子痫前期患者血清IGF-Ⅱ与MMP-9表达变化及其对胎儿生长发育的影响

Changes of serum IGF-Ⅱand MMP-9 expressions in patients with preeclampsia and their effects on fetal growth and development

目的探讨子痫前期患者血清IGF-Ⅱ、MMP-9表达变化及其对胎儿生长发育的影响。方法收集2016年5月至2017年6月期间在本院产科住院并分娩的子痫前期患者82例,根据病情轻重将患者分为轻度组34例,重度组48例。另外选择同期年龄、孕周相近的正常孕产妇35例作为对照组;比较三组血清IGF-Ⅱ、MMP-9水平及胎儿生长发育指标(新生儿胎龄、新生儿出生体质量和胎盘质量、身长、BMI);分析子痫前期患者血清IGF-Ⅱ、MMP-9水平与胎儿生长发育指标的关系。结果重度组、轻度组血清IGF-Ⅱ、MMP-9水平均低于对照组,收缩压、舒张压均高于对照组,差异均有统计学意义(均P<0.05);重度组血清IGF-Ⅱ、MMP-9水平分别为(45.1±1.4)μg/L、(154.2±3.0)μg/L,均低于轻度组(55.8±1.6)μg/L、(235.6±6.8)μg/L,收缩压、舒张压分别为(185.0±10.7)mmHg(1 mmHg=0.133 kPa)、(117.9±11.5)mmHg,均高于轻度组(138.2±11.7)mmHg、(97.3±9.2)mmHg,差异均有统计学意义(均P<0.05);三组新生儿身长比较,差异无统计学意义(P>0.05);重度组、轻度组胎龄、出生体质量、胎盘质量、BMI均明显低于对照组,差异均有统计学意义(均P<0.05);重度组胎龄、出生体质量、胎盘质量、BMI分别为(37.0±1.1)周、(2760.1±480.7)g、(429.5±58.9)g、(12.1±1.1)kg/m2,均明显低于轻度组(38.4±1.2)周、(3124.0±368.5)g、(465.2±67.1)g、(12.7±1.3)kg/m2,差异均有统计学意义(均P<0.05);Spearman相关分析,子痫前期孕产妇血清IGF-Ⅱ、MMP-9水平分别与收缩压或舒张压呈负相关,差异均有统计学意义(均P<0.05);分别与胎龄、新生儿出生体质量、胎盘质量、新生儿BMI呈正相关,差异均有统计学意义(均P<0.05)。结论子痫前期患者存在血清IGF-Ⅱ、MMP-9水平低下现象,并随病情的加重而降低,同时对其胎儿生长发育影响较大,故可通过对子痫前期患者进行血清IGF-Ⅱ、MMP-9水平的动态监测,以了解其病情进展情况,并评估胎儿发育情况,这对于改善患者妊娠结局有积极意义。

Objective To investigate the changes of serum IGF-Ⅱand MMP-9 expressions in patients with preeclampsia and their effects on fetal growth and development.Methods 82 patients with preeclampsia treated at our department were collected,and were divided into a mild group(n=34)and a severe group(n=48)according the severities.35 normal pregnant women with similar age and gestational weeks during the the same period were selected as a control group.The serum levels of IGF-Ⅱand MMP-9 and the fetal growth and development indicators,including fetal age,birth weight,placenta mass,body length,and BMI,were compared between the three groups.The relationship between the levels of IGF-Ⅱand MMP-9 on one hand and the fetal growth and development indicators on the other hand were analyzed.Results The levels of IGF-Ⅱand MMP-9 were significantly lower and the systolic and diastolic pressures were significantly higher in the severe group and the mild group than in the control group(all P<0.05).The levels of IGF-Ⅱand MMP-9 were significantly lower and the systolic and diastolic pressures were significantly higher in the severe group than in the mild group[(45.1±1.4)μg/L vs.(55.8±1.6)μg/L,(154.2±3.0)μg/L vs.(235.6±6.8)μg/L,(185.0±10.7)mmHg(1 mmHg=0.133 kPa)vs.(138.2±11.7)mmHg,and(117.9±11.5)mmHg vs.(97.3±9.2)mmHg;all P<0.05].There was no statistical difference in the body length between these 3 groups(P>0.05).The gestational age,birth weight,placental mass,and BMI were significantly lower in the severe group and mild group than in the control group(all P<0.05),and were significantly lower in the severe group than in the mild group[(37.0±1.1)weeks vs.(38.4±1.2)weeks,(2760.1±480.7)g vs.(3124.0±368.5)g,(429.5±58.9)g vs.(465.2±67.1)g,and(12.1±1.1)kg/m2 vs.(12.7±1.3)kg/m2;all P<0.05].Spearman correlation analysis showed that the levels of IGF-Ⅱand MMP-9 were negatively correlated with systolic and diastolic blood pressures(all P<0.05),and positively with gestational age,birth weight,placental mass,and BMI(all P<0.05).Conclusion The levels of IGF-Ⅱand MMP-9 in patients with preeclampsia are lower,and decrease with the disease aggravation.At the same time,they have a great influence on the growth and development of their fetuses.Therefore,we can monitor the levels of IGF-Ⅱand MMP-9 in patients with preeclampsia to dynamically understand the disease progress and evaluate the fetus development,which has a positive effect on improving their pregnancy outcomes.