重度子痫前期患者胎盘绒毛外滋养细胞VCAM-1、E-selectin的表达及意义

目的探讨子宫胎盘界面绒毛外滋养细胞（EVCT）上血管细胞粘附分子（VCAM-1）及E-选择素（E—selectin）的表达特点以及与妊娠期高血压疾病的关系。方法采用免疫组织化学法观察20例重度子瘸前期胎盘（妊高征组）以及孕周相配的20例正常妊娠胎盘（对照组）子宫胎盘界面蜕膜中绒毛外滋养细胞VCAM-1、E-selectin的表达；光镜下计算EVCT阳性染色强度，并用医学图象分析软件测定EVCT阳性染色的平均光密度值（MOD）。结果与正常对照比较，子瘸前期患者子宫胎盘界面EVCT上VCAM-1、E-selectin的染色强度及MOD值均降低。差异有统计学意义（P〈0．05、P〈0．01）。结论子痫前期子宫胎盘界面EVCT上血管内皮细胞特性的粘附分子VCAM-1、E-selectin的表达减少。可能引起滋养细胞对子宫壁和血管的浸润性降低，导致子宫胎盘血管形成障碍。

VCAM-1 and E-selectin Expression in Extravillous Cytotrophoblasts of Severe Preeclampsia

Objective To investigate the expression pattern of vascular cell adhesion molecule-1(VCAM-1) and endothelial selectin(E-selectin) in the placental bed extravillous cytotrophoblast (EVCT) as well as its relationship with preeclampsia. Methods Placentas from severe preeclampsia (n=20) and gestional age-matched normal pregnancies (n=20) were studied. The staining intensity and the Mean Optical Density (MOD) of VCAM-1 and E-selectin in EVCT of placental bed deciduas were measured by immunohistochemistry. Results The staining intensity and MOD of VCAM-1 and E-selectin on placental bed EVCT in severe preeclampsia were significantly lower than those in the control group respectively (P<0.05, P<0.01). Conclusion The decreased EVCT expression of vascular adhesion phenotype VCAM-1 and E-selectin may account for the shallow trophoblast invasion in preeclampsia, which is the major pathological change of this disease.