糖尿病患者妊娠后胎盘组织缺氧诱导因子-1α及内皮素-1的表达及与妊娠结局关系  

Expressions of hypoxia-inducible factor-lαand endothelin-1 in placenta of diabetic patients after pregnancy and their relationship with pregnancy outcomes

作　　者：杨晓菊[1] 孙玲玲[1] 张萌[1] 万欣[1] 徐金娥[1] 

机构地区：[1]青岛大学医学院附属医院产科,山东青岛266003

出　　处：《中华实用诊断与治疗杂志》2014年第1期15-17,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：山东省青岛市科技局基金资助项目(kzd-12)

摘　　要：目的探讨缺氧诱导因子-1α(hypoxia-inducible factor-lα,HIF-1α)和内皮素-1(endothelin-1,ET-1)在糖尿病(diabetes mellitus,DM)患者妊娠后胎盘中的表达及与妊娠结局的关系。方法 DM妊娠患者24例(DM+妊娠组)、妊娠期糖尿病(gestational diabetes mellitus,GDM)患者38例(GDM组)以及正常孕妇35例(对照组),采用放射免疫法测定血清游离雌三醇(free estriol,FE3)和人胎盘泌乳素(human placental lactogen,hPL)水平判断胎盘功能,免疫组织化学SP法测定HIF-1α、ET-1蛋白在胎盘中的表达,比较各组检测指标差异及其与妊娠结局的关系,分析DM患者妊娠后血清FE3、hPL水平与胎盘HIF-lα、ET-1蛋白表达的相关性。结果 DM+妊娠组及GDM组妊娠期高血压疾病等发生率高于对照组,DM+妊娠组妊娠期高血压疾病发生率高于GDM组,DM+妊娠组胎盘功能低于对照组和GDM组(P<0.05);3组胎盘均有HIF-1α和ET-1蛋白表达,DM+妊娠组、GDM组HIF-1α蛋白表达明显增强,DM+妊娠组ET-1表达明显增强;DM+妊娠组HIF-1α、ET-1蛋白阳性表达率为83.3%、87.5%,GDM组为73.6%、31.6%,对照组为22.9%、17.1%;DM+妊娠组FE3、hPL水平与其胎盘HIF-1α、ET-1蛋白表达呈正相关(r=0.79/0.83;r=0.86/0.88,P<0.05)。结论 DM患者妊娠后胎盘HIF-1α、ET-1高表达,其表达水平与胎盘功能损害有关,对妊娠结局可产生不良影响。Objective To investigate the expressions of hypoxia-inducible factor-1α（HIF-1α） and endothelin-1 （ET-1） in placenta of diabetes mellitus （DM） patients after pregnancy and their relationship with pregnancy outcomes. Methods The levels of free estriol （FE3） and human placental lactogen （hPL） were detected by radioimmunoassay to assess placental function in 24 DM patients after pregnancy （DM＋ pregnancy group）, 38 patients with gestational diabetes mellitus （GDM group） and 35 normal pregnant women （control group）. The expressions of HIF-1α and ET-1 protein in placenta were detected by immunohistochemistry, and their relationship with pregnancy outcomes was analyzed. The correlation of FE3 and hPL with HIF-1α and ET-1 was analyzed in DM patients after pregnancy. Results The incidence of hypertensive disorders in pregnancy was higher in DM＋pregnancy group and GDM group than that in control group, and was higher in DM＋pregnancy group than that in GDM group （P〈0.05）. The placental function was lower in DM＋ pregnancy group than that in GDM group and control group （P〈0.05）. HIF-1α and ET-1 were expressed in placenta in all groups. HIF-1α level was higher in DM＋pregnancy group and GDM group than that in control group （P〈O. 05）, and ET-1 level was higher in DM＋pregnaney group than that in GDM group and control group （P〈0.05）. The positive expression rates of HIF-1α and ET-1 were 83.3% and 87.5% in DM＋pregnancy group, 73. 6% and 31.6% in GDM group, and 22.90% and 17.1% in control group. The FE3 and hPL levels were positively correlated with the expressions of HIF-1α and ET-1 in DM＋pregnancy group （r=0. 79/0. 83; r=0. 86/0.88, P〈O. 05）. Conclusions HIF-1α and ET-1 are overexpressed in placenta in DM patients after pregnancy, their expression levels are correlated with placental dysfunction, and it could result in bad pregnancy outcomes.

关 键 词：妊娠 糖尿病 胎盘 缺氧诱导因子-1Α 内皮素-1 

分 类 号：R714.2[医药卫生—妇产科学]