子痫前期孕妇血清及胎盘组织中GRP78、P53表达及与疾病相关性

Expression of GRP78 and P53 in Serum and Placental Tissues of Pregnant Women with Preeclampsia and the Correlation Analysis

目的分析子痫前期(PE)孕妇血清及胎盘组织中葡萄糖调节蛋白78(GRP78)、P53的表达及与病情、预后的相关性。方法选取本院2017年4月至2020年5月收治且经临床确诊的150例PE孕妇纳入研究组,并分为早发型78例(早发组),晚发型72例(晚发组),选取同期本院健康妊娠女性90例作为对照组。比较两组及不同病情PE患者血清中GRP78、P53蛋白及胎盘组织中GRP78、P53mRNA表达。并记录PE孕妇产后不良结局发生情况。结果对照组血清GRP78、P53蛋白与胎盘组织中GRP78、P53 mRNA水平均显著低于研究组,差异具有统计学意义(P<0.05)。对照组血清GRP78、P53蛋白与胎盘组织中GRP78、P53 mRNA水平均显著低于早发组与晚发组,差异具有统计学意义(P<0.05)。早发组GRP78、P53阳性表达率分别为76.92%、73.08%,晚发组GRP78、P53阳性表达率分别为80.56%、76.39%,组间比较差异无统计学意义(P>0.05)。但两组GRP78、P53阳性表达率均显著高于对照组,差异具有统计学意义(P<0.05)。150例PE患者中预后不良38例(25.33%)。年龄、总胆固醇、肌酐、GRP78及P53表达情况为影响PE患者预后不良的单因素(P<0.05)。进一步Logistic回归分析显示:年龄、总胆固醇、肌酐、GRP78及P53阳性表达是影响PE预后不良的独立危险因素(P<0.05)。结论 PE孕妇血清及胎盘组织中GRP78、P53蛋白均呈高表达,与PE发病机制密切相关,检测GRP78、P53蛋白水平可有效评估患者预后。

Objective To analyze the expression of Glucose regulatory protein 78(GRP78)and P53 protein in serum and placenta tissue of pregnant women with preeclampsia(PE)and their correlation with the condition and prognosis.Methods The clinical data of 150 pregnant women with PE who were admitted to our hospital from April 2017 to May 2020 and were clinically diagnosed were collected and included in the study group,including 78 cases with early attack(early attack group)and 72 cases with late attack(late at⁃tack group).During the same period,90 healthy pregnant women in our hospital were selected as the control group.The expressions of GRP78 and P53 protein in serum and placental tissue between the two groups and PE patients with different conditions and the expression of GRP78 and P53 mRNA in placental tissue were com⁃pared.The incidence of adverse postpartum outcomes of PE pregnant women was recorded.Results The lev⁃els of serum GRP78 and P53 protein in the control group and the GRP78 and P53 mRNA levels in placental tis⁃sue were significantly lower than those in the study group(P<0.05).The levels of serum GRP78,P53 protein and GRP78 and P53 mRNA in placental tissues of the control group were significantly lower than those of the early⁃attack group and the late attack group(P<0.05).The positive expression rates of GRP78 and P53 in the early attack group were 76.92%and 73.08%,respectively,and the positive expression rates of GRP78 and P53 in the late attack group were 80.56%and 76.39%,respectively.The positive expression rates of GRP78 and P53 in the two groups were significantly higher than those in the control group(P>0.05).Among 150 PE patients,38 had poor prognosis,accounting for 25.33%.Univariate analysis showed that age,total cholester⁃ol,creatinine,GRP78 and P53 expression have some relationship with the poor prognosis of PE patients(P<0.05).Logistic regression analysis showed that age,total cholesterol,creatinine,GRP78 and P53 positive ex⁃pression are independent risk factors affecting the poor prognosis of PE(P<0.05).Conclusion GRP78 and P53 proteins are highly expressed in the serum and placenta tissue of PE pregnant women,which are closely re⁃lated to the pathogenesis of PE.The detection of GRP78 and P53 protein levels can effectively assess the prog⁃nosis of patients.