正常妊娠孕妇和子痫前期患者妊娠中晚期血清和胎盘中妊娠相关蛋白浓度的变化  

Second-and third-trimester serum and placental tissue levels of placental proteins in normal pregnant women and patients with pre-eclampsia at term

作　　者：谢恺俐[1] 

机构地区：[1]湖南省株洲市一医院产科,湖南株洲412000

出　　处：《安徽医药》2009年第2期166-168,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的通过检测正常妊娠孕妇及子痫前期患者血清和胎盘组织中妊娠相关血浆蛋白A(PAPP-A)、妊娠特异性β1糖蛋白(SP1)、人胎盘催乳素(HPL)和胎盘生长因子(PLGF)的浓度,探讨PAPP-A、SP1、HPL和PLGF与子痫前期的关系。方法选取22例不同孕期健康孕妇(对照组)及23例进行性子痫前期患者(子痫前期组),分别在妊娠第17,25,33和37周抽血,采用酶联免疫吸附试验(ELISA)法检测患者血清PAPP-A、SP1、HPL和PLGF浓度,并在妊娠≥37周后产时收集胎盘组织,-80℃保存,经处理后采用特殊酶联免疫吸附试验(ELISA)法检测胎盘组织中PAPP-A、SP1、HPL和PLGF浓度。结果子痫前期组血清中PAPP-A、SP1、HPL和PLGF浓度在第17周时比对照组低,第25,33和37周时只有PLGF浓度低于对照组(P<0.05),血清PAPP-A浓度明显高于对照组(P<0.05)。胎盘组织中PAPP-A浓度明显高于对照组(P<0.05),而PLGF、HPL和SP1浓度与对照组相比没有显著差异。结论在妊娠中期初始(17周),子痫前期患者血清中PAPP-A、SP1、HPL浓度明显低于正常妊娠妇女,提示胎盘存在一定的病理改变;胎盘在子痫前期患者血清中妊娠相关蛋白浓度变化中起了部分的代偿作用,血清中PAPP-A及PLGF的浓度变化可作为诊断子痫前期的参考指标。Aim To study the relationships between pre-eclampsia and the serum and placental tissue levels of placental proteins in second-and third-trimester. Methods We compared maternal serum levels of PAPP-A, SP1, HPL and PLGF at 17,25,33 and 37weeks, and placental tissue （ ≥37 weeks of gestation） levels of four proteins in pregnancies developing preeclampsia （ n = 23 ）, with gestationmatched controls （ n = 22）. The proteins were quantified using mieroplate enzyme immunometrie assays and the serum levels at 17,25,33 and 37 weeks, and the placental tissue levels compared between the two groups by non-parametric statistical tests. All data were analyzed with SPSS 13.0. Results In pregnancies with subsequent pre-eclampsia PAPP-A, SP1, HPL and PLGF were reduced at 17 weeks of gestation whereas at 25,33 and 37 weeks only PLGF remained below the controls. Placental contents of PAPP-A were significantly higher in pre-eclampsia placental extracts compared with the controls （ P 〈 0.05 ）. SP1, HPL and PLGF levels were not altered in the term preeelampsia placenta. Conclusion The reduced serum levels of the placental proteins PAPP-A, SP1 and HPL in the early second trimester （ 17 weeks） in pregnancies with subsequent pre-eclampsia involve an underlying role for the placenta in either pathology independent from the other. The placenta,possibly by a compensatory mechanism,is at least in part responsible for the altered serum levels observed in preeclampsia. The serum levels of PAPP-A and PLGF are suspected to be correlated with the occurrence and development of pre-eclampsia.

关 键 词：子痫前期 妊娠相关蛋白A 妊娠特异性Β1糖蛋白 人胎盘催乳素 胎盘生长因子 

分 类 号：R714.1[医药卫生—妇产科学] R714.2[医药卫生—临床医学]