TNF—α在妊娠高血压疾病中的作用机制  

Mechanism of tumor necrosis factor-α in the pathogenesis of hypertensive disorder complicating pregnancy

作　　者：张玉萍[1] 孙笑繁[1] 孙静汾[1] 曹玉莲[1] 

机构地区：[1]山西省妇幼保健院,030013

出　　处：《中华围产医学杂志》2007年第2期76-79,I0001,共5页Chinese Journal of Perinatal Medicine

摘　　要：目的探讨肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）在妊娠高血压疾病（hypertensive disorder complicating pregnancy，HDCP）发病中的作用机理。方法采用放免法检测60例HDCP患者（研究组）血清TNF-α，并与同期正常晚期妊娠孕妇20例（对照组）对照。并用免疫组化法观察两组胎盘组织中的TNF-α和肿瘤坏死因子-α受体1（tumor necrosis factor receptor1，TNFR1）的表达。结果（1）血清TNF-α浓度对照组为（0．79±0．14）μg／L，妊娠期高血压组为（0．90±0．14）μg／L，轻度子癎前期（mild preeclampis，MPE）组为（1．13±0．15）μg／L，重度子癎前期（severepreeclampsia，SPE）组为（1．32±0．31）μg／L，对照组与MPE及SPE、研究组组内比较均有统计学意义（P〈0．01）。（2）胎盘组织中TNF-α的阳性表达率对照组为（41．5±11．37）％，妊娠期高血压组为（63．5±12．68）％，MPE组为（72．5±11．64）％，SPE组为（79．0±8．52）％，对照组与研究组比较差异均有统计学意义（P〈0．01）。妊娠期高血压的阳性表达率均低于MPE及SPE（P〈0．05，P〈O．01）；（3）胎盘组织TNFR1的阳性表达率对照组为（43．5±9．33）％，妊娠期高血压组为（63．5±12．68）％，MPE组为（71．5±11．82）％，SPE组为（78．5±9．88）％，对照组与研究组之间、研究组组内比较均差异均有统计学意义（P〈O．05或P〈0．01）。结论HDCP患者血清中的TNF-α水平、胎盘TNF-α和TNFR1的阳性率随病情的加重而升高，TNF-α与HDCP有密切的关系，可能为HDCP的发病原因之一。Objective To investigate the mechanism of tumor necrosis factor-α （TNF-α） in the pathogenesis of hypertensive disorder complicating pregnancy（HDCP）. Methods Radioimmunoassay was used to measure the levels of TNF-α in 60 women with HDCP and 20 normal pregnant women （control） at the third trimester. Immuno-histochemistry was used to detect the expression of TNF-α and tumor necrosis factor reeeptorl （TNFR1） in the placenta. Results The plasma level of TNF-α in the control group was （0.79 ±0.14）μg/L, （0.90±0.14） μg/L in the gestational hypertension group, （1.13±0.15）μg/L in the mild preeclampsia group （MPE）, and （1.32±0.31）μg/L in the severe preeclampsia group （SPE） with significant difference between the MPE, SPE groups and the control （P〈0.01,respectively） and also within the HDCP group （P〈0.05, P〈0.01）. The expression rate of TNF-α in placenta tissue in the control group was （41.5±11.37） %, （63.5±12.68） % in the gestational hypertension group, （72.5 ± 11.64） % in the MPE group, and （79.0 ± 8.52）% in the SPE group with significant difference between the control and HDCP group （P〈0.01, respectively） and between the gestational hypertension group and the MPE and SPE group （P〈0. 05, P〈0.01）. The expression rate of TNFR1 in placenta tissue of the control was （43.5 ± 9.33） %, （63.5 ± 12.68） % in the gestational hypertension group, （71.5 ± 11.82） % in the MPE group, and （78.5±9.88） % in the SPE group with significant difference between HDCP and control （P〈0.01, respectively） and within the HDCP group （P〈0. 05, P〈0.01）. Conclusions The plasma level of TNF-α, the expression rate of TNF-α and TNFR1 in placental tissue were higher with the deteriorating of HDCP. So TNF-α may play an important role in the pathogenesis of HDCP.

关 键 词：妊娠并发症 心血管 高血压 受体 肿瘤坏死因子 放射免疫测定 

分 类 号：R714[医药卫生—妇产科学]