重度子痫前期患者胎盘合体滋养细胞凋亡的研究

目的 比较早发型与晚发型重度子痫前期患者胎盘合体滋养细胞凋亡水平变化,探讨其病因及发病机制的差异.方法 选择2008年11月至2009年5月在上海交通大学附属第六人民医院住院剖宫产分娩的早发型重度子痫前期患者15例(早发型组)、晚发型重度子痫前期患者15例(晚发型组)和健康妊娠妇女10例(对照组),采用酶联免疫吸附试验检测孕妇血浆中合体滋养细胞微粒(STBM)水平,蛋白印迹法检测胎盘组织中凋亡蛋白--半胱氨酸天冬氨酸蛋白酶3(caspase-3)蛋白表达水平.结果 (1)STBM:早发型组孕妇血浆STBM水平为(71±21)μg/L,高于晚发型组的(42±30)μg/L和对照组的(26±11)μg/L,分别比较,差异均有统计学意义(P＜0.05);晚发型组血浆STBM水平与对照组比较,差异无统计学意义(P＞0.05).(2)caspase-3蛋白:早发型组胎盘组织中caspase-3蛋白表达水平为0.85±0.61,晚发型组为0.77±0.46,对照组为0.32±0.15,早发型和晚发型组胎盘组织中caspase-3蛋白表达水平均高于对照组,差异有统计学意义(P＜0.05);但早发型组和晚发型组比较,差异无统计学意义(P＞0.05).结论 早发型与晚发型重度子痫前期可能存在不同的发病机制,早发型重度子痫前期可能是一种胎盘疾病,而晚发型则可能与母体因素有关.

Study on apoptosis of placental syncytiotrophoblast in patients with severe preeclampsia

Objective To investigate apoptosis of placental syncytiotrophoblast in patients with early-onset and late-onset severe preeclampsia. Methods From November 2008 to May 2009, 15 cases with early-onset severe preeclampsia and 15 cases with late-onset severe preeclampsia matched with 10 women with normal pregnancies as control at Sixth Affiliated Hospital of Shanghai Jiaotong University were enrolled in this study. Enzyme-linked immunosorbent assay was used to measure syncytiotrophoblast microparticles (STBM) levels in peripheral venous plasma. Caspase-3 were measured by western blotting.Results (1)STBM: the level of STBM of (71 ± 21 )μg/L in early-onset group were significantly higher than (42 ±30)μg/L in late-onset group and (26 ± 11)μg/L in control group(P ＜0.05). The level of STBM in late-onset group and control group did not reach statistical difference ( P ＞ 0. 05 ). ( 2 ) Caspase-3:the level of caspase-3 protein were 0. 85 ± 0. 61 in early-onset group and 0. 77 ± 0. 46 in late-onset group,which were all significantly higher than 0. 32 ± 0. 15 in control group( P ＜ 0. 05 ). However, the level of caspase-3 protein in early-onset group did not show remarkable difference compared with that in late-onset group (P＞0. 05). Conclusion STBM are shed into the maternal circulation in higher amounts in earlyonset preeclampsia, which indicated that early-onset and late-onset severe preeclampsia may have different etiology and pathogenesis.