子痫前期母胎胆固醇排出情况及胎盘CYP27A1表达分析

Analysis of maternal-fetal cholesterol excretion and placental CYP27A1 expression in preeclampsia

目的探讨子痫前期母胎胆固醇排出情况,并分析胎盘组织中固醇-27羟化酶(CYP27A1)表达水平。方法我院2018年8月—2020年5月收治的子痫前期孕妇60例作为子痫前期组,我院同时收治的足月正常妊娠孕妇60例作为对照组,均于我院产科进行分娩。比较两组母体的血脂指标[三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)]、血压指标[收缩压(SBP)、舒张压(DBP)],测定两组母胎胆固醇排出率及胎盘组织中CYP27A1表达水平,并分析胎盘CYP27A1表达水平与血脂、血压指标的相关性。结果子痫前期组的血清TC、LDL-C水平以及SBP、DBP均显著高于对照组,血清HDL-C水平低于对照组(P<0.05)。且子痫前期重度组血清TC、LDL-C水平以及SBP、DBP均显著高于轻度组,血清HDL-C水平显著低于轻度组(P<0.05)。子痫前期组母胎的胆固醇排出率以及胎盘CYP27A1表达水平显著均高于对照组,且重度组母胎的胆固醇排出率以及胎盘CYP27A1表达水平显著高于轻度组(P<0.05)。胎盘CYP27A1表达与母体血清TC、LDL-C水平以及SBP、DBP呈显著正相关(r=0.522、0.496、0.628、0.691,P<0.05),与血清HDL-C水平呈显著负相关(r=-0.711,P<0.05)。结论子痫前期母胎胆固醇排出率与胎盘CYP27A1表达水平均增高,这可能是子痫前期的应激保护机制。

Objective To analyze the maternal-fetal cholesterol excretion in preeclampsia and the expression of cholesterol-27 hydroxylase(CYP27A1) in the placenta tissue. Methods 60 pregnant women in preeclampsia who were admitted to our hospital from August 2018 to May 2020 were included as the preeclampsia group, and 60 pregnant women with normal full-term pregnancy admitted to our hospital at the same time were selected as the control group. And they were all delivered in the obstetrics department of our hospital. The maternal blood lipid indexes [triglycerides(TG), total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C)], blood pressure indexes [systolic blood pressure(SBP), diastolic blood pressure(DBP)] of the two groups were compared. The maternal-fetal cholesterol excretion rate and the expression level of CYP27A1 in placenta tissue were determined. The correlation between the expression level of placenta CYP27A1 and blood lipids and blood pressure were analyzed. Results The levels of serum TC, LDL-C, SBP,and DBP in the preeclampsia group were higher than those in the control group, and the serum HDL-C levels were lower than those in the control group significantly(P<0.05). In the severe group in preeclampsia, the serum TC, LDL-C level, SBP, and DBP were significantly higher than that in the mild group(P<0.05). And the serum HDL-C level was lower than that in the mild group significantly(P<0.05). And Maternal-fetal cholesterol excretion rates and placental CYP27A1 expression levels in the preeclampsia group were significantly higher than those in the control group(P<0.05). And the maternal-fetal cholesterol excretion rates and placental CYP27A1 expression levels in the severe group were higher than those in the mild group significantly(P<0.05). Placental CYP27A1 expression was positively correlated with maternal serum TC, LDL-C levels, SBP and DBP(r=0.522, 0.496, 0.628, 0.691, P<0.05), and negatively correlated with serum HDL-C levels(r=-0.711, P<0.05). Conclusion Maternal-fetal cholesterol excretion rate and placental CYP27A1 expression in preeclampsia patients increased, which may be the stress protection mechanism of preeclampsia.