胎盘中HGF和IGF-1的表达及与妊娠期高血压疾病发病的关系

目的探讨肝细胞生长因子（Hepatocyte growth factor,HGF）与胰岛素样生长因子-1（Insu lin like growth fac-tor-1,IGF-1）在正常晚孕妇女及妊娠期高血压疾病患者胎盘组织中的表达以及在妊娠期高血压疾病发病中的作用。方法采用免疫组织学方法检测62例妊娠期高血压疾病患者（妊娠期高血压疾病组,其中妊娠期高血压21例。轻度子痫前期19例,重度子痫前期22例）及20例正常晚孕妇女（对照组）的胎盘组织中HGF及IGF-1的表达强度,同时HE染色,选取5个高倍视野,计数绒毛血管数。结果（1）HGF主要表达于绒毛间质细胞胞浆,蜕膜细胞有少量表达。重度子痫前期患者胎盘绒毛间质细胞HGF的表达强度显著低于对照组（H=8.548,P=0.003）,而妊娠期高血压及轻度子痫前期患者与对照组比较,差异无显著性（H=0.018,P=0.892;H=3.739,P=0.053）;（2）IGF-1主要表达于胎盘合体滋养细胞、细胞滋养细胞及蜕膜细胞的胞膜及胞质中。胎盘组织中IGF-1的表达,轻、重度子痫前期患者明显低于对照组（H=4.948,P=0.026;H=15.245,P=0.001）而妊娠期高血压与对照组比较,差异无显著性（H=0.118,P=0.731）;（3）不同程度妊娠期高血压疾病组胎盘绒毛血管密度均较对照组减少,重度子痫前期患者胎盘绒毛血管密度为（59.69±3.86）个/×400,与对照组（67.67±4.55）个/×400相比,差异有显著性（P〈0.01）;（4）相关性分析显示两组孕妇胎盘组织中HGF、IGF-1表达强度分别与绒毛血管密度、新生儿出生体重呈正相关（r=0.695,r=0.386;r=0.270,r=0.782）;对照组及妊娠期高血压患者胎盘组织中HGF与IGF-1的表达强度呈强正相关性（r=0.950,P〈0.01;r=0.864,P〈0.01）。结论胎盘组织中HGF、IGF-1分泌减少与妊娠期高血压疾病发病及病情发展有关,IGF-1可能参与了HGF水平的调节。

Relationship between expression of HGF and IGF - 1 in placenta and pathogenesis of hypertensive disorder complicating pregnancy.

Objective：To study the expression of Hepatocyte growth factor（HGF） and Insulin like growth factor-1（IGF-1） in placenta from normal pregnancy and hypertensive disorder complicating pregnancy and their roles in the pathogenesis of hypertensive disorder complicating pregnancy.Methods：Immunohistochemial technique was used to determine the location and intensity of HGF and IGF-1 in placenta from 62 patients with hypertensive disorder complicating pregnancy（hypertensive disorder complicating pregnancy group） and 20 normal pregnant women（control group）.HE staining was used in order to count the number of the vessles.Results：（1） HGF mostly were expressed in villous core mesenchymal cells,less in decidual cells.The intensity of HGF immnostaining was significantly reduced in the severe preecalmpsia group compared with the control group（H=8.548,P=0.003）,while there were no statistical differences among the gestational hypertension,mild preeclampsia and the control group（H=0.018,P=0.892;H=3.739,P=0.053）;（2） IGF-1 were expressed in placental syncytiotrophoblast,cytotrophblast and decidual cells.Its expression in mild and severe preeclampsia patients were lower than that in control group（H=4.948,P=0.026;H=15.245,P=0.001）.There was no statistical differences between the gestational hypertension and the control group.（H=0.118,P=0.731）;（3） The count of vessels reduced in severe preeclampsia group（P〈0.01）.（4） There were positive correlation between the count of vessels in villous and the expression of HGF and IGF-1（r=0.695,r=0.386）;There were positive correlation between newborn birth weight and the expression of HGF and IGF-1（r=0.270,r=0.792）;There were strong positive correlations between the expression of HGF and IGF-1 in the control and the gestational hypertension group（r=0.950,P〈0.01;r=0.864,P〈0.01）.Conclusion：The reduction of HGF and IGF-1 in human placenta are related to the occurrence and development of hypertensive disorder complicating pregnan