Molvarec Attila, Prohászka Zoltán, Nagy Bálint, Kalabay László, Szalay János, Füst Georg, Karádi István, Rigó János
Department of Obstetrics and Gynecology, Kútvölgyi Clinical Center, Semmelweis University, Budapest, Hungary.
3rd Department of Internal Medicine, Semmelweis University and Research Group on Metabolism and Atherosclerosis, Hungarian Academy of Sciences, Budapest, Hungary.
J Reprod Immunol. 2007 Apr;73(2):172-179. doi: 10.1016/j.jri.2006.07.002. Epub 2006 Oct 4.
The primary aim of this study was to determine serum Hsp70 concentrations in HELLP syndrome. We measured also the serum concentrations of three acute phase proteins: C-reactive protein (CRP), alpha(2)-macroglobulin (AMG) and alpha(2)-HS glycoprotein (AHSG). Ten severe preeclamptic patients with HELLP syndrome, 20 severe preeclamptic patients without HELLP syndrome and 20 normotensive, healthy pregnant women were included in this case-control study. Serum concentrations of Hsp70, CRP, AMG and AHSG were measured using an enzyme-linked immunosorbent assay (Hsp70), particle-enhanced immunoturbidimetric assay (CRP) and radial immunodiffusion (AMG, AHSG). The serum Hsp70 and CRP concentrations were significantly higher, whereas the serum AHSG concentration was significantly lower in the HELLP group (H) than the severe preeclamptic (P) and control (C) groups (median (25-75 percentile); Hsp70: 2.02 ng/ml (0.76-2.23) (H) versus 0.54 ng/ml (0.47-0.79) (P), p<0.01, and 0.30 ng/ml (0.27-0.33) (C), p<0.001; CRP: 43.9 mg/l (27.1-84.5) (H) versus 6.5 mg/l (2.7-10.7) (P), p<0.001, and 2.5 mg/l (1.1-6.7) (C), p<0.001; AHSG: 588 microg/ml (492-660) (H) versus 654 microg/ml (576-768) (P), p<0.05, and 738 microg/ml (666-804) (C), p<0.01, respectively). The serum AMG concentration did not differ between the study groups. In the HELLP group, there was a statistically significant negative correlation between serum Hsp70 concentration and platelet count (Spearman R=-0.69, p=0.026). In conclusion, serum Hsp70 and CRP concentrations are increased, whereas serum AHSG concentration is decreased, in HELLP syndrome. The maternal systemic inflammation seems to be more pronounced in HELLP syndrome than preeclampsia without HELLP syndrome, as suggested by the alterations in serum CRP and AHSG levels. However, it requires further investigation to determine whether these changes are causes or consequences of the disease.
本研究的主要目的是测定HELLP综合征患者血清Hsp70浓度。我们还检测了三种急性期蛋白的血清浓度：C反应蛋白（CRP）、α2巨球蛋白（AMG）和α2-HS糖蛋白（AHSG）。本病例对照研究纳入了10例患有HELLP综合征的重度子痫前期患者、20例未患HELLP综合征的重度子痫前期患者以及20例血压正常的健康孕妇。采用酶联免疫吸附测定法（检测Hsp70）、颗粒增强免疫比浊法（检测CRP）和放射免疫扩散法（检测AMG、AHSG）测定血清Hsp70、CRP、AMG和AHSG的浓度。与重度子痫前期组（P）和对照组（C）相比，HELLP组（H）血清Hsp70和CRP浓度显著升高，而血清AHSG浓度显著降低（中位数（第25 - 75百分位数）；Hsp70：2.02 ng/ml（0.76 - 2.23）（H） 对比 0.54 ng/ml（0.47 - 0.79）（P），p<0.01，以及0.30 ng/ml（0.27 - 0.33）（C），p<0.001；CRP：43.9 mg/l（27.1 - 84.5）（H） 对比 6.5 mg/l（2.7 - 10.7）（P），p<0.001，以及2.5 mg/l（1.1 - 6.7）（C），p<0.001；AHSG：588 μg/ml（492 - 660）（H） 对比 654 μg/ml（576 - 768）（P），p<0.05，以及738 μg/ml（666 - 804）（C），p<0.01）。各研究组间血清AMG浓度无差异。在HELLP组中，血清Hsp70浓度与血小板计数之间存在统计学显著的负相关（Spearman相关系数R = -0.69，p = 0.026）。总之，HELLP综合征患者血清Hsp70和CRP浓度升高，而血清AHSG浓度降低。血清CRP和AHSG水平的变化表明，HELLP综合征患者的母体全身炎症似乎比重度子痫前期患者更明显。然而，这些变化是该疾病的原因还是后果，仍需进一步研究来确定。
