妊娠期高血压疾病患者胎盘组织中凋亡相关基因表达的变化及硫酸镁与川芎嗪治疗对其的影响  

Effect of magnesium sulfate and lignstrazine on expression of apoptosis associated gene in human placenta of hypertensive disorder complicating pregnancy

作　　者：胡志英[1] 方马荣[2] 王伊萍[1] 陈丽[1] 吴林珍[1] 

机构地区：[1]浙江省中西医结合医院妇产科,杭州310003 [2]浙江大学医学院

出　　处：《中国综合临床》2007年第2期183-185,共3页Clinical Medicine of China

基　　金：浙江省杭州市卫生局资助课题（99A17）

摘　　要：目的研究凋亡相关基因Bax、bcl-2及FAS在妊娠期高血压疾病患者胎盘绒毛中的表达，以及硫酸镁与川芎嗪治疗后表达的变化，探讨硫酸镁与川芎嗪治疗妊娠期高血压疾病对凋亡相关基因表达的影响及疗效机制。方法采用免疫组织化学PAP法结合计算机显微图像分析，检测正常孕妇（15例）、妊娠期高血压疾病患者（19例）、硫酸镁治疗后患者（28例）和硫酸镁与川芎嗪治疗后患者（25例）的胎盘组织中Bax、bcl-2及FAS表达情况。结果胎盘绒毛中有Bax、bcl-2和FAS基因蛋白表达，Bax、bcl-2主要分布于合体滋养层细胞，FAS则主要分布于干绒毛的血管壁平滑肌细胞；子痫前期时Bax、bcl-2和FAS阳性反应平均灰度值分别为53．9±8．1、55．1±6．2和100．9±12．6，较正常妊娠组的42．3±5．7、31．7±3．8和59．9±6．5及同组妊娠期高血压的43．7±7．1、32．1±5．1和60．7±10．3明显增加（均为P〈0．01）；2组妊娠期高血压疾病治疗组Bax、bcl-2表达均无明显改变，但子痫前期硫酸镁与川芎嗪治疗组FAS阳性反应平均灰度值为82．3±10．1，较妊娠期高血压疾病组（100．9±12．6）和硫酸镁组（98．7±15．9）明显减弱（P〈0．01）。结论胎盘组织中Bax、bcl-2及FAS在妊娠期高血压疾病，尤其子痫前期发病中可能起重要作用；硫酸镁与川芎嗪治疗能使胎盘绒毛FAS基因蛋白表达减弱，抑制胎盘绒毛的细胞凋亡，提高子宫-胎盘-胎儿血供。Objective To investigate the expression of apoptosis associated gene including Bax, bcl-2 and FAS in human placenta of hypertensive disorder complicating pregnancy （HDCP）, and to evaluate the influence of magnesium sulfate combined with ligustrazine on apoptosis associated gene and the efficiency mechanism. Methods Placental tissues from 15 normal gravidas, 19 HDCP women, 28 post-treatment women with magnesium sulfate and 25 post-treatment women with magnesium sulfate and lignstrazine were collected. The expressions of Bax, bcl-2 and FAS were analyzed using immunohistochemistry （PAP） staining and computer microphotography. Results The expressions of Bax,bcl-2 and FAS were evident in human placental villi. Bax and bcl-2 were mostly located in syncytitrophoblast cell,but FAS expression was evident chiefly in the smooth muscle cell of vascular wall of villi. The average grey value difference （GVD） indicating positive staining of Bax,of bcl-2 and FAS were respectively 53.9±8.1, 55.1±6.2 and 100.9±12.6 in pre-eclampsia group,which were significantly higher than there of the normal gravidas （42.3±5.7,31.7±3.8 and 59.9±6.5） and gestational hypertension （43.7±7.1,32.1±5.1 and 60.7±10.3） （P 〈 0.01 for each）. There were no apparent alterations of the expression of Bax and bcl-2 in the two HDCP treatment groups. Furthermore,the average GVD of FAS was 82.3±10.1 in pre-eclampsia group after treatment with the magnesium sulfate and ligustrazine, which was significantly lower than those of the pre-treated HDCP group （100.9±12.6） and magnesium sulfate group （98.7±15.9） （P〈0.01）. Conclusion Bax,bcl-2 and FAS in placenta may play an important role in the pathogenesis of HDCP,especially in pre-eclampsia cases. Magnesium sulfate treatment combined with ligustraxzine could reduce the expression of FAS and the apoptosis of placental villi, and increase the blood supply of uterus-placenta-fetus and improve therapeutic efficiency.

关 键 词：妊娠高血压疾病 凋亡 硫酸镁 川芎嗪 

分 类 号：R714[医药卫生—妇产科学]