子(癎)前期和子(癎)的治疗进展

子癎前期和子癎是妊娠期特有的严重并发症,是导致孕产妇和围生儿病率和死亡率升高的主要原因。临床除了对症治疗外,及时发现和掌握疾病发展的进程,并予妥善处理,对保证母亲安全及降低胎儿和新生儿并发症意义重大。现就近几年的治疗进展作一综述。     

子(癎)前期-子(癎)并发脑血管病38例临床和影像学特点

目的 探讨子癎前期-子癎患者并发脑血管疾病的临床和影像学特点.方法 采用磁共振对2005年2月至2008年2月在天津医科大学总医院及武警医学院附属医院38例因出现脑病症状的子癎前期-子癎患者进行检查,根据检查结果 分组,并对患者的临床症状、血压、肝肾功能、血常规、电解质等指标进行回顾性分析.结果 磁共振捡查异常的患者26例,24例为可复性后部脑病综合征,1例脑梗塞,1例颅内静脉窦血栓形成.磁共振检查异常组与磁共振检查正常组相比,血浆尿酸水平两组问比较差异有统计学意义(t=3.63,P=0.01),其余指标差异无统计学意义.结论 磁共振检查显示子癎前期-子癎发生脑血管疾病绝大多数为后循环可复性脑病综合征.血尿酸水平可能在监测子癎前期-子癎患者发生脑血管痰病中有一定的应用价值.     

白藜芦醇在子痫前期中的作用机制及研究进展

子痫前期是起源于胎盘功能障碍的全身炎性多系统综合征,严重威胁母婴健康.白藜芦醇(Resveratrol)是一种抗衰老、抗氧化应激、抗炎、诱导细胞凋亡和增强胰岛素敏感性的天然多酚化合物.研究表明,白藜芦醇通过抑制氧化应激,抵抗炎症,调节血管功能,促进滋养细胞侵袭,调节免疫功能等在子痫前期的病理生理过程中发挥有效作用.综述...     

重度子(癎)前期并发腹水的临床特点和终止妊娠时机的探讨

目的 探讨重度子(癎)前期并发腹水的临床特点及终止妊娠时机. 方法 对179例重度子(癎)前期患者的临床资料进行回顾性分析,根据有无并发腹水分为腹水组(32例)和非腹水组(147例),分析两组孕妇一般情况、分娩方式、合并症/并发症(包括子(癎)、HELLP综合征、肝肾功能不全、心功能不全、低蛋白血症、胎盘早剥、产后出血、产褥感染).收集两组围产儿(腹水组38例,无腹水组157例)的临床资料,分别比较两组间和腹水组内胎龄＜32周,32周～,34周～,36周～组的小于胎龄儿(small for gestational age,SGA)的发生率和死亡率. 结果 (1)腹水组平均入院孕周和平均分娩孕周均早于无腹水组[入院:(32.5±2.1)周和(36.1±3.5)周,分娩:(34.1±2.3)周和(37.2±1.5)周,P均＜0.05).腹水组系统产前检查率低于无腹水组(25.0%和53.7%,P＜0.05).腹水组低蛋白血症(100.0%和47.0%)、肝肾功能不全(31.2%和8.2%)、HELLP综合征(9.4%和2.0%)、产后出血发生率(18.8%和2.0%)均高于无腹水组(P均＜0.05).(2)腹水组不同胎龄围产儿SGA发生率均高于同胎龄无腹水组,但仅胎龄＞36周组差异有统计学意义(7/9和30.2%,P＜0.05).腹水组胎龄＜32周和32周～围产儿死亡率高于无腹水组(＜32周:69.2%和19.2%,P＜0.05;32周～:2/7和0,P＜0.05).(3)腹水组内围产儿胎龄＜32周时围产儿死亡率较其他胎龄组高,胎龄＞36周围产儿SGA发生率最高(P＜0.05). 结论 重度子(癎)前期并发腹水发病早,并发症多,母婴预后不佳.腹水是重度子(癎)前期的一个危险信号,应该引起产科医生的高度重视.对于重度子(癎)前期并发腹水围产儿,32～36周可能为终止妊娠的良好时机.     

