妊娠期高血压病患者胎盘组织中IGF-Ⅱ、IGFBP-1和抵抗素的表达及相关性分析

Expression and correlation of IGF-Ⅱ, IGFBP-1, and resistin in placenta of hypertensive disorder complicating pregnancy

目的:探讨胰岛素样生长因子-Ⅱ(IGF-Ⅱ)、胰岛素样生长因子结合蛋白-1(IGFBP-1)和抵抗素在妊娠期高血压病(HDCP)患者胎盘组织中的表达及相关性分析。方法:收集120例HDCP胎盘组织为病例组,其中妊娠期高血压48例,轻度子痫前期40例,重度子痫前期32例,并取正常妊娠胎盘组织50例为对照组。采用免疫组化S-P法检测各组样本IGF-Ⅱ、IGFBP-1和抵抗素表达强度,并进行相关性分析。观察HDCP患者的预后情况,根据预后结果分为预后不良组和预后良好组,观察两组胎盘组织中IGF-Ⅱ、IGFBP-1和抵抗素的表达情况。结果:病例组较对照组IGF-Ⅱ阳性表达率明显降低(P<0.01),IGFBP-1和抵抗素阳性表达率明显升高(P<0.01);病例组内比较,IGF-Ⅱ阳性表达率随病情加重逐渐降低,IGFBP-1和抵抗素阳性表达率随病情加重逐渐升高,重度子痫前期患者胎盘组织IGFBP-1、抵抗素的阳性表达明显高于妊娠期高血压,重度子痫前期IGF-Ⅱ的阳性表达水平明显低于轻度子痫前期患者(P<0.05)。Spearman相关性分析显示,抵抗素与IGFBP-1表达正相关(r=0.5937,P<0.05),与IGF-Ⅱ表达负相关(r=-0.6785,P<0.05);IGFBP-1与IGF-Ⅱ表达负相关(r=-0.6774,P<0.05)。预后不良组IGF-Ⅱ阳性表达明显低于预后良好组,而IGFBP-1和抵抗素阳性表达水平明显高于预后良好组,差异均有统计学意义(P<0.05)。结论:IGF-Ⅱ、IGFBP-1和抵抗素可能参与了HDCP的发生发展过程,三者间存在相互作用关系,并与病情严重程度及预后相关。

Objective: To investigate the expression and correlation of insulin-like growth factor-Ⅱ(IGF-Ⅱ), insulin-like growth factor binding protein-1 (IGFBP-1), and resistin in patients with hypertensive disorder complicating pregnancy (HDCP). Methods: The 120 cases of HDCP were selected as case group, including 48 cases of gestational hypertension, 40 cases of mild preeclampsia, and 32 cases of severe preeclampsia. Meanwhile, 50 cases of normal pregnancy placenta were selected as control group. The expressions of IGF-Ⅱ, IGFBP-1, and resistin were analyzed by using the immunohistochemical S-P method, and the correlation analysis was conducted to observe the prognosis of patients with HDCP. According to the prognosis, the patients were divided into poor prognosis group and good prognosis group, and the expressions of IGF-Ⅱ, IGF-BP-1 and resistin in placenta tissues were observed in the two groups. Results: Compared with control group, the positive expression rate of IGF-Ⅱ in the case group was significantly reduced, while the levels of IGFBP-1 and resistin were significantly increased ( P <0.01). Within the case group, the positive expression rate of IGF-Ⅱ decreased gradually as the severity of the disease increased. The positive expression rates of IGFBP-1 and resistin increased gradually as the severity of the disease increased. The positive expression of IGFBP-1 and resistin in severe preeclampsia subgroup was significantly higher than that in the gestational hypertension subgroup;the positive expression level of IGF-Ⅱ in severe preeclampsia subgroup was significantly lower than that in the mild preeclampsia subgroup ( P <0.05). According to Spearman correlation analysis, resistin was positively correlated with IGFBP-1 expression ( r =0.5937, P <0.05), while negatively correlated with IGF-Ⅱ expression ( r =-0.6785, P <0.05), and IGFBP-1 was negatively correlated with IGF-Ⅱ expression ( r =-0.6774, P < 0.05 ). Compared with the good prognosis group, positive expression of IGF-Ⅱ in the poor prognosis group was significantly lower, while the positive expression rates of IGFBP-1 and resistin were significantly higher, and the difference was statistically significant ( P <0.05). Conclusions: IGF-Ⅱ, IGF-BP-1, and resistin may be involved in the occurrence and development of HDCP, and there is an interaction among them, which may have certain correlation with the severity and prognosis of the disease.