前置胎盘及合并胎盘植入组织中LC3、Beclin1、HMGB1表达及临床意义

Expressions and clinical significances of microtubule associated protein light chain 3, Beclin1, and high mobility group protein B1 in placenta tissue of pregnant women with placenta previa and placenta implantation

目的:探究前置胎盘及胎盘植入组织中微管相关蛋白轻链3(LC3)、Beclin1及高迁移率族蛋白B1(HMGB1)表达及临床意义。方法:收集2019年1月-2020年12月本院收治的前置胎盘孕妇96例(前置组)和正常剖宫产孕妇75例(对照组),检测两组胎盘组织中LC3、Beclin1及HMGB1表达,并根据前置组孕妇是否合并胎盘植入分为植入组与未植入组,探究发生植入的危险因素。结果:前置组和对照组年龄无差异,前置组孕周小于对照组,孕次、产次、既往剖宫产次数和距上次剖宫产时间均大于对照组(P<0.05);前置组合并胎盘植入42例(43.8%)为植入组,未植入组54例(56.3%),植入组与未植入组年龄、孕周、孕次间无差异,产次、既往剖宫产次数、距上次剖宫产时间、前置胎盘类型、胎盘位置、LC3、Beclin1及HMGB1表达等均差异(P<0.05)。前置组胎盘组织中LC3(1.67±0.29)、Beclin1(1.58±0.43)及HMGB1(1.03±0.13)表达均高于对照组(1.06±0.12、1.07±0.12、0.68±0.09),植入组(1.93±0.37、1.72±0.52、1.13±0.15)高于未植入组(1.46±0.34、1.39±0.40、1.13±0.15)(均P<0.05)。经多因素logistic分析,影响孕妇发生前置胎盘的因素包括孕周、孕次、产次、既往剖宫产次数、与上次剖宫产间隔时间、LC3、Beclin1及HMGB1高表达;影响前置胎盘孕妇发生胎盘植入的因素包括产次多、既往剖宫产次数多、距上次剖宫产时间长、前置胎盘类型、胎盘位置、LC3、Beclin1及HMGB1表达。结论:LC3、Beclin1及HMGB1蛋白在前置胎盘中表达升高,且合并胎盘植入胎盘中表达更高,LC3、Beclin1及HMGB1蛋白升高是发生前置胎盘和胎盘植入的危险因素。

Objective: To investigate the expressions and clinical significances of microtubule associated protein light chain 3(LC3), Beclin1, and high mobility group protein B1(HMGB1) in placenta tissue of pregnant women with placenta previa and placenta implantation. Methods: 96 pregnant women with placenta previa were included in group A and 75 healthy pregnant women with cesarean delivery were included in group B from January 2019 to December 2020. The expression levels of LC3, Beclin1, and HMGB1 in the placenta tissues of the women in the two groups were detected. The women in group A were further divided into group A1(women with placenta implantation) and group A2(women without placenta implantation), thereafter, the risk factors affecting the occurrence of placenta implantation were explored. Results: There was no significant difference in the age of the women between group A and group B. The gestational weeks when delivery of the women in group A was significantly less than that of the women in group B, and the gravidity number, the parity number, the number of previous cesarean section, and the time from last cesarean section to this pregnancy of the women in group A were significantly higher than those of the women in group B(P<0.05). There were 42(43.8%) cases in group A1 and 54(56.3%) in group A2. There were no significant differences in the age, the gestational weeks when delivery, and the gravidity of the women between group A1 and group A2. There were significant differences in the parity number, the number of previous cesarean section, the time from last cesarean section to this pregnancy,the previa type,the placenta position,and the expression levels of LC3,Beclin1,and HMGB1of the women between group A1and group A2(P<0.05).The expression levels of LC3(1.03±0.13),Beclin1(1.58±0.43),and HMGB1(1.67±0.29)in placental tissue of the women in group A were significantly higher than those(1.06±0.12,1.07±0.12,and 0.68±0.09)of the women in group B.The expression levels of LC3,Beclin1,and HMGB1(1.93±0.37,1.72±0.52,and 1.13±0.15)of the women in group A1significantly higher than those(1.46±0.34,1.39±0.40,and 1.13±0.15)of the women in group A2(all P<0.05).Multiple logistic analysis showed that the factors affecting the occurrence of placenta previa of the pregnant women included the gestational weeks,the gravidity number,the parity number,the number of previous cesarean section,the time from last cesarean section to this pregnancy,and the levels of LC3,Beclin1,and HMGB1.The factors affecting the occurrence of placenta implantation of the women with placenta previa included the parity number,the number of previous cesarean section,the time interval since last cesarean section,the type of placenta previa,the placenta location,and the expression levels of LC3,Beclin1,and HMGB1.Conclusion:The expressions of LC3,Beclin1,and HMGB1proteins in placenta tissues of the women with placenta previa increase,and which of the women with placenta previa complicating placenta implantation are higher.The high expressions of LC3,Beclin1,and HMGB1of the women are the risk factors of their development of placenta previa and placenta implantation.