180例重度子痫前期胎盘临床病理特点分析

Clinicopathological characteristics analysis of placenta in 180 cases of severe preeclampsia

目的分析180例重度子痫前期胎盘的临床病理特点,为临床治疗重度子痫前期提供参考依据。方法选择2015年1月至2019年10月西北妇女儿童医院妇产科收治的180例重度子痫前期孕妇(重度组)、180例轻度子痫前期孕妇(轻度组)、180例健康孕妇(对照组),观察重度子痫前期胎盘病理学改变发生情况。采集三组孕妇的胎盘组织进行病理学检查,比较三组血管内皮生长因子(VEGF)及其受体mRNA表达、人类白细胞抗原G(HLA-G)及其受体mRNA表达情况。结果重度组胎盘蜕膜血管病变和绒毛发育不良发生率均明显高于轻度组(P<0.05);两组胎盘梗死和血栓形成发生率无明显差异(P>0.05)。三组孕妇胎盘的VEGF、VEGF mRNA、HLA-G、HLA-G mRNA表达水平比较,差异具有统计学意义(P<0.05);重度组的VEGF、VEGF mRNA表达水平明显高于轻度组和对照组,HLA-G、HLA-G mRNA表达水平均明显低于轻度组和对照组(P<0.05)。结论重度子痫前期孕妇的胎盘多发生蜕膜血管病变、胎盘梗死、血栓形成、绒毛发育不良等病理学改变,且重度子痫前期孕妇胎盘组织中的VEGF及其受体mRNA表达出现异常上调,胎盘组织中的HLA-G及其受体mRNA表达出现异常下调。

Objective To analyze the clinicopathological characteristics of placenta in 180 cases of severe preeclampsia,and to provide reference for clinical treatment of severe preeclampsia.Methods A total of 180 pregnant women with severe preeclampsia(severe group),180 pregnant women with mild preeclampsia(mild group)and 180 healthy pregnant women(control group)admitted from January 2015 to October 2019 in the obstetrics and gynecology department of Northwest women's and children's hospital were selected,the pathological changes of placenta in severe preeclampsia was observed.The placental tissues of three groups of pregnant women were collected for pathological examination,the expression of vascular endothelial growth factor(VEGF)and its receptor mRNA,and the expression of human leukocyte antigen G(HLA-G)and its receptor mRNA were compared among the three groups.Results The incidences of placental decidual vasculopathy and chorionic dysplasia in the severe group were significantly higher than those in the mild group(P<0.05);there were no significant differences in incidences of placental infarction and thrombosis between the two groups(P>0.05).There were significant differences in the expression levels of VEGF,VEGF mRNA,HLA-G and HLA-G mRNA in placenta of the three groups(P<0.05);the expression levels of VEGF and VEGF mRNA in the severe group were significantly higher than those in the mild group and the control group,and the expression levels of HLA-G and HLA-G mRNA were significantly lower than those in the mild group and the control group(P<0.05).Conclusion The placentas of severe preeclampsia pregnant women often have pathological changes such as decidual angiopathy,placental infarction,thrombosis and chorionic dysplasia.The expression of VEGF and its receptor mRNA in placentas of severe preeclampsia pregnant women is abnormally up-regulated,and the expression of HLA-G and its receptor mRNA in placentas is abnormally down regulated.