Mirror综合征还是子(癎)前期?

目的　研究水肿胎与Mirror综合征及子(癎)前期(preeclampsia,PE)之间的关系. 方法　分析13例水肿胎(均为妊娠28周后)的临床资料及相关文献. 结果 13例水肿胎中有8例诊断为PE,5例为Mirror综合征.水肿胎无论是并发Mirror综合征还是PE均发生严重的母体并发症. 结论 胎儿、胎盘水肿与母体临床症状之间存在着紧密联系,临床医生必须认识到水肿胎与Mirror综合征及PE之间的关系,及时发现Mirror综合征,防止病情发展为PE.Mirror综合征的病理机制目前还不清楚.关注水肿胎的同时要重视监护母体情况.     

十年间重度先兆子癎处理变化与母儿预后(附654例分析)

目的了解10年来我院对重度先兆子癎处理的改变与母儿预后的关系。方法收集我院1999年1月至2003年12月(后5年)重度先兆子癎病例资料305例,将其并发症与处理、分娩方式及围产儿预后,与前5年349例(1994年1月至1998年12月)资料进行对比性分析。结果早发型重度先兆子癎(<34周)后5年占28．9％(88／305),前5年为10．6％(37／349),差异有统计学意义(P<0．01)。后5年中≤34周者行促胎肺成熟治疗占76．5％(78／102),明显高于前5年的11．1％(6／54,P<0．01)。后5年<34周的致死性引产显著减少,分别为30．3％(10／33)和7．9％(7／88),P<0．01。前后5年围产儿死亡率为8．49％(31／365)与10．56％(34／322),差异无统计学意义(P>0．05),但后5年<34周围产儿死亡率明显降低,分别为29．5％(26／88)和69．7％(23／33),P<0．01。外院转来患者平均终止孕周明显小于在本院保健患者(P<0．05),且其母儿并发症明显增多(P<0．05)。结论加强孕期保健、母儿监护,对<34周早发型重先兆子癎可减少致死性引产,促胎肺成熟,适时终止妊娠,密切产儿科合作,有望减少母儿并发症、降低孕产妇和围产儿死亡率。     

子(癎)前期胎盘组织syncytin及其受体ASCT2的表达

目的研究syncytin及其受体ASCT2在子前期(PE)胎盘组织中的表达。方法胎盘组织来源于广东省人民医院和广州医学院附属第三医院2006年7月至2007年7月住院分娩病例。依孕周匹配,入组孕妇共48例,分为轻度PE组(17例),重度PE组(13例)和正常对照组(18例),应用实时PCR方法检测syncytin及ASCT2mRNA的转录水平,比较检测结果。结果各组均检测到syncytin及ASCT2mRNA。与正常对照组(6.37±2.74)相比,轻、重度PE组胎盘组织syncytinmRNA水平明显降低(1.69±1.34,1.38±1.29),差异有统计学意义(P<0.01);对照组及轻、重度PE组ASCT2mRNA水平(分别为5.51±3.05,3.51±2.93,2.97±1.48)差异无统计学意义(P>0.05);轻、重度PE两组间syncytin及ASCT2mRNA差异均无统计学意义(P>0.05)。结论胎盘syn-cytin表达下调可能与PE发病有关,但其转录水平与病变程度似不相关,其受体ASCT2与PE发生无明显相关性。     

