LRRFIP1在妊娠期高血压疾病患者血清中的表达及临床意义

Expression and clinical significance of serum LRRFIP1 in patients with hypertensive disorders of pregnancy

目的探讨妊娠期高血压疾病(HDP)患者血清中富亮氨酸重复序列相互作用蛋白1(LRRFIP1)的表达及其临床意义。方法选取2014年5月至2016年5月西安市第四医院妇产科收治的70例妊娠高血压疾病患者(包括妊娠高血压组、轻度子痫前期组、重度子痫前期组)和30例妊娠晚期正常孕妇(正常妊娠组),采用血细胞分析仪检测血小板计数(PLT)、血小板平均体积(MPV)、血小板分布宽度(PDW)等血小板参数;采用血凝分析仪检测凝血酶原时间(PT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)等凝血指标;采用酶联免疫吸附测定(ELISA)法检测血浆LRRFIP1、α-颗粒膜蛋白(GMP-140)和D-二聚体(D-dimer)水平,并进行统计分析。结果与正常妊娠组相比,妊娠高血压疾病患者PLT、PT、APTT值均降低,MPV、PDW、FIB值均增高,且轻度子痫前期组与正常妊娠组比较差异显著(t值分别为-2.206、-2.264、-2.458、2.413、2.017、2.031,均P<0.05),重度子痫前期组与轻度子痫组比较差异显著(t值分别为-2.307、-2.026、-2.020、2.488、2.192、2.196,均P<0.05),各组间TT值比较无显著差异(P>0.05)。与正常妊娠组相比,轻度子痫前期患者血浆LRRFIP1、GMP-140、D-dimer表达水平均显著增加(t值分别为3.965、3.759、4.364,均P<0.05),而重度子痫前期组LRRFIP1、GMP-140、D-dimer值较轻度子痫前期组亦显著增加(t值分别为2.220、3.496、3.309,均P<0.05)。此外,妊娠高血压疾病患者血浆LRRFIP1的表达与PLT呈显著负相关(r=-0.28,P<0.05),而与FIB(r=0.25,P<0.05)、GMP-140(r=0.44,P<0.01)、D-dimer(r=0.42,P<0.01)呈显著正相关。结论妊娠高血压疾病患者血清中存在LRRFIP1表达上调,可能引起血小板异常活化,导致血小板功能障碍,使患者血液处于高凝状态。

Objective To explore the expression of Leucine-rich repeat flightless interacting protein 1 （LRRFIP1） in serum of patients with hypertensive disorders of pregnancy （HDP） and its clinical significance. Methods Blood cell analyzer was used to detect platelet count （PLT）, mean platelet volume （MPV） and platelet distribution width （PDW）, and blood coagulation analyzer was used to detect prothrombin time （PT）, activated partial thromboplastin time （APTT）, thrombin condensation time （TT） and fibrinogen content （FIB） of 70 patients with HDP （including gestational hypertension group, mild preeclampsia group and severe preeclampsia group） and 30 normal pregnant women in late pregnancy （normal pregnancy group）. The serum levels of LRRFIP1, platelet alpha-granule membrane protein （GMP-140） and D-dimer were detected and statistically analyzed by enzyme linked immunosorbent assay （ELISA） method. Results The levels of PLT, PT and APTT were significantly decreased, while MPV, PDW and FIB were significantly increased in HDP group when compared to normal pregnancy group, and the differences between mild preeclampsia group and normal pregnancy group were significant （t value was --2.206, -2.264, 2.458, 2.413, 2.017 and 2.031, respectively, all P〈0.05）, and those between severe preeclampsia group and mild preeclampsia group were also obvious （t value was -2.307, -2.026, -2.020, 2.488, 2.192 and 2.196, respectively, all P〈0.05）. TT had no significant difference among groups （P〉0.05）. The plasma levels of LRRFIP1, GMP-140 and D-dimer were significantly increased in mild preeclampsia group when compared to normal pregnancy group （t value was 3.965, 3.759 and 4.364, respectively, all P〈0.05）, and those increased remarkably in severe preeclampsia group when compared to mild preeclampsia group （t value was 2. 220, 3. 496 and 3. 309, respectively, all P〈0.05）. Moreover, LRRFIP1 level was negatively correlated with PLT （r = - 0.28, P 〈0.05） but positively correlated with FIB （r=0.25, P〈0.05）, GMP-140 （r=0.44,P〈0.01）, D-dimer （r=0.42,P〈0.01）.Conelusion Upregulation of LRRFIP1 in patients with HDP may cause abnormal platelet activation and lead to platelet dysfunction and high blood coagulation state.