重度子痫前期合并胎儿生长受限胎盘组织VCAM-1表达的研究

目的研究血管细胞黏附分子-1(VCAM-1)在重度子痫前期及重度子痫前期合并胎儿生长受限胎盘组织的表达情况。方法分别选取中国医科大学附属盛京医院产科2008年1～12月入院病人中重度子痫前期合并胎儿生长受限(fetal growth restriction,FGR)病人的胎盘组织14例(研究组1),单纯重度子痫前期病人的胎盘组织15例(研究组2)作研究组;取同期的正常产妇胎盘组织19例作对照。用免疫组织化学方法检测VCAM-1在胎盘合体细胞及绒毛血管内皮细胞中的表达情况并进行分析。结果 VCAM-1在研究组1、研究组2和对照组合体细胞中的阳性表达率分别为57.14%、53.33%和89.47%。研究组1和研究组2胎盘合体细胞中VCAM-1阳性表达率均显著低于对照组,差异有显著性(均P<0.05);VCAM-1在研究组1、研究组2和对照组胎盘绒毛血管内皮中的阳性表达率分别为92.86%、60.00%和21.05%。研究组1和研究组2胎盘绒毛血管内皮中VCAM-1阳性表达率均显著高于对照组,差异有显著性(均P<0.05);VCAM-1在研究组1阳性表达率显著高于研究组2,差异有显著性(均P<0.05)。结论 VCAM-1不仅与重度子痫前期及重度子痫前期合并FGR的胎盘着床表浅有关,而且参与了重度子痫前期及重度子痫前期合并FGR胎盘绒毛血管内皮损伤过程。重度子痫前期合并FGR时,VCAM-1参与了FGR的发生机制,并且FGR的发生可能与VCAM-1在血管内皮中表达增多有关。

The expression of VCAM-1 in placenta tissue of patients with severe pre-eclampsia complicating FGR

【Objective】 To study the expression of VCAM-1 in the placentas of severe pre-eclampsia and severe pre-eclampsia complicating fetal growth restriction.【Methods】 The specimens were collected from 14 placenta tissue of patients with severe pre-eclampsia complicating fetal growth restriction(group1),15 placenta tissue of patients with severe pre-eclampsia(group2) and 19 placenta tissue of normal parturients(control group),in which the expressions of VCAM-1 both in syncytiums and vascular endothelial cells were detected by immunohistochemistry.【Results】 The ratios of positive expression of VCAM-1 in syncytiums of group1,group2 and control group were 57.14%,53.33% and 89.47%.The ratios of positive expression of VCAM-1 in syncytiums of group1 and group2 were significantly lower than that of control group(P <0.05);the ratios of positive expression of VCAM-1 in vascular endothelial cells of group1,group2 and control group were 92.86%,60% and 21.05%.The ratios of positive expression of VCAM-1 in vascular endothelial cells of group 1 and group 2 were significantly higher than that of control group(P <0.05);and the ratio of positive expression of VCAM-1 in vascular endothelial cells of group1 was significantly higher than that of group2(P <0.05).【Conclusion】 VCAM-1 is related with the superficial nidation of placenta in severe pre-eclampsia and severe pre-eclampsia complicating fetal growth restriction,meanwhile,it involves in the procedure of the damage of placental blood vessel endothelium in severe pre-eclampsia and severe pre-eclampsia complicating fetal growth restriction.VCAM-1 participates in the mechanism of FGR,and the occurrence of FGR is probably related with high expression of VCAM-1 in blood vessel endothelium during the severe pre-eclampsia.