胎儿生长受限孕妇胎盘组织、血浆和胎儿脐血中内皮细胞蛋白C受体的表达

Expression of endothelial cell protein C receptor in placental tissue,plasma and fetal cord blood of pregnant women with fetal growth restriction

目的探讨胎儿生长受限(FGR)孕妇胎盘组织、血浆和胎儿脐血中内皮细胞蛋白C受体(EPCR)的表达及意义。方法收集2017年4月至2018年10月在徐州医科大学附属徐州妇幼保健院FGR孕妇60例,按首次诊断FGR的孕周分为早发组(≤32周)30例,晚发组(>32周)30例;选择同期健康晚孕期妇女30例作为对照组(孕周≥37周)。应用免疫组化SP法和Western blot法检测3组孕妇胎盘组织中EPCR蛋白的表达情况,逆转录聚合酶链式反应(RT-PCR)技术检测3组孕妇胎盘组织中EPCR mRNA的表达水平,ELISA法检测3组孕妇血浆和胎儿脐血中可溶性EPCR(sEPCR)的含量。结果免疫组化法检测显示,EPCR蛋白主要表达于胎盘合体滋养细胞和血管内皮细胞的细胞膜、细胞质以及部分细胞核,呈棕黄色染色。Western blot检测显示,3组EPCR蛋白相对表达量比较有统计学差异(P<0.01);早发组显著低于晚发组和对照组(P<0.01),晚发组和对照组比较无统计学差异(P>0.05)。RT-PCR检测显示,3组EPCR mRNA表达水平比较有统计学差异(P<0.01);早发组显著低于晚发组和对照组(P<0.01),晚发组和对照组比较无统计学差异(P>0.05)。ELISA法检测显示,3组孕妇血浆和胎儿脐血中sEPCR表达水平比较有统计学差异(P<0.01);早发组显著高于晚发组和对照组(P<0.01),晚发组和对照组比较无统计学差异(P>0.05)。结论胎盘组织中EPCR减少,母静脉血、胎儿脐血中sEPCR增加可能是FGR发病的重要环节。

Objective To investigate the expression and significance of endothelial cell protein C receptor (EPCR) in placental tissue,plasma and fetal cord blood of pregnant women with fetal growth restriction (FGR).Methods A total of 60 pregnant women with FGR from Xuzhou Maternity and Child Health Hospital affiliated to Xuzhou Medical University from April 2017 to October 2018 were enrolled.According to the gestational age at first diagnosis,they were divided into early-onset group (≤32 weeks,30 cases) and late-onset group (> 32 weeks,30 cases);30 healthy pregnant women in the same period were selected as the control group (gestational age≥ 37 weeks).The expression of EPCR protein in placental tissue of three groups was detected by immunohistochemical SP method and Western blot.The expression of EPCR mRNA in placental tissue was detected by reverse transcription polymerase chain reaction (RT-PCR).The content of soluble EPCR (sEPCR) in plasma and fetal cord blood was detected by ELISA.Results Immunohistochemistry showed that EPCR protein was mainly expressed in the cell membrane,cytoplasm and part of the nucleus of placental syncytiotrophoblasts and vascular endothelial cells,which were stained brown.Western blot showed that the relatine expression of EPCR protein was statistically different among three groups (P < 0.01 ),and in early-onset group was significantly lower than that in late-onset group and the control group (P < 0.01) respectively,there was no significant difference between the late-onset group and the control group(P > 0.05).RT-PCR showed that the expression of EPCR mRNA was statistically different among three groups(P < 0.01),and in early-onset group was significantly lower than that in late-onset group and the control group (P < 0.01) respectively,but there was no statistical difference between the lateonset group and the control group (P > 0.05).ELISA showed that the expression levels of sEPCR in plasma and fetal cord blood were significantly different between three groups (P < 0.01),and in early-onset group was significantly higher than that in late-onset group and the control group (P < 0.01) respectively,there was no statistical difference between late-onset groups and control group(P > 0.05).Conclusions The decrease of EPCR in placenta and the increase of sEPCR in maternal venous blood and fetal cord blood may be an important link in the pathogenesis of FGR.