重度子痫前期胎盘组织中sVCAM-1、GDF-15的表达及其临床意义

Expression and clinical significance of sVCAM-1 and GDF-15 in placental tissues of severe preeclampsia

目的探讨重度子痫前期(SPE)胎盘组织中可溶性血管内皮黏附分子-1(sVCAM-1)、生长分化因子-15(GDF-15)的表达及临床意义。方法选取2018年5月—2021年5月江苏大学附属医院行剖宫产术终止妊娠的204例妊娠高血压患者,其中单纯妊娠高血压患者87例(妊娠高血压组),子痫前期(PE)患者52例(PE组),SPE患者65例(SPE组),另选取同期该院产检住院行剖宫产分娩的健康妊娠孕妇52例为对照组。通过实时荧光定量聚合酶链反应(qRT-PCR)检测所有研究对象胎盘组织中sVCAM-1、GDF-15的表达。分析不同人群胎盘组织中sVCAM-1 mRNA、GDF-15 mRNA相对表达量,Pearson法分析sVCAM-1 mRNA与GDF-15 mRNA的相关性;多因素Logistic回归模型分析影响SPE发生的因素。结果对照组胎盘组织中sVCAM-1 mRNA、GDF-15 mRNA相对表达量低于妊娠高血压组、PE组及SPE组(P<0.05),妊娠高血压组sVCAM-1 mRNA、GDF-15 mRNA相对表达量低于PE组和SPE组(P<0.05),PE组sVCAM-1 mRNA、GDF-15 mRNA相对表达量均低于SPE组(P<0.05)。Pearson相关性分析结果显示,SPE组sVCAM-1 mRNA与GDF-15 mRNA呈正相关(P<0.05)。多因素Logistic回归分析结果显示,sVCAM-1 mRNA[O^R=3.550(95%CI:1.461,8.628)]、GDF-15 mRNA[O^R=4.059(95%CI:1.670,9.865)]是SPE发生的影响因素(P<0.05)。结论胎盘组织中sVCAM-1、GDF-15的异常表达可能与PE发病有关,sVCAM-1、GDF-15高表达可能使PE患者进展为SPE。

Objective To investigate the expression and clinical significance of soluble vascular endothelial adhesion molecule(sVCAM-1)and growth differentiation factor 15(GDF-15)in placental tissues of severe preeclampsia(SPE).Methods A total of 204 patients with gestational hypertension who were hospitalized for cesarean section and terminated pregnancy in our hospital from May 2018 to May 2021 were selected,including 87 patients with gestational hypertension,65 patients with SPE,and 52 patients with preeclampsia(PE).In addition,52 healthy pregnant women who were hospitalized and delivered by cesarean section in our hospital were selected as the control group.The expression of sVCAM-1 and GDF-15 in the placental tissues of all subjects was detected by real-time fluorescence quantitative PCR.The relative expression levels of sVCAM-1 and GDF-15 mRNA in placental tissues of different populations were analyzed,and the factors affecting SPE occurrence were analyzed.Results The mRNA relative expression levels of sVCAM-1 and GDF-15 in the placental tissues of the control group were lower than the gestational hypertension group,PE group,and SPE group(P<0.05),and the mRNA relative expression levels of sVCAM-1 and GDF-15 in the gestational hypertension group were lower than the PE and SPE group(P<0.05).The mRNA relative expression levels of sVCAM-1 and GDF-15 in PE group were lower than SPE group(P<0.05).Pearson correlation analysis showed that the relative expression of sVCAM-1 and GDF-15 mRNA in the SPE group was positively correlated(P<0.05).Logistic multifactor regression analysis showed that the relative expression levels of SVCAM-1[O^R=3.550(95%CI:1.461,8.628)]and GDF-15 mRNA[O^R=4.059(95%CI:1.670,9.865)]were the influencing factors of SPE occurrence(P<0.05).Conclusion The abnormal expression of sVCAM-1 and GDF-15 in placental tissues may be related to the pathogenesis of PE,and the high expression of sVCAM-1 and GDF-15 may lead to the progression of SPE in PE patients.