血管内皮生长因子胎盘微血管密度在胎盘植入并发感染患者中的表达及意义

Expression and Significance of VEGF and MVD in Patients with Placental Implantation Complicated by Infection

目的:探究血管内皮生长因子(Vascular endothlial growth factor,VEGF)、胎盘微血管密度(Placental microvesseldensity,MVD)与产后胎盘植入并发感染的关系。方法:本医院2011年9月至2021年2月胎盘植入患者535例,所有产妇治疗过程中取出的胎盘组织和静脉血为样本。使用实时荧光定量聚合酶链式反应(Real-time quantitative reverse transcription polymerase chain reaction,RT-qPCR)、酶联免疫吸附试验(Enzyme-linked immunosorbent test,ELISA)、蛋白免疫印迹(Western blotting,WB)实验和免疫组织化学实验检测胎盘组织和血清中VEGF蛋白及其mRNA表达和MVD表达。采用Pearson相关性分析VEGF与MVD的关系。结果:与胎盘植入无并发感染组相比,胎盘植入并发感染组35岁以上所占比例、剖宫产次数≥1患者所占比例和人工流产次数≥2患者所占比例更高(χ^(2)=80.558、82.320、116.681,P均<0.001),且VEGF的mRNA、蛋白表达和血清含量均显著升高(t=22.834、15.575、7.862,P均<0.001),MVD值也显著升高(t=10.096,P<0.001)。Pearson相关分析,胎盘组织VEGF含量与MVD值呈正相关(r=0.645,P<0.001)。结论:VEGF、MVD在胎盘植入并发感染胎盘中表达升高,与胎盘植入并发感染呈正相关,且VEGF含量与MVD值在感染胎盘中呈正相关,可作为胎盘植入并发感染治疗依据。

Objective:To explore the relationship between vascular endothelial growth factor(VEGF),placental microvessel density(MVD)and postpartum placental accretacomplicated with infection.Methods:Placental tissue and fasting venous blood were taken as samples of 535 pregnant women with placental accretain admitted to our hospital from September 2011 to February 2021.Real-time quantitative reverse transcription polymerase chain reaction(RT-qPCR),enzyme-linked immunosorbent test(ELISA),western blotting(WB)test and immunohistochemistry were used to detect the expression of VEGF protein,VEGF mRNA and MVD in placental tissue and serum.Pearson correlation was used to analyze the relationship between VEGF and MVD.Results:Compared with the placenta accreta without complicated infection group,the proportion of patients over 35 years old,the proportion of cesarean section times≥1 and the proportion of induced abortion times≥2 patients in the placenta accreta complication group were higher(χ^(2)=80.558,82.320,116.681,P<0.001),and the mRNA,protein expression and serum content of VEGF were significantly increased(t=22.834,15.575,7.862,P<0.001),and the MVD value was also significantly increased(t=10.096,P<0.001).Pearson correlation analysis showed that the content of VEGF in placenta was positively correlated with MVD value(r=0.645,P<0.001).Conclusion:The expression of VEGF and MVD increased in placenta accreta complicated with infection,which was positively correlated with placenta accreta complicated infection,and VEGF content was positively correlated with MVD value in infected placenta,which could be used as the basis for the treatment of placenta accreta complicated with infection.