LXA4、TNF-α及其比值与子痫前期发生发展的相关性研究

Relationship between lipoxin A4,tumor necrosis factor and their ratio and occurrence and development of preeclampsia

目的探讨脂氧素A4(LXA4)、肿瘤坏死因子!(TNF-α)在子痫前期(PE)中的表达及意义。方法选取2016年2月至2017年2月在海南省人民医院分娩的PE产妇78例,其中轻度PE产妇45例,重度PE产妇33例,同时选取正常产妇50例作为对照组,采用ELISA法检测产妇血清LXA4、TNF-α表达,采用免疫组化法检测胎盘组织LXA4受体和TNF-α表达。结果轻度PE组和重度PE组LXA4受体蛋白阳性表达率为55.55%、60.61%,明显低于对照组,差异均有统计学意义(χ~2值分别为19.077、14.246,均P<0.05),而TNF-α蛋白阳性表达率为80.00%和81.82%,明显高于对照组,差异均有统计学意义(χ~2值分别为25.688、23.035,均P<0.05);轻度PE组血清LXA4为(176.55±43.21)ng/L,明显高于对照组和重度PE组,差异均有统计学意义(t值分别为12.163、10.476,均P<0.05);轻度PE组和重度PE组TNF-α分别为(18.03±1.43)ng/mL和(18.22±2.03)ng/mL,明显高于对照组,差异均有统计学意义(t值分别为48.500、37.304,均P<0.05);重度PE组LXA4/TNF-α为(5.02±1.10),明显低于对照组和轻度PE组,差异均有统计学意义(t值分别为25.271、16.106,均P<0.05);轻度PE组LXA4/TNF-α为(9.80±1.42),明显低于对照组,差异有统计学意义(t=16.970,P<0.05);轻度PE组和重度PE组血清LXA4与TNF-α呈负相关(r值分别为-0.522、-0.413,均P<0.05);对照组和重度PE组胎盘组织LXA4受体和TNF-α表达呈负相关(rs值分别为-0.344、-0.321,均P<0.05);LXA4/TNF-α与PE患者病情呈负相关(rs=-0.412,P<0.05)。结论PE患者血清LXA4、TNF-α及胎盘组织LXA4受体、TNF-α表达异常,可能与疾病的发生发展有关,其中LXA4/TNF-α比值可一定程度反映患者病情程度。

Objective To investigate the expression and significance of lipoxin A4（LXA4）and tumor necrosis factor（TNF-α）in preeclampsia（PE）.Methods Altogether 78 cases of PE parturients delivering in Hainan Provincial People＇s Hospital from February 2016 to February 2017,including 45 cases of mild PE and 33 cases of severe PE were selected,and 50 normal parturients were chosen at the same time as control group.Expressions of LXA4 and TNF-αin maternal serum were detected by ELISA method,and LXA4 receptor and TNF-αexpressions in placenta were detected by immunohistochemical method.Results Positive expression rate of LXA4 receptor protein in mild PE group and severe PE group was 55.55%and 60.61%,respectively,which was significantly lower than that in the control group,and differences had statistical significance（χ~2 value was 19.077 and 14.246,respectively,both P〈0.05）,while positive expression rate of TNF-αprotein in mild PE group and severe PE group was 80.00%and 81.82%,respectively,which was significantly higher than that in the control group,and differences had statistical significance（χ~2 value was 25.688 and 23.035,respectively,both P〈0.05）.Serum LXA4 in mild PE group was 176.55±43.21 ng/L,which was significantly higher than that in the control group and severe PE group,and differences had statistical significance（t value was12.163 and 10.476,respectively,both P〈0.05）.TNF-αin mild PE group and severe PE group was 18.03±1.43 ng/mL and 18.22±2.03 ng/mL,respectively,which was significantly higher than that in the control group,and differences had statistical significance（t value was 48.500 and 37.304,respectively,both P〈0.05）.LXA4/TNF-αin severe PE group was 5.02±1.10,which was significantly lower than that in the control group and mild PE group,and differences had statistical significance（t value was 25.271 and 16.106,respectively,both P〈0.05）.LXA4/TNF-αin mild PE group was 9.80±1.42,which was significantly lower than that in the control group,and difference had statistical significance（t=16.970,P〈0.05）.Serum LXA4 was negatively correlated with TNF-αin mild PE group and severe PE group（r value was-0.522 and-0.413,respectively,both P〈0.05）.Placenta LXA4 receptor was negatively correlated with TNF-αexpression in the control group and severe PE group（rsvalue was-0.344 and-0.321,respectively,both P〈0.05）.LXA4/TNF-αwas negatively correlated with severity of PE patient（rs =-0.412,P〈0.05）.Conclusion Expressions of serum LXA4 and TNF-αand placenta LXA4 receptor as well as TNF-αare abnormal in PE patients,which may be related to occurrence and development of disease and LXA4/TNF-αratio can reflect the severity of disease to some extent.