脐动脉波形异常伴胎儿宫内生长迟缓患者胎盘血管内皮生？…

目的 探讨胎儿脐动脉波形异常伴宫内生长迟缓（ＩＵＧＲ）与胎盘血管内皮生长因子（ＶＥＧＦ）表达水平的关系,并得出胎盘的氧水平。方法 应用彩色多谱勒超声,对４０例妊娠晚期妇女进行胎儿脐动脉搏动指数（ＰＩ）、阻力指数（ＲＩ）及收缩期末最大血流速度与舒张期末最小血流速度比值（Ｓ／Ｄ）测定,根据脐动脉波形变化分为４个组。脐动脉波形异常伴ＩＵＧＲ组（ＡＶＡＷ组）、脐动脉波形异常不伴ＩＵＧＲ组（ＡＶＮＷ组）、脐

Vascular endothelial growth factor expression in placenta from intrauterine growth retardation fetus with abnormal umbilical artery flow velocity waveforms

OBJECTIVE: To study the relationship between placental vascular endothelial growth factor (VEGF) expression and intrauterine growth retardation (IUGR) with abnormal Umbilical artery flow velocity waveforms (UmA FVWS), and deduce the oxygen content in placental terminal villi. METHODS: The VEGF expression levels in syncytiotrophoblast and stroma cells were determined by sp immunohistochemistry, and were compared between the following 4 groups: abnormal UmA FVWS and IUGR (AVAW), abnormal UmA FVWS and normal birth-weight (AVNW), normal UmA FVWS and IUGR (NVAW), normal UmA FVWS and normal birth-weight (NVNW). Each group included 10 cases. RESULTS: In all the placentae, VEGF was mainly expressed in syncytiotrophoblasts with less immunostaining in stroma cells. The intensity of VEGF immunostaining in stroma cells was similar in the groups studied so far. The VEGF expression in syncytiotrophoblasts was significantly reduced in group AVAW (VEGF positive rate in syncytiotrophoblasts is 13.0%), compared with NVAW (VEGF positive rate in syncytiotrophoblasts is 38.50%; P < 0.01) and NVNW (VEGF positive rate in syncytiotrophoblasts is 39.6%; P < 0.01). There was a negative linear correlation between VEGF positive rate in syncytiotrophoblasts and the values of UmA PI (r = -0.52, P < 0.001), RI (r = -0.43, P < 0.01), S/D (r = -0.40, P < 0.01). CONCLUSIONS: The reduction of VEGF expression levels in syncytiotrophoblasts correlates with abnormal UmA FVWS and IUGR. The reduced expression of VEGF in syncycciotrophoblasts may be responsible for the impaired development of all classes of vessels and villi of the placentas from IUGR with abnormal UmA FVWS. The oxygen content is increased within terminal villi of IUGR with abnormal UmA FVWS.