血浆同型半胱氨酸与子(癎)前期发病的关系

目的 研究孕妇血浆同型半胱氨酸(homocysteine,Hcy)水平和亚甲基四氢叶酸还原酶(methylenetetrahydrofolate reductase,MTHFR)基因C677T的多态性,以探讨其在子癎前期发病中的作用.方法 选取子癎前期孕妇50例(子痴前期轻度14例,子癎前期重度36例),正常孕妇40例为研究对象.采用荧光偏振免疫法测定血浆Hcy水平,PCR法检测MTHFR基因C677T的多态性.结果 研究组Hcy水平显著高于对照组[(12.00±4.59)μmol/L和(7.85±1.51)μmol/L,P<0.05];轻度子癎前期组Hcy水平[(8.63±3.94)μmol/L高于对照组,但差异无统计学意义(P>0.05),重度子癎前期组Hcy水平(13.30±2.06)μmol/L]明显高于对照组(P<0.01);子痢前期组MTHFR基因677位点CT、TT基因型频率分布(C/T:42.0%;T/T:14.0%)和子癎前期组总的突变T等位基因频率(T:35.0%)均显著高于对照组(P<0.05).结论 血浆Hey水平升高可能是子瘸前期发病机制中的重要因素,而MTHFR基因C677T多态性影响了Hcy的代谢途径.可能是子癎前期的病因学机理之一.     

子(癎)前期的研究进展

本文简要介绍近几年中，美国产科医学界在子痫前期科研和医疗上的研究进展。主要体现在以下4个方面：（1）妊娠期高血压疾病的定义和分类。（2）子痫前期的发病机制。（3）子痫前期的治疗。（4）子痫前期的麻醉管理。     

人类白细胞抗原-G的表达变化在子(癎)前期发病机制中的作用

目的 探讨人类白细胞抗原-G(human leukocyte antigen-G,HLA-G)的表达变化在子(癎)前期发病机制中的作用.方法 收集2004年1月至2006年1月在华中科技大学同济医学院附属协和医院妇产科分娩的40名正常妊娠妇女和38例子(癎)前期患者(其中轻度子(癎)前期患者20例,重度子(癎)前期患者18例)的胎盘组织和血浆样本,运用实时荧光定量RT-PCR技术检测胎盘组织中HLA-G mRNA的表达,HLA-G mRNA的表达以PCR循环数阈值(Ct值)表示.Western blot印迹法检测胎盘组织中HLA-G蛋白质的表达,同时运用双抗体夹心酶联免疫吸附(ELISA)法检测血浆中可溶性HLA-G(soluble HLA-G,sHLA-G)的表达水平.结果 与正常妊娠妇女比较,轻、重度子(癎)前期患者胎盘组织中HLA-G mRNA(38.65±0.03、49.13±0.02;59.32±0.02)及其蛋白质(0.31±0.03、0.19±0.04;0.40±0.05)和血浆中sHLA-G[(1.13±0.03)g/L、(0.54±0.05)g/L;(1.95±0.03)g/L]的表达水平均显著降低,差异均有统计学意义(P＜0.05).与轻度子(癎)前期患者比较,重度子(癎)前期患者胎盘组织中HLA-G mRNA及其蛋白质和血浆中sHLA-G的表达水平均显著降低,差异均有统计学意义(P＜0.05).结论 滋养细胞下调HLA-G基因的转录,降低其蛋白质的表达水平,可能在子(癎)前期的发病机制中发挥重要作用.     

DNA damage and oxidative stress in patients with mild preeclampsia and offspring

Objective

Oxidative stress has been shown to play an important role in the pathogenesis of pre-eclampsia, and DNA damage frequently occurs in cells exposed to such stress. The aim of the present study was to investigate DNA damage and oxidative stress in mildly pre-eclamptic women and their offspring.

Study design

We studied 25 mildly pre-eclamptic mothers, 20 healthy controls, and their infants. Mononuclear leukocyte DNA damage, total antioxidant status (TAS), and total oxidant status (TOS) were determined and the oxidative stress index (OSI) was calculated.

Results

DNA damage, and TOS and OSI levels were significantly increased, and TAS levels significantly decreased, in maternal and cord blood samples of the mildly pre-eclamptic group. A positive correlation between the extent of DNA damage and diastolic blood pressure was evident in pre-eclamptic mothers and there was a negative correlation between the extent of DNA damage and TOS.

Conclusion

Both oxidative stress and DNA damage are elevated in mildly pre-eclamptic patients and their offspring. Increased oxidative stress may be important in inducing DNA damage in pre-eclamptic patients.     

