以妊娠期糖尿病孕妇血中糖基化终产物指标与血管生长因子水平作为胎盘血管病变和母婴结局指标预测的研究  

Prediction of placental angiopathies and maternal-fetal complications by using AGEs and VEGF levels in GDM maternal serum

作　　者：汤栩文 秦庆新[2] 谢晓斌[3] 

机构地区：[1]广州市妇女儿童医疗中心,510623 [2]广州市第一人民医院 [3]广州医学院病理学教研室

出　　处：《中国糖尿病杂志》2012年第12期900-903,共4页Chinese Journal of Diabetes

基　　金：2011年度广州市卫生局医药卫生科技项目;一般引导项目(201102A213037)

摘　　要：目的探讨妊娠期糖尿病(GDM)孕妇血中糖基化终产物(AGEs)指标和血管生长因子(VEGF)水平与常见母胎并发症的关系,测量胎盘中AGE与VEGF受体蛋白表达量,以探求GDM孕妇血中AGE、VEGF浓度与胎盘血管病变、母婴并发症的相关性及预测价值。方法在孕龄24～28周采用酶联免疫法检测孕母血清AGE、VEGF水平,分娩后立即收集胎盘低温保存,用于分析组织中RAGE及VEGFR蛋白的表达。结果 GDM组孕母血清AGE、VEGF水平均高于对照(NC)组。(1)GDM合并胎儿宫内发育受限(FGR)组孕母血清AGE、VEGF水平明显低于其他组,P<0.05;(2)GDM合并妊娠期高血压疾病组孕母血清AGE、VEGF水平明显高于其他组,P<0.05;(3)GDM合并胎儿FGR组胎盘组织中RAGE及VEGFR蛋白表达量明显低于其他组,P<0.05;(4)GDM合并妊娠期高血压疾病组胎盘组织中RAGE及VEGFR蛋白表达量明显高于其他组,P<0.05;(5)Logistic回归分析显示AGEs、VEGF浓度是GDM母胎并发症的危险因子;(6)GDM组孕母血清AGE与VEGF水平呈正相关(r=0.625,P<0.01)。结论 GDM孕母血清低AGE、VEGF水平可作为GDM产前预测合并FGR的筛查指标之一。GDM孕母血清高AGE、VEGF水平可作为GDM产前预测合并妊娠期高血压疾病的筛查指标之一。VEGF的表达水平与其上游因子AGE的表达水平呈正相关。Objective To measure the expressions of AGE and VEGF receptor proteins in placenta for exploring the relationship of AGEs and VEGF levels in GDM maternal serum with the placental angiopathies and common maternal-fetal complications. Methods The pregnant women in 24 - 28 gestational weeks diagnosed as GDM plus maternal-fetal complications were attributed to the case group （n=264）, while the pregnant women with GDM and no maternal-fetal complications were taken into the control group （n= 30）. AGE and VEGF levels in maternal serum were detected by ELISA. The placenta tissues were collected freshly and kept in hypothermia for detecting on the expressions of RAGE and VEGFR proteins. Results The maternal serum AGE and VEGF levels were higher in the ease group than in the control group. In the case group. （1） The serum AGE and VEGF levels in the GDM group complicated with fetus growth restriction （FGR） were significantly lower than in other groups （P〈 0. 05）. （2） The serum AGE and VEGF levels in the GDM group complicated with hypertension were significantly higher than in other groups （P〈0. 05）. （3） The expressions of RAGE and VEGFR proteins were significantly higher in the GDM group complicated with FGR were significantly lower than in other groups （P〈0. 05）. （4） The expressions of RAGE and VEGFR proteins were signifiicantly higher in the GDM group complicated with hypertension than in other groups （P〈 0. 05）. （5） Logistic regression analysis showed that the AGEs and VEGF levels were predictors of GDM maternal-fetal complications. （6） The maternal serum AGE level in the ease group were positively correlated with VEGF level （r= 0. 625, P〈0. 01）. Conclusion （1） Low AGE and VEGF levels in GDM maternal serum may be one of the screening indicators to predict GDM complicated with FGR. （2） Similarly, high AGE and VEGF levels in GDM maternal serum may be one of the screening indicators to predict GDM complicated with hypertension. （3） The VEGF expres

关 键 词：妊娠期糖尿病 糖基化终产物 血管内皮生长因子 胎儿生长受限 妊娠期高血压疾病 

分 类 号：R714.25[医药卫生—妇产科学]