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子痫前期患者母体血液及胎盘组织中膜联蛋白V的表达变化及临床意义

[Expression changes and clinical significance of annexin V in maternal blood and placenta in patients with preeclampsia].

作者信息

Xin Hong, Wang Hui-lan

机构信息

Department of Obstetrics and Gynecology, Second Hospital of Hebei Medical University, Shijiazhuang 050000, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2011 Feb;46(2):88-93.

Abstract

OBJECTIVE

To evaluate the expression of annexin V in maternal blood and placenta, and to explore the relationship between annexin V and preeclampsia (PE).

METHODS

120 women with PE who delivered babies in the Second Hospital of Hebei Medical University from December 2007 to December 2009 were chosen as study groups. They were classified into four groups: early-onset mild group (n = 30), early-onset severe group (n = 30), late-onset mild group (n = 30) and late-onset severe group (n = 30). 30 women without perinatal complications who accepted elective term cesarean section were chosen as control group. Western blot and immunohistochemistry were used to detect the expression and localization of annexin V in placenta and maternal blood. Flow cytometry was employed to detect the apoptosis of cytotrophoblast. AnnexinVmRNA level was determined by reverse transcription (RT)PCR. Prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FiB), international normalized ratio (INR) were detected in each group.

RESULTS

(1) The expression of annexin V in placenta and maternal blood were: 0.54 ± 0.12 and 0.62 ± 0.17 in early-onset mild group; 0.47 ± 0.15 and 0.56 ± 0.24 in early-onset severe group; 0.74 ± 0.23 and 1.08 ± 0.32 in late-onset mild group; 0.68 ± 0.28 and 0.72 ± 0.21 in late-onset severe group; 1.73 ± 0.35 and 1.55 ± 0.27 in control group. They were significantly lower in PE groups than in control group (P < 0.05). However, there was no significant difference among PE groups (P > 0.05). (2) The early apoptosis, late apoptosis percentage of trophoblast cells were: 3.21%, 0.86%, in early-onset mild group; 5.32%, 0.72%, in early-onset severe group; 2.43%, 0.63%, in late-onset mild group; 4.28%, 0.48% in late-onset severe group; 1.05%, 0.59%, in control group. Early apoptosis percentage in each group of PE was higher than that in control group (P < 0.05). However, there was no significant difference among PE groups (P > 0.05). (3) The annexin V mRNA levels in placenta were: 25.0 ± 3.0 in early-onset mild group; 24.8 ± 3.0 in early-onset severe group; 25.4 ± 3.9 in late-onset mild group; 25.1 ± 2.7 in late-onset severe group, respectively. All were significantly higher than that in control group (30.6 ± 3.0, P < 0.05), and no significant difference was found among PE groups (P > 0.05). (4) PT, APTT, FiB, INR levels were: (11.3 ± 2.4), (25.6 ± 2.9) s, (4.6 ± 0.9) g/L and 0.9 ± 0.2 in early-onset mild group; (12.1 ± 1.9), (27.2 ± 2.1) s, (5.0 ± 1.0) g/L and 0.9 ± 0.2 in early-onset severe group; (11.7 ± 2.3), (26.5 ± 2.3) s, (5.0 ± 0.7) g/L and 0.8 ± 0.3 in late-onset mild group; (11.4 ± 2.6), (27.3 ± 3.0) s, (4.3 ± 0.8) g/L and 0.8 ± 0.3 in late-onset severe group; (12.4 ± 2.7), (28.0 ± 1.9) s, (5.1 ± 1.2) g/L and 0.9 ± 0.2 in control group. There was no significant difference among PE groups and control group (P > 0.05).

CONCLUSION

The expression changes of annexin V in placenta and maternal blood were observed in patients with PE. This indicated that annexin Vplayed an important role in the pathogenesis and progression of PE by affecting coagulation.

摘要

目的

评估膜联蛋白V在孕妇血液和胎盘中的表达,并探讨膜联蛋白V与子痫前期(PE)之间的关系。

方法

选取2007年12月至2009年12月在河北医科大学第二医院分娩的120例PE患者作为研究组。将其分为四组:早发型轻度组(n = 30)、早发型重度组(n = 30)、晚发型轻度组(n = 30)和晚发型重度组(n = 30)。选取30例接受择期足月剖宫产且无围产期并发症的孕妇作为对照组。采用蛋白质免疫印迹法和免疫组织化学法检测膜联蛋白V在胎盘和孕妇血液中的表达及定位。采用流式细胞术检测细胞滋养层细胞的凋亡情况。通过逆转录(RT)-PCR测定膜联蛋白V mRNA水平。检测每组的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FiB)、国际标准化比值(INR)。

结果

(1)胎盘和孕妇血液中膜联蛋白V的表达分别为:早发型轻度组0.54±0.12和0.62±0.17;早发型重度组0.47±0.15和0.56±0.24;晚发型轻度组0.74±0.23和1.08±0.32;晚发型重度组0.68±0.28和0.72±0.21;对照组1.73±0.35和1.55±0.27。PE各组的表达均显著低于对照组(P < 0.05)。然而,PE各组之间无显著差异(P > 0.05)。(2)滋养层细胞的早期凋亡率、晚期凋亡率分别为:早发型轻度组3.21%、0.86%;早发型重度组5.32%、0.72%;晚发型轻度组2.43%、0.63%;晚发型重度组4.28%、0.48%;对照组1.05%、0.59%。PE各组的早期凋亡率均高于对照组(P < 0.05)。然而,PE各组之间无显著差异(P > 0.05)。(3)胎盘中膜联蛋白V mRNA水平分别为:早发型轻度组25.0±3.0;早发型重度组24.8±3.0;晚发型轻度组25.4±3.9;晚发型重度组25.1±2.7。均显著高于对照组(30.6±3.0,P < 0.05),且PE各组之间无显著差异(P > 0.05)。(4)PT、APTT、FiB、INR水平分别为:早发型轻度组(11.3±2.4)、(25.6±2.9)s、(4.6±0.9)g/L和0.9±0.2;早发型重度组(12.1±1.9)、(27.2±2.1)s、(5.0±1.0)g/L和0.9±0.2;晚发型轻度组(11.7±2.3)、(26.5±2.3)s、(5.0±0.7)g/L和0.8±0.3;晚发型重度组(11.4±2.6)、(27.3±3.0)s、(4.3±0.8)g/L和0.8±0.3;对照组(12.4±2.7)、(28.0±1.9)s、(5.1±1.2)g/L和0.9±0.2。PE各组与对照组之间无显著差异(P > 0.05)。

结论

观察到PE患者胎盘和孕妇血液中膜联蛋白V的表达变化。这表明膜联蛋白V通过影响凝血在PE的发病机制和进展中起重要作用。

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