子痫前期产妇胎盘组织中的氧化应激对Wiskott-Aldrich综合征关联蛋白2表达的影响

目的 探讨子痫前期产妇胎盘组织存在的氧化应激对胎盘滋养细胞Wiskott-Aldrich综合征关联蛋白2 (Wiskott-Aldrich syndrome related protein 2,WAVE 2)表达的影响. 方法 研究对象为2011年8月15日至2012年2月23日在重庆医科大学附属第一医院分娩的子痫前期产妇20例及正常足月产妇23例(对照组).剖宫产术后取胎盘组织,采用免疫组织化学法检测胎盘组织WAVE2的定位及分布.采用蛋白质印迹法检测胎盘组织WAVE2的表达,实时荧光定量聚合酶链反应法检测胎盘中WAVE2 mRNA的表达,采用组织匀浆法检测2组产妇胎盘组织活性氧(reactive oxygen species,ROS)水平,并对胎盘组织中ROS水平与WAVE2表达水平进行相关性分析.(2)通过构建体外滋养细胞缺氧复氧损伤模型,模拟缺血再灌注诱导的氧化应激损伤.人妊娠早期绒毛外滋养细胞株HTR 8/SVneo细胞贴壁完全后分别置于常氧(常氧组)和缺氧复氧条件(缺氧复氧组)下48 h,采用流式细胞仪分析细胞内ROS水平.采用Transwell实验观察细胞迁移侵袭状况.采用细胞免疫荧光法和蛋白质印迹法检测HTR-8/SVneo细胞内WAVE2的定位及表达水平的变化.采用独立样本t检验及Pearson相关检验对数据进行分析. 结果 (1)子痫前期组24 h尿蛋白、母体收缩压及舒张压均高于对照组,新生儿出生体重及胎盘重量均低于对照组[24 h尿蛋白:(1.96±0.24)g与(0.08±0.05)g,t=19.436;母体收缩压:(154±13) mm Hg与(98±11) mm Hg,t=11.324;母体舒张压:(105±14)mm Hg与(69±8)mm Hg,t=9.612;新生儿出生体重:(2446±187)g与(3207±233)g,t=16.307;胎盘重量:(432±53)g与(536±67)g,t=14.562;均P＜0.05].子痫前期组WAVE2 mRNA表达低于对照组[(0.28±0.07)与(1.01±0.02),t=12.747],WAVE2相对表达量低于对照组[(0.63±0.08)与(1.34±0.19),t=11.648],ROS水平高于对照组[(144.22±12.32) nmol/(mg·prot)与(75.17±8.71)nmol/(mg·prot),t=20.467],差异均有统计学意义(均P＜0.05).子痫前期组胎盘组织中ROS水平与WAVE2表达水平呈显著负相关(r=-0.726,P=0.000).(2)在常氧组中,HTR-8/SVneo细胞内的ROS水平为(82.9±5.8)％,而缺氧复氧组为(155.6±8.1)％,高于常氧组(t=12.747,P＜0.05).缺氧复氧48 h后的HTR-8/SVneo细胞与常氧组相比,迁移和侵袭力明显降低[缺氧复氧组分别为(58.4±4.2)％和(51.9±3.3)％,常氧组为100％,t值分别为11.034和13.839,P均＜0.05].细胞免疫荧光检测结果显示,WAVE2定位于滋养细胞的细胞质中.缺氧复氧48 h后,HTR-8/SVneo细胞中WAVE2的表达强度明显弱于常氧组(0.37±0.05与0.76±0.06,t=8.631,P＜0.05). 结论 子痫前期胎盘组织中存在过度氧化应激,与胎盘组织中WAVE2表达下调密切相关.缺氧复氧致氧化应激损伤可下调滋养细胞WAVE2的表达;WAVE2表达下调可能损伤滋养细胞迁移侵袭能力,从而参与子痫前期的发生发展.     

