血清护骨素和核因子-κB受体活化子配体的表达对妊娠期高血压病的诊断价值

Significance of measurement of serum osteoprotegerin and receptor activator of nuclear factor kappa B ligand in patients with hypertensive disorders complication pregnancy

目的研究血清护骨素(OPG)和核因子-κB受体活化子配体(RANKL)在妊娠期高血压疾病(HDCP)患者血清中的表达并探讨其与妊娠期高血压疾病的关系。方法采用(ELISA)检测49例妊娠期高血压患者(妊娠期高血压18例、轻度子痫前期16例、重度子痫前期15例)及16例同期正常孕妇和15例健康育龄妇女的血清OPG和RANKL的水平。结果(1)血清OPG水平:妊娠期高血压组(9.23±3.55)pmol/L与正常妊娠组(7.07±2.36)pmol/L和非孕育龄对照组(6.01±0.95)pmol/L比较,差异有统计学意义(P【0.05,P【0.01),正常妊娠组与非孕育龄对照组比较差异无统计学意义(P】0.05);妊娠期高血压组为(7.88±1.42)pmol/L,轻度子痫前期组为(8.23±2.21)pmol/L,重度子痫前期组为(10.50±2.78)pmol/L,妊娠期高血压组和轻度子痫前期组相比,差异无统计学意义(P】0.05),妊娠期高血压组和重度子痫前期组比较,差异有统计学意义(P【0.05)。(2)血清RANKL水平:妊娠期高血压组为(0.49±0.18)pmol/L与正常妊娠组(0.71±0.48)pmol/L和非孕育龄对照组(0.78±0.31)pmol/L比较,差异有统计学意义(P【0.01);妊娠期高血压组为(0.49±0.18)pmol/L,轻度子痫前期组为(0.44±0.16)pmol/L,重度子痫前期组为(0.28±0.09)pmol/L,妊娠期高血压组和重度子痫前期组比较,差异有统计学意义(P【0.01),轻度子痫前期组和重度子痫前期组比较,差异有统计学意义(P【0.05)。结论孕妇血清中有OPG、RANKL的表达与妊娠期高血压疾病的发病存在一定的关联性,在妊娠妇女骨转换中扮演了重要角色,为临床预测妊娠期高血压的发生和监测疾病进展提供可靠的实验依据。

Objective To investigate the expression of osteoprotegerin(OPG)and receptor activator of nuclear factor kappa B ligand(RANKL)in patients with hypertensive disorders complication pregnancy(HDCP),and to explore their significance in pathogenesis of HDCP.Methods The serum levels of OPG and RANKL in 49 patients with HDCP(18 cases of pregnancy hypertension,16 cases of mild preeclampsia and 15 cases of severe preeclampsia),16 normal pregnant women and 15 healthy women of child-bearing age were measured with ELISA kits.Results The serum levels of OPG in women of HDCP,normal pregnancy and child-bearing age were 9.23±3.55 pmol/L,7.07±2.36 pmol/L,and 6.01+0.95 pmol/L,respectively(HDCP vs normal pregnancy:P<0.05;HDCP vs child-bearing age women:P<0.01;normal pregnancy vs child-bearing age women:P>0.05).The serum levels of OPG in patients with pregnancy hypertension,mild preeclampsia and severe preeclampsia were 7.88±1.42 pmol/L,8.23±2.21 pmol/L,10.50±2.78 pmol/L,respectively(pregnancy hypertension vs mild preeclampsia:P>0.05;pregnancy hypertension vs severe preeclampsia:P<0.05;mild preeclampsia vs severe preeclampsia:P>0.05).The serum levels of RANKL in women of HDCP,normal pregnancy and child-bearing age were 0.40±0.18 pmol/L,0.71±0.48 pmol/L and 0.78±0.31 pmol/L,respectively(HDCP vs normal pregnancy:P<0.01;HDCP vs child-bearing age women:P<0.01).The serum levels of RANKL in patients with pregnancy hypertension,mild preeclampsia and severe preeclampsia were 0.49+0.18 pmol/L,0.44±0.16 pmol/L,0.28±0.09 pmol/L,respectively(pregnancy hypertension vs mild preeclampsia:P>0.05;pregnancy hypertension vs severe preeclampsia:P<0.01;mild preeclampsia vs severe preeclampsia:P<0.05).Conclusion It’s demonstrated that there exist certain associations between serum levels of OPG,RANKL and pathogenesis of HDCP.It’s suggested that OPG and RANKL play key roles in bone metabolism in pregnancy.It’s shown that measurement of OPG and RANKL may provide reliable laboratory data for study on pathogenesis and prognosis of HDCP.