胎儿宫内缺氧的脐血流超声特征评估及其与氧化应激损伤、胎盘细胞凋亡的相关性研究

The ultrasonic umbilical artery flow features of fetal intrauterine hypoxia and their correlation with oxidative stress injury and placental cell apoptosis

目的:研究胎儿宫内缺氧的脐血流超声特征评估及其与氧化应激损伤、胎盘细胞凋亡的相关性。方法:选择存在胎儿宫内缺氧的孕妇作为病理组,同期健康的孕妇作为对照组。妊娠过程中对脐动脉的PI、RI进行超声评估,分娩后测定脐带血内氧化应激指标的含量及胎盘中氧化应激基因、凋亡基因的表达量。结果:病理组孕妇妊娠31~36周及妊娠37~41周时脐动脉的PI及RI均高于对照组;病理组孕妇脐带血中MDA、AOPP的含量以及胎盘中Keap1、Nrf2、ARE、HO-1、NOQ1、Caspase-3、Beclin-1、LC3-II的mRNA表达量显著高于对照组,脐带血中GSH-Px、SOD的含量以及胎盘中Keap1、Survivin、XIAP的mRNA表达量显著低于对照组。病理组孕妇脐动脉PI、RI的水平与脐带血中MDA、AOPP的含量以及胎盘中Keap1、Nrf2、ARE、HO-1、NOQ1、Caspase-3、Beclin-1、LC3-II的mRNA表达量呈正相关,与脐带血中GSH-Px、SOD的含量以及胎盘中Keap1、Survivin、XIAP的mRNA表达量呈负相关。结论:胎儿宫内缺氧的脐血流超声特征为阻力增加、流量减少且与氧化应激损伤、胎盘细胞凋亡的程度密切相关。

Objective:To study the ultrasonic umbilical artery flow features of fetal intrauterine hypoxia and their correlation with oxidative stress injury and placental cell apoptosis.Methods:Pregnant women with fetal intrauterine hypoxia between January 2016 and October 2017 were selected as pathology group and healthy pregnant women during the same period were selected as control group.The PI and RI of umbilical artery were evaluated by ultrasound in the course of pregnancy,and the contents of oxidative stress indexes in umbilical cord blood as well as the expression of oxidative stress genes and apoptosis genes in placenta were determined after delivery.Results:The umbilical artery PI and RI of pathology group were higher than those of control group at 31 36 weeks and 37 41 weeks of gestation;MDA and AOPP contents in umbilical cord blood as well as Nrf2,ARE,HO 1,NOQ1,Caspase 3,Beclin 1 and LC3 II mRNA expression in placenta were significantly higher than those of control group whereas GSH Px and SOD contents in umbilical cord blood as well as Keap1,Survivin and XIAP mRNA expression in placenta were significantly lower than those of control group.The umbilical artery PI and RI levels of pathology group were positively correlated with MDA and AOPP contents in umbilical cord blood as well as Nrf2,ARE,HO 1,NOQ1,Caspase 3,Beclin 1 and LC3 II mRNA expression in placenta,and negatively correlated with GSH Px and SOD contents in umbilical cord blood as well as Keap1,Survivin and XIAP mRNA expression in placenta.Conclusion:The ultrasonic umbilical artery flow features of fetal intrauterine hypoxia are increased resistance and decreased flow and they are closely related to the degree of oxidative stress injury and placenta cell apoptosis.