Fatty acids, antioxidants, and oxidative stress in pre-eclampsia

OBJECTIVE: To investigate whether free radical-mediated membrane lipid peroxidation may be implicated in the pathogenesis of pre-eclampsia. METHODS: A prospective study using a sample of 55 healthy pregnant women and 60 pre-eclamptic women recruited at Bharati Medical Hospital, Pune, India. Maternal and cord samples were examined for (red blood cells and plasma) fatty acid profiles, antioxidants, and oxidative stress levels. Mean values were compared between case and control groups using the t test and Wilcoxon rank test. RESULTS: Pre-eclamptic women showed reduced total omega-3 fatty acids (P<0.05), increased omega-6:omega-3 ratio (P<0.05), higher oxidative stress (P<0.05), and lower antioxidant (P<0.05) levels. Similar trends were also observed in cord samples. CONCLUSION: Reduced antioxidants and increased oxidative stress leading to impaired essential polyunsaturated fatty acid levels may be a key factor in the development of pre-eclampsia.     

Plasma sFlt-1-to-PlGF ratio is correlated with inflammatory but not with oxidative stress in Chinese preeclamptic women

Purpose  Considerable interest has been focused on angiogenic factors and angiogenic imbalance in the field of pre-eclampsia (PE), owing to its gaining role in the development of PE. This study was addressed to investigate the associations of sFlt-1-to-PlGF plasma ratios with oxidative stress assessed by the level of 8-isoprostane, and inflammation measured by the level of high-sensitive C-reactive protein (hs-CRP), and adipocytokines. Methods  A total of 83 patients with PE including 47 mild PE (MPE) and 36 severe PE (SPE) and 50 age-matched normotensive subjects in the third trimester of pregnancy were examined. Measurements included body mass index (BMI), systolic and diastolic blood pressure (BP) levels, plasma concentrations of hs-CRP, 8-isoprostane, adiponectin, and leptin. Results  Subjects with PE had higher levels of sFlt-1/PlGF (P < 0.01), hs-CRP (P < 0.01), 8-isoprostane and leptin (both P < 0.01) and lower adiponectin (P < 0.01) than did normotensive control subjects. Significant positive correlations were found between plasma sFlt-1/PlGF and hs-CRP (r = 0.437, P < 0.01) or leptin (r = 0.656, P < 0.01). A weak inverse correlation emerged between sFlt-1/PlGF and adiponectin (r = −0.306, P < 0.01). When a multiple regression analysis was performed, with sFlt-1/PlGF as a dependent variable and all the other parameters as independent variables, sFlt-1/PlGF maintain a significant relationship with leptin (β = 0.219, P < 0.05) and with hs-CRP (β = 0.295, P < 0.01) as well as with systolic BP(β = 0.446, P < 0.05). Conclusions  In Chinese preeclamptic women, plasma sFlt-1-to-PlGF ratio is correlated with inflammatory and adipocytokines but not with oxidative stress.     

Comprehensive analysis of oxidative stress markers and antioxidants status in preeclampsia

Preeclampsia is a hypertensive disorder in pregnant women, which can be the leading cause of maternal and neonatal death or premature birth. Although the cause of preeclampsia is still not clear, local or systemic oxidative stress may explain the pathological features associated with this complication. However, it is not clear whether oxidative stress is the cause or the result of preeclampsia. For this purpose, the present meta-analysis was intended to evaluate the oxidant and antioxidant status in women with preeclampsia.Relevant studies were identified after a preliminary investigation of research articles published up to September 2017.In the overall analysis, including 2953 cases and 3621 controls, a statistically significant reduction in total antioxidant capacity, nitric oxide, superoxide dismutase, glutathione, vitamin E and C was observed in preeclampsia women. On the other hand, a statistically significant increase in malondialdehyde, protein carbonyl, total peroxide, glutathione peroxidase, catalase and uric acid were observed in preeclampsia women. The increased products of oxidative stress, which were found in the present meta-analysis might be an underlying mechanism for endothelial dysfunction in preeclampsia.This meta-analysis provides a scientific support that primary reduction of antioxidant capacity and increased levels of oxidative stress products may induce a condition in which the pathways responsible for blood pressure homeostasis are disrupted. In conclusion, it is hypothesized when oxidative stress is established, a protective response is induced by increasing some antioxidants. Further studies are warranted to investigate the role of dietary supplementation and genetic variation in women with different ethnicity.     

