胎儿生长受限对其肾脏发育的影响

目的：探究胎儿生长受限（fetal growth restriction，FGR）的宫内环境对胎儿肾脏发育的影响。方法：收集2009年11月—2011年12月于天津市中心妇产科医院产科因胎儿原因要求引产的11例FGR和同期12例非FGR死胎或死产胎儿的肾脏组织标本（所有标本的采集均征得患方的知情同意和院伦理委员会的认可），测量其质量和体积，应用TUNEL法分析肾脏组织细胞凋亡率，并对Bax和Bcl-2蛋白在凋亡细胞中的阳性表达率进行检测。结果：与非FGR组相比，FGR组胎儿的平均肾脏体积、质量和肾单位数目均明显下降（P＜0.01），而其细胞凋亡率明显增加（P＜0.01）。进一步检测发现，FGR组细胞内促凋亡蛋白Bax的阳性表达率明显增加（P＜0.01），伴随有凋亡抑制基因Bcl-2的阳性表达率显著降低（P＜0.01）。结论：生长受限的宫内环境可能通过促进细胞凋亡而影响胎儿肾脏发育，为将来进一步探讨FGR的分子机制和成人期疾病的发病机制提供了新的线索。

Effects of Fetal Growth Restriction on the Development of Kidney

Objective:To investigate the effect of intrauterine environment of fetal growth restriction (FGR) on the development of fetal kidney. Methods:Renal specimens of 11 fetal growth restriction (FGR) cases and 12 non-FGR cases were collected from November 2009 to December 2011 in the department of obstetrics of Tianjin Central Hospital of Gynecology Obstetrics. The mass and volume were calculated first,and the apoptosis rate of cells was analyzed by TUNEL. In addition,the positive expression rate of Bcl-2 and Bax proteins in apoptotic cells were also detected. Results:Compared with the non-FGR group,the average volume,quality and number of renal units were significantly decreased in the FGR group (P<0.01), while the apoptosis rate of cells was significantly increased (P<0.01). The positive expression rate of pro-apoptotic protein Bax in the FGR group cells was significantly increased (P<0.01),with the expression rate of anti-apoptotic gene Bcl-2 decreased (P<0.01) after future detection. Conclusions:Our study indicates that increased apoptosis may effect human kidney development in FGR environment,which is helpful to provide new clues for further exploring the molecular mechanism of FGR and the pathogenesis of adult diseases.