Syncytin-1和HtrA4在子痫前期患者母血及胎盘组织中的表达及临床意义

Expressions of Syncytin-1 and Htr A4 in maternal blood and placental tissues of patients with preeclampsia and the clinical significance

目的探讨子痫前期(PE)患者母血及胎盘组织中Syncytin-1及Htr A4的表达变化及其与新生儿出生体质量及脐动脉血流动力学参数的相关性,研究Syncytin-1和Htr A4在PE患者母血及胎盘组织中的表达及临床意义。方法选取2016年1月-2017年6月于该院住院分娩的重度PE患者110例(研究组),其中晚发型PE组52例,早发型PE组58例,同期随机选取正常分娩孕妇50例设为正常组。检测各组胎儿脐动脉收缩压与舒张压的比值(S/D)、搏动指数(PI)及阻力指数(RI)。采用ELISA法和免疫组化法测定母血和胎盘中Syncytin-1和Htr A4的含量变化。结果研究组母血和胎盘组织中Syncytin-1表达水平显著低于正常组,早发型PE组显著低于晚发型PE组(均P<0.05);早发型PE组母血和胎盘组织中Htr A4表达水平显著高于晚发型PE组,晚发型PE组高于正常组(均P<0.05)。早发型PE组S/D值显著高于晚发型PE组和正常组(均P<0.05)。早发型PE组PI值及RI值显著高于晚发型PE组,晚发型PE组高于正常组,差异均有统计学意义(均P<0.05)。结论 Htr A4和Syncytin-1参与PE发病,且与疾病的严重程度相关。PE孕妇胎盘组织和母血中Syncytin-1表达与脐动脉S/D、PI、RI值及新生儿出生体质量均呈负相关,而Htr A4表达与脐动脉上述指标及新生儿出生体质量均呈正相关。Syncytin-1与Htr A4呈负相关。Htr A4可能抑制Syncytin-1的融合分化作用,带来胎盘血管重铸障碍及胎盘浅着床,进而导致PE的发生。

Objective To explore the changes of Syncytin-1 and Htr A4 expressions in maternal blood and placental tissues of patients with preeclampsia and the correlations with birth weight of neonates and umbilical artery hemodynamic parameters,research the expressions of Syncytin-1 and Htr A4 in maternal blood and placental tissues of patients with preeclampsia and the clinical significance. Methods A total of 110 patients with severe preeclampsia giving birth to their babies in Yuncheng County People＇s Hospital from January 2016 to June 2017 were selected as study group,52 patients with late-onset preeclampsia and 58 patients with early-onset preeclampsia were included. Fifty normal pregnant women were randomly selected as normal group during the same period. The ratios of peak systolic velocityto end diastolic velocity（ S/D）,the levels of pulsatility index（ PI） and resistance index（ RI） in different groups were detected. ELISA and immunohistochemical method were used to detect the changes of Syncytin-1 and Htr A4 levels in maternal blood and placental tissues. Results The expression levels of Syncytin-1 in maternal blood and placental tissues in study group were statistically significantly lower than those in normal group（ P〈0. 05）. The expression levels of Syncytin-1 in maternal blood and placental tissues in early-onset preeclampsia group were statistically significantly lower than those in late-onset preeclampsia group（ P〈0. 05）. The expression levels of Htr A4 in maternal blood and placental tissues in early-onset preeclampsia group were statistically significantly higher than those in late-onset preeclampsia group（ P 0. 05）. The expression levels of Htr A4 in maternal blood and placental tissues in late-onset preeclampsia group were statistically significantly higher than those in normal group（ P〈0. 05）. S/D ratio in early-onset preeclampsia group was statistically significantly higher than those in late-onset preeclampsia group and normal group（ P〈0. 05）. The levels of PI and RI in early-onset preeclampsia group were statistically significantly higher than those in late-onset preeclampsia group（ P〈0. 05）. The levels of PI and RI in late-onset preeclampsia group were statistically significantly higher than those in normal group（ P〈0. 05）. Conclusion Both Htr A4 and Syncytin-1 are involved in the pathogenesis of preeclampsia,which are correlated with severity of the disease. The expression levels of Syncytin-1 in maternal blood and placental tissues of pregnant women with preeclampsia are negatively correlated with umbilical artery S/D,PI,RI,and neonatal birth weight. The expression levels of Htr A4 in maternal blood and placental tissues of pregnant women with preeclampsia are positively correlated with umbilical artery S/D,PI,RI,and neonatal birth weight. The expression levels of Syncytin-1 in maternal blood and placental tissues of pregnant women with preeclampsia are negatively correlated with the expression levels of Htr A4. Htr A4 may inhibit the fusion and differentiation of Syncytin-1,induce placental vascular remodeling disorder,placental superficial implantation,and preeclampsia.