胎盘IGF-Ⅱ、IGFBP-1表达与妊高征围生儿不良结局的关系

Relationships between placental IGF-Ⅱ, IGFBP-1 expressions and perinatal adverse outcomes of pregnancy induced hypertension

目的检测妊高征患者胎盘组织中胰岛素样生长因子-Ⅱ(insulin-like growth factor-Ⅱ,IGF-Ⅱ)、胰岛素样生长因子结合蛋白-1(insulin-like growth factor binding protein-1,IGFBP-1)的表达水平,并分析其与围生儿不良结局的关系。方法取126例妊高征患者(妊娠高血压48例、轻度子痫前期44例、重度子痫前期34例,分别记为A组、B组和C组)和40例正常孕产妇(记为对照组)的胎盘组织检测IGF-Ⅱ、IGFBP-1的表达。结果 A组、B组、C组胎盘组织IGF-Ⅱ阳性表达率均低于对照组,B组和C组均低于A组,C组低于B组,胎盘组织IGFBP-1阳性表达率、围生儿不良结局发生率变化趋势相反,分别两两比较差异均有统计学意义(P<α);妊高征患者围生儿不良结局发生率为22.22%,且母亲高龄产妇、母亲确诊孕周>32周、母亲重度病情、母亲疾病进展、母亲治疗不依从、胎盘组织IGFBP-1阳性表达均为其危险因素,胎盘组织IGF-Ⅱ阳性表达是其保护因素。结论妊高征患者胎盘组织IGF-Ⅱ阳性表达率低,而IGFBP-1阳性表达率高,二者与疾病类型、病情程度、围生儿不良结局均有密切关联。

Objective To detect expression levels of insulin-like growth factor-Ⅱ(IGF-Ⅱ) and insulin-like growth factor binding protein-1(IGFBP-1) in placenta of PIH patients and to analyze the relationships between the expression levels and perinatal adverse outcomes. Methods The placental tissues of 126 PIH patients(48 cases of PIH, 44 cases of mild preeclampsia and 34 cases of severe preeclampsia, respectively, were recorded as group A, group B and group C) and 40 normal pregnant women(as control group), and the expressions of IGF-Ⅱ and IGFBP-1 were detected. Results The positive expression rates of IGF-Ⅱ in placenta of group A, group B and group C were lower than those of control group, of which the group B and group C were lower than those of group A, of which the group C were lower than those of group B, while the positive expression rate of IGFBP-1 and the incidence of adverse perinatal outcomes were opposite, and there were significant differences between each two groups by partition test(P<α’). The incidence of adverse perinatal outcomes was 22.22%, and the risk factors were old mothers, more than 32 weeks of pregnancy, severe illness, progress of disease, non-compliance of treatment and positive expression of IGFBP-1 in placenta, while the positive expression of IGF-Ⅱ in placenta was a protective factor. Conclusion The positive rate of IGF-Ⅱ in placenta of PIH patients is low, of which IGFBP-1 is high, and they are closely related to the type of disease, the degree of disease and the adverse outcomes of perinatal.