子痫前期孕妇胎盘中趋化因子免疫反应性及其与胎盘组织病理学变化、不良妊娠结局关系

The immunoreactivity of fractalkine in placenta of pregnant women with preeclampsia and its correlation with their placental histopathological changes and their adverse pregnancy outcomes

目的:研究子痫前期患者胎盘组织内趋化因子fractalkine免疫反应性及其与胎盘组织病理学改变、不良妊娠结局关系。方法:2017年6月-2020年6月本院收治的子痫前期患者68例及正常妊娠孕妇30例分别纳为观察组及对照组,采用免疫组织化学法检测两组胎盘组织内fractalkine,分析其与子痫前期患者胎盘病理学改变及不良妊娠结局关系。结果:观察组中轻度子痫前期26例,重度子痫前期42例,3组新生儿体重、分娩时胎龄、胎儿宫内生长受限、早产、舒张压、收缩压及24h尿蛋白水平等均存在差异(P<0.05);对照组、轻度子痫前期组、重度子痫前期组发生胎盘组织内合体滋养层基底膜增厚、合胞体结、纤维蛋白样坏死者占比及其末端绒毛血管化评分均依次升高,3组胎盘滋养层细胞及毛细血管内皮中fractalkine免疫反应性强度分级存在差异(均P<0.05)。观察组胎盘组织fractalkine免疫反应性与胎儿宫内生长受限、早产,及合体滋养层基底膜增厚、合胞体结、纤维蛋白样坏死、末端绒毛血管化等病理改变均存在一定相关性(P<0.05)。结论:与正常妊娠孕妇相比,子痫前期患者胎盘组织中fractalkine免疫反应性增强,且与患者胎盘组织病理改变及不良妊娠结局存在相关性,提示fractalkine及其相关通路可能与子痫前期发病机制有关。

Objective:To investigate the immunoreactivity of placental fractalkine(CX3 CL1)in placenta of pregnant women with preeclampsia,and to study its correlation with their placental histopathological changes and their adverse pregnancy outcomes.Methods:68 pregnant women with preeclampsia were selected in observation group and 30 healthy pregnant women were selected in control group from June 2017 to June 2020.The levels of CX3 CL1 in placental tissue of the women in the two groups were determined by immunohistochemical method.The relationship between the levels of CX3 CL1 of the women and their pathological changes and adverse pregnancy outcomes was analyzed.Results:In the observation group,there were 26 women with mild preeclampsia in group A and 42 women with severe preeclampsia in group B.There were significant differences in neonatal weight,gestational weeks of delivery,the rates of intrauterine growth restriction and premature delivery,and the values of diastolic blood pressure,systolic blood pressure,and 24 h urinary protein level of the women among group A,group B,and the control group(P<0.05).The proportions of syncytiotrophoblast basement membrane thickening,syncytial knots,and fibrinoid necrosis in placenta tissue,and the score of vascularization of terminal villi of the women in the control group,group A,and group B had increased gradually.There were significant differences in CX3 CL1 immune reactivity scales in placental trophoblastic cells and in capillary endothelial among the control group,group A,and group B(all P<0.05).In the observation group,the immunoreactivity of CX3 CL1 in placental tissue of the women was correlated with their fetal intrauterine growth restriction,premature delivery,thickening of syncytiotrophoblast basement membrane,syncytial node,fibrinoid necrosis,and terminal villus vascularization.Conclusion:Compared with that of the normal pregnant women,fractalkine immunoreactivity in placental tissues of the pregnant women with preeclampsia is enhanced,and which is correlated with the pathological changes of their placental tissues and their adverse pregnancy outcomes,which means that CX3 CL1 and its related pathways may be involved in the pathogenesis of preeclampsia.