瘦素在子癎前期患者胎盘和血清的表达和意义

目的 探讨子癎前期患者胎盘和血清中瘦素的表达变化及其和子癎前期发病的关系.方法 采用免疫组化SP法检测45例子癎前期患者(研究组,其中重度组28例,轻度组17例)和30例同期正常妊娠妇女(对照组)胎盘瘦素水平,并用酶联免疫吸附实验检测两组孕妇产前血清瘦素水平.结果 (1)两组胎盘瘦素均在合体滋养细胞胞浆表达,随病情加重,染色逐渐加深,胎盘瘦素与子癎前期存在线性相关关系.(2)研究组、轻度组、重度组和对照组血清瘦素浓度分别为(10.41±4.78)ng/ml、(6.33±1.87)ng/ml、(12.88±4.27)ng/ml、(5.73±2.19)ng/ml,轻度组稍高于对照组但无统计学意义(P>0.05),研究组和对照组、轻和重度组、重度组和对照组相比,均有性统计学意义(P<0.01),瘦素表达水平和病情严重程度呈正相关.(3)血清瘦素与体重指数无相关性(P>0.05);但其与收缩压、舒张压及平均动脉压均呈正相关(r=0.602、0.566和0.585,P均<0.05).结论 瘦素在子癎前期患者胎盘和血清中均高表达,高瘦素水平参与子癎前期的发生和发展.

Expression and significance of leptin in placenta and serum in preeclampsia

Objective To investigate the expression and alteration of leptin in placenta and serum in preeclampsia and its relationship with the disease. Methods Immunohistochemistry(SP) was used to determine the distribution and intensity of leptin staining in the placenta of 45 cases of preeclampsia(28 severe and 17 mild) and 30 cases of normal gravidas(contr01 group).Antepartum leptin level was examined using enzyme-linked immunosorbent assay method. Results (1)Leptin expression was located in the endochylema of the syncytiotrophoblast in both groups.Positive linear correlation existed between the leptin level and the severity of preeelampsia,expressed as darker staining with aggravating disease condition.(2)The serum leptin levels in all preeclampsia,mild and severe preeclampsia and normal group were(10.41±4.78)ng/ml,(6.33±1.87)ng/ml,(12.88±4.27)ng/ml and(5.73±2.19)ng/ml,respectively.Significant differences were found between preeclampsia women and normal group,mild and severe group,and severe and normal group(P<0.01).No significant difference was found when comparing mild and normal group(P>0.05).Positive linear correlation existed between the leptin expression and the severity of preeclampsia.(3)Serum leptin level had a positive correlation with systolic pressure,diastolic pressure,and mean arterial pressure(r=0.602,0.566 and 0.585,P<0.05),while no significant correlation was found between leptin level and patients'BMI(P>0.05).Conclusion Increased level of leptin in placenta and serum in preeclampsia may be involved in the occurrence and the development of the disease.