子痫患者血清TNF-α、IL-6、CRP、Lp-PLA2、PON-1和APN水平的变化及临床研究

Clinical Significance of TNF-α,IL-6,CRP,Lp-PLA2,PON-1 and APN Value Changes in Pregnant Women with Preeclampsia

目的探讨肿瘤坏死因子(TNF-α)、白介素6(IL-6)、C反应蛋白(CRP)、血清脂蛋白相关磷脂酶A2(Lp-PLA2)、对氧磷酶1(PON-1)以及脂联素(APN)在子痫前期孕妇血清中的变化及其临床意义。方法选择2013年8月至2016年6月我院产科进行检测的孕妇160例,其中,妊娠期高血压孕妇(GH),轻度子痫前期孕妇(MPE)、重度子痫前期孕妇(SPE)和正常妊娠期孕妇(NC)各40例。采用酶联免疫吸附法检测IL-6、TNF-α以及Lp-PLA2水平,采用乳胶增强透射免疫比浊法检测血清CRP含量,利用qRT-PCR法检测PON-1和APN mRNA表达水平,采用免疫印迹法检测PON-1和APN蛋白表达水平,并比较各组之间的差异。结果子痫前期孕妇血清TNF-a、IL-6、CRP以及Lp-PLA2水平明显高于正常妊娠对照组及妊娠期高血压组,差异存在统计学意义(P<0.05)。重度子痫前期患者血清TNF-a、IL-6、CRP以及Lp-PLA2水平明显高于轻度子痫前期患者,差异存在统计学意义(P<0.05)。子痫前期孕妇血清PON-1和APN mRNA和蛋白表达水平明显低于正常妊娠对照组及妊娠期高血压组,差异存在统计学意义(P<0.05),且重度子痫前期患者血清PON-1和APN mRNA和蛋白水平明显低于轻度子痫前期患者,差异存在统计学意义(P<0.05)。结论子痫前期患者血清中TNF-a、IL-6、CRP以及Lp-PLA2水平的升高,PON-1和APN水平的降低可能参与子痫前期的发生。

Objective To investigate the level of tumor necrosis factor-a, （TNFa）, interleukin-6 （IL-6）, C- reactive protein （ CRP ）, plasma lipoprotein associated phospholipase A2 （ Lp- PLA2 ）, paraoxonase- 1, （PON-1） as well as adiponectin （APN） in the irate pregnancy women with preeclampsia （PE）, and to evaluate their clinical significance. Methods From August 2013 to June2016,160 cases of pregnant women were selected as research objects, which include gestational hypertension （GH） （ n = 40 ）, mild preeclampsia （MPE） （ n ： 40 ） , severe preeclampsia （ n = 40 ） （SPE） and normal pregnant woman （ NC ） （ n = 40 ）. The levels of TNF- a, IL- 6, Lp- PLA2 were detected by Elisa （ enzyme- linked immune sorbent assay） method. The level of CRP was measured by latex enhanced transmission immunoturbidimetry assay. The level of PON-1 and APN mRNA and protein were determined by qRT-PCR and Western blot respectively. Results The serum level of TNF-a,IL-6,CRP,Lp-PLA2 in PE pregnant woman were markedly elevated compared with normal group and gestational hypertension group. Meanwhile, for severe preeclampsia patients, their serum levels of TNF-a, IL-6, CRP, Lp-PLA2 were significantly higher than mild preeclampsia patients. Moreover, we found that the serum level of PON-1 and APN mRNA and protein in PE pregnant woman were markedly reduced compared with normal group and gestational hypertension group. Meanwhile, severe preeclampsia patient＇ s serum levels of PON-1 and APN mRNA and protein were significantly lower than normal group and gestational hypertension group. Conclusion Increased level of TNF- a, IL-6, CRP, Lp- PLA2 and decreased levels of PON-1 and APN could be involved in the pathogenesis of PE patients.