Increased oxidative stress in pre-eclamptic placenta is associated with altered proteasome activity and protein patterns

Analysis of the amount of oxidatively damaged proteins in placenta proteins from normal pregnancies and pre-eclampsia revealed a relative increase of about 30 per cent of damaged proteins in pre-eclamptic placenta. Previous work has demonstrated that these cell- and tissue-damaging oxidatively stressed proteins are metabolized particularly by the 20S proteasome. Evaluation of the proteasomal activity revealed a significantly reduced proteasome function in pre-eclamptic placenta by about 30 per cent, suggesting that the accumulation of oxidatively damaged proteins in pre-eclampsia is associated with reduced proteasomal activity. To investigate these effects at molecular levels, separation of placental proteins by two-dimensional SDS-PAGE and subsequent anti-proteasome Western blot revealed several sets of approximately 20 kDa and 30 kDa protein subunits in normal placenta which appear at low or undetectable expression levels in pre-eclamptic placenta. Control Western blots against the placenta protein 14 (PP14) demonstrated equal loading and no significant differences in the PP14 protein patterns. These data suggested that alteration of the multifactorial proteasomal protein complex in pre-eclamptic placenta is accompanied by reduced metabolization of oxidatively damaged proteins. Consequently, the accumulation of these damaged proteins in the placenta may be associated with metabolic interference and thus contribute to certain developments of pre-eclampsia. Silver staining of the two-dimensional SDS-PAGE revealed a variety of acidic proteins in the range of 20 kDa and 45 kDa, respectively, which are differentially expressed in normal and pre-eclamptic placenta and thus provide further analytic potential for metabolic interference.     

Increased breath markers of oxidative stress in normal pregnancy and in preeclampsia

OBJECTIVES: The purpose of this study was to compare the intensity of oxidative stress in normal pregnancy, preeclampsia, and nonpregnant women using a breath test. STUDY DESIGN: We studied primiparous women in third trimester pregnancy (38 uncomplicated, 26 with preeclampsia) and 60 nonpregnant control subjects. Volatile organic compounds (VOCs) in alveolar breath were analyzed by gas chromatography/mass spectroscopy to construct the breath methylated alkane contour (BMAC), a 3-dimensional display of abundance of C4-C20 alkanes and monomethylated alkanes. RESULTS: The mean volume under curve (VUC) of the BMAC was significantly higher in preeclampsia patients than in normal pregnant women (P < .003) and nonpregnant control subjects (P < .005). A predictive model employing 5 VOCs distinguished preeclampsia from uncomplicated pregnancy (sensitivity = 92.3%, specificity = 89.7%; cross-validated sensitivity = 88.5%, specificity = 79.3%). CONCLUSION: A breath test significantly demonstrated greater oxidative stress in women with preeclampsia than in uncomplicated pregnancy and nonpregnant control subjects. The breath test accurately identified women with established preeclampsia, but further studies are required to determine if this test can predict the onset of disease.     

The transient increase of oxidative stress during normal pregnancy is higher and persists after delivery in women with pre-eclampsia

