葡萄糖转运蛋白在妊娠期高血压及子痫前期发病机制中的作用

Study the role of glucose transporter protein l of pregnant women for the pathogenesis of their hypertensive disorder complicating pregnancy and preeclampsia

目的:探讨葡萄糖转运蛋白1(GLUT-1)在妊娠期高血压以及子痫前期发病机制中的作用。方法:选取2015年4月-2018年9月本院产科收治的妊娠期高血压疾病(HDP)患者110例为研究对象,其中妊娠期高血压22例、轻度子痫前期48例、重度子痫前期40例。同期产前检查正常产妇30例为对照组。比较对照组与不同程度HDP患者血清GLUT-1、基质金属蛋白酶-2(MMP-2)水平及相关性分析。根据随机数字表法将子痫前期患者随机分为常规治疗组(n=44)和硝苯地平治疗组(n=44)分别治疗。比较两组治疗前及治疗5d后血清GLUT-1、MMP-2、24 h尿蛋白水平及妊娠结局。结果:血清GLUT-1、MMP-2水平在正常组、妊娠期高血压组、轻度子痫前期组、重度子痫前期组依次降低(P<0.05),血清GLUT-1与MMP-2水平呈正相关(r=0.583,P<0.05);治疗后硝苯地平治疗组血清GLUT-1、MMP-2水平高于常规治疗组,24 h尿蛋白低于常规治疗组,分娩孕周及新生儿体重均高于常规治疗组(P均<0.05)。结论:HDP患者GLUT-1水平异常降低,可能参与了HDP进展,考虑与其下调MMP-2表达,影响滋养细胞入侵能力有关。硝苯地平可有效提高HDP患者GLUT-1、MMP-2水平,减少尿蛋白,延长孕周,增加新生儿体重。

Objective:To investigate the role of glucose transporter protein l(GLUT-1)of pregnant women for the pathogenesis of their hypertensive disorder complicating pregnancy(HDP)and preeclampsia.Methods:110 pregnant women with HDP were enrolled in study group from April 2015 to September 2018,which included 22 women with HDP in group A,48 cases with mild preeclampsia in group B,and 40 cases with severe preeclampsia in group C.Another 30 normal pregnant women who underwent antenatal examination were selected in control group during the same period.The expression levels of serum GLUT-1 and matrix metalloproteinase-2(MMP-2)of the women were compared among these groups.The correlation between the serum GLUT-1 and MMP-2 levels of the women and their degree of HDP was analyzed.According to the random number table method,88 women with preeclampsia were randomly divided into group D(44 women were given conventional treatment)and group E(44 women were given the released-controlled nifedipine treatment).The expression levels of serum GLUT-1,MMP-2,and 24h urinary protein,and the pregnancy outcomes of the women before and after 5 days of treatment were compared between the two groups.Results:The serum GLUT-1 and MMP-2 levels of the women in the control group,group A,group B,and group C had decreased successively(P<0.05),and there was a positive correlation between the serum GLUT-1 level and the serum MMP-2 level(r=0.583,P<0.05).After treatment,the serum GLUT-1 and MMP-2 levels of the women in group E were significantly higher than those of the women in group D,but 24 h urinary protein level of the women in group E was significantly lower(P<0.05).The gestational weeks when delivery and the neonatal weight of the women in group E were significantly higher than those of the women in group D(P<0.05).Conclusion:The level of GLUT-1 of the pregnant women with HDP abnormally decreases,which may be involved in the progression of HDP,and is related to influencing the invasion ability of trophoblast by down-regulation of MMP-2 expression.Nifedipine can effectively increase the levels of GLUT-1 and MMP-2 of the pregnant women with HDP,can reduce their urine protein level,can prolong gestational weeks when delivery,can increase the weight of the newborns.