妊娠高血压综合征患者胎盘和脐带血管内皮细胞损伤与肿瘤坏死因子的关系

目的　探讨妊娠高血压综合征 (妊高征 )患者胎盘和脐带血管内皮细胞损伤及功能变化与肿瘤坏死因子 (TNF)的关系。方法　采用放射免疫分析法 ,测定 41例妊高征患者 (妊高征组 )和 35例正常妊娠妇女 (对照组 )血浆TNF、内皮素和一氧化氮的水平 ;采用透射电镜观察两组胎盘和脐带血管内皮细胞的超微结构 ,并与在体外人重组TNF(rTNF)作用下培养的脐带血管内皮细胞形态相比较。结果　 (1)妊高征组血浆TNF和内皮素分别为 (2 .2 7± 0 .42 ) μg/L和 (73.31± 9.98)ng/L ,一氧化氮为(10 4.93± 2 0 .5 4) μmol/L ;对照组血浆TNF和内皮素分别为 (1.72± 0 .2 5 ) μg/L和 (5 2 .32± 10 .44 )ng/L ,一氧化氮水平为 (138.2 5± 2 2 .16 ) μmol/L。妊高征组TNF及内皮素增高 ,一氧化氮减少。两组比较 ,差异有显著性 (P <0 .0 5 )。(2 )电镜显示 ,妊高征组中除轻度患者的胎盘及脐带血管未见异常改变外 ,中、重度患者的胎盘和脐带血管内皮细胞均有损伤性表现。与rTNF作用下于体外培养的脐带血管内皮细胞形态学的改变相似。结论　TNF可引起胎盘和脐带血管内皮细胞损伤 ,可导致血管调节因子失衡 ,在妊高征的发病中有一定作用。

Endothelial Dysfunction and Injury of Placental and Umbilical Vessels in Pregnancy-induced Hypertension is Associated with Tumor Necrosis Factor

OBJECTIVE: To investigate the relation between endothelial dysfunction and injury of placental and umbilical vessels in pregnancy-induced hypertension (PIH) and tumor necrosis factor (TNF). METHODS: The concentration of plasma TNF, endothelin (ET) and nitric oxide (NO) in PIH women and normal pregnant women (control group) were measured. The ultrastructure of placenta and umbilical vein endothelial cells in PIH and normal pregnant women was observed. The ultrastructure of endothelial cells in culture with TNF (400 u/ml) was also observed. RESULTS: Maternal plasma TNF and ET levels in PIH patients were (2.27 +/- 0.42) micrograms/L and (73.31 +/- 9.98) ng/L, respectively, higher than that in the control TNF and ET lever were (1.72 +/- 0.25) micrograms/L and (2.32 +/- 10.44) ng/L, respectively]. NO level in PIH patients was (104.93 +/- 20.54) mumol/L, lower than that in the control NO lever was (138.25 +/- 22.16) mumol/L] (P < 0.05). The ultrastructure of placental and umbilical vascular endothelial cells in moderate and severe PIH patients revealed injured. Similar injury was observed in endothelial cells in culture with TNF. CONCLUSIONS: TNF can induce the endothelial cells dysfunction and injury. It may be involved the pathogenesis of PIH.