OBJECTIVES: Glutathione, an intracellular tripeptide, functions in the protection of cells against free radicals and toxins of endogenous and exogenous origin. To maintain the intracellular redox status in presence of reactive oxygen species, glutathione (GSH) and other thiols are oxidized. The oxidative status of thiols is reflected by the free-to-oxidized ratio and is a real-time measure for oxidative stress. Previously, we have reported abnormal ratios for the thiols cysteine (Cys), homocysteine (Hcy) and cysteinylglycine (CysGly) in women with pre-eclampsia. The aims of this study were to confirm our previous findings in a different case-control cohort and more importantly to determine whether these differences persist postpartum. STUDY DESIGN: At onset of disease and at 6-8 weeks postpartum we analyzed whole blood of 41 women with pre-eclampsia and of 31 women with normotensive pregnancies for the free-to-oxidized ratio of thiols by the assessment of free and oxidized thiol levels using high performance liquid chromatography. Differences between values were determined using either the paired t-test (antepartum versus postpartum) or the t-test (pre-eclampsia versus normotensive pregnancy). RESULTS: Antepartum levels of free GSH as well as the free-to-oxidized ratios of Hcy were lower in pre-eclampsia and normotensive pregnancy when compared with corresponding postpartum values (P<0.0001 and P<0.01, respectively). Moreover, the free-to-oxidized ratio for Hcy was significantly lowered in pre-eclamptic compared with normotensive women, during as well as after pregnancy (both P< or =0.01). CONCLUSION: The data suggest that pregnancy is a state of higher oxidative stress when compared to the postpartum period. In women with pre-eclampsia, oxidative stress is higher and persists in the postpartum period.     

子痫前期患者胎盘组织氧化应激与PeroxiredoxinⅡ

目的:研究子痫前期胎盘组织氧化应激情况及PeroxiredoxinⅡ的表达,探讨PeroxiredoxinⅡ在子痫前期氧化应激机制中的作用。方法:用蛋白免疫印迹法检测15例子痫前期患者及15例正常妊娠者胎盘组织中PeroxiredoxinⅡ表达,测定相应组织中SOD活力及MDA、H2O2含量。结果:子痫前期患者胎盘组织中,PeroxiredoxinⅡ的表达明显低于正常妊娠组(P<0.05)。子痫前期组氧化应激指标SOD活力为89.74±18.26U/mg-prot,明显低于正常妊娠组105.23±21.88U/mgprot(P<0.01);MDA含量96.69±32.88nmol/mgprot,明显高于对照组63.29±13.74nmol/mgprot(P<0.05);H2O2含量为81.65±17.93nmol/mgprot,显著高于对照组的68.58±13.55nmol/mgprot(P<0.01)。H2O2含量与PeroxiredoxinⅡ表达量呈负相关。结论:PeroxiredoxinⅡ与子痫前期发生发展中的氧化应激机制存在密切关系。     

Placental inflammation and oxidative stress in the mouse model of assisted reproduction

Higher rates of low birth weight and prematurity are observed in pregnancies generated with assisted reproduction technologies (ART). Both conditions have been associated with placental inflammation and oxidative stress. Since placental and fetal levels of progesterone, a major anti-inflammatory steroid, are decreased in murine ART, we investigated placental inflammation and oxidative stress in this model as potential mediators of negative birth outcomes. After generating mouse pregnancies by in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) we evaluated the antioxidant defense network and major inflammatory cytokines in maternal, placental and fetal tissues. Additionally, placentas were analyzed for total lipid levels, fibrosis, apoptosis, reactive oxygen species and integrity of intracellular nucleotides. Placentas from ART contained significantly less lipids, with greater levels of apoptosis and degraded nucleotides. Placentas from ICSI pregnancies had lower activities of superoxide dismutase (SOD), thioredoxin reductase (TrxR), xanthine oxidase (XO), catalase, glutathione-S-transferase (GST) glutathione peroxidase, and glutathione reductase (GR). Furthermore, GR, GST and SOD were also lower in fetal livers from ICSI pregnancies. Placentas from IVF pregnancies had decreased levels of SOD, TrxR and XO only. In placentas from both ICSI and IVF pregnancies IL-6 levels were significantly increased. These data suggest that ART is associated with placental inflammation (IL-6), oxidative stress and apoptosis but not fibrosis or remodeling. These effects are markedly greater with the ICSI technique. Since ICSI is ubiquitous, oxidative stress and placental inflammation associated with this method may be a critical factor in negative birth outcomes such as prematurity and low birth weight.