Objective To research the serum and placental expression of monocyte chemoattractant protein - 1 （ MCP - 1 ） in fetal growth restriction（ FGR）, and analyze their effect and mechanism. Methods In 50 patients with fetal growth restriction （group） and 50 normal term pregnant women （ control group） the level of MCP - 1 in maternal serum and placenta were detected by enzyme linked immunosorbent assay （ELISA） and the placental tissue sections were analyzed by pathological morphologly. Results In the FGR group, the main pathological changes were different degrees of villous dysplasia, increased syncytiotrophoblast nodules and chorioamnionitis o The incidence rates were significantly higher than that in the control group [ 64. 0% （32/50） vsl2. 0% （6/50）, P 〈 0. 05] ;The incidence of chorioamnionitis among the pathological change of placental tissue was 31% （10/32）. In the placental pathological change group of the FGR group, the concentration of MCP - 1 in the placenta was higher than the control group [ placenta MCP - 1 ： （ 136.97 ± 10. 24） vs （ 129.76 ± 5.67 ）ng/mL ,P 〈 0. 05 ] ; In the Placental pathological change group with chorioamnionitis, the concentration of MCP - 1 in the placenta was significantly higher than the control group [ （ 149.76 ± 8. 67） vs （ 129.76 ± 5.67 ） ng/mL, P 〈 0. 05 ] ; There was no significant difference in the concentration of serum MCP - 1 between the the placental pathological change group and the control group. [serum MCP -1 （137.14 ±9.73） vs（140. 16 ± 10. 34） ng/mL,P 〉0.05]. Conclusion MCP - 1 is associated with the occurrence and development of FGR, and the mechanism may be caused by excessive inflammatory reaction, which result in placental malperfusion.