脂蛋白脂酶在重度子痫前期胎盘和脐血中的表达及与其子代代谢异常的关系  

Expression of Lipoprotein Lipase in Placenta and Fetal Cord Serum with Severe Preeclamp- sia and the Correlation with Fetus Metabolism

作　　者：沈虹[1] 程蔚蔚[1] 陈一飞[1] 

机构地区：[1]上海交通大学附属国际和平妇幼保健院,上海200030

出　　处：《实用妇产科杂志》2014年第1期39-42,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:通过研究脂蛋白脂酶(LPL)在重度子痫前期产妇胎盘、脐血中的表达及胎儿脐血中血脂、血糖、胰岛素的水平,以探讨LPL在子痫前期发病中的可能作用及与子痫前期子代代谢异常的关系。方法:选择2011年11月至2012年6月在本院剖宫产分娩的重度子痫前期产妇30例为重度子痫前期组,同期剖宫产分娩的30例正常产妇为正常对照组。运用逆转录-聚合酶链反应实时定量PCR(RT-PCR)法检测胎盘组织中的LPL基因的相对表达水平;采用酶联免疫吸附法(ELISA)检测胎儿脐血中LPL浓度;采用全自动生化分析仪检测两组胎儿脐血中的血脂、血糖浓度及化学发光法检测胰岛素浓度。结果:①重度子痫前期组胎盘组织中LPL mRNA水平明显高于正常对照组(P=0.010)。②重度子痫前期组胎儿脐血中LPL浓度明显低于正常对照组(P=0.009)。③重度子痫前期组胎儿脐血中甘油三酯、总胆固醇、低密度脂蛋白水平、动脉硬化指数均高于正常对照组(P=0.000)。④重度子痫前期组胎儿脐血中胰岛素水平及胰岛素抵抗指数明显高于正常对照组(P=0.022,P=0.009)。胎儿脐血中LPL浓度与胰岛素水平及胰岛素抵抗指数呈负相关(r=-0.370,P=0.004;r=-0.389,P=0.002)。结论:重度子痫前期产妇胎盘、胎儿脐血中LPL存在明显的表达异常,LPL与子痫前期病理发病机制可能有相关性。重度子痫前期胎儿脐血中血脂明显异常,并存在胰岛素抵抗,LPL可能与子痫前期子代远期代谢综合征的高发风险有关。Objective：To explore the effect of lipoprotein lipase（LPL）on preeclampsia pathogenesis and potential influence to the fetus. Methods：30 patients with severe preeclampsia and 30 women with normal pregnancy who underwent cesarean section from Nov 2011 to June 2012 were enrolled in this work. The mR- NA of LPL in placenta was quantified by real-time RT-PCR. The concentration of LPL in fetal cord serum was measured with enzyme-linked immunosorbent assay; Lipids,glucose and insulin in fetal cord blood were de- tected using automatic biochemical analyzer and chemiluminescence method, respectively. Results：l^The expression of LPL mRNA in placenta in sever preeclampsia group was higher（ P =0. 010）than that in control group. ~LPL concentration in fetal cord serum was significantly decreased in sever preeclampsia group than that in control group（ P =0. 009）. ~The concentrations of TG, total cholesterol esters（ CHO）, low-density lip- oprotein（LDL） and AI in fetal cord blood were all lower（ P = 0. 000, respectively）in sever preeclampsia group than those in control group. ~ Insulin concentration （ P = 0. 022 ） and insulin resistance （ HOMA-IR ） （ P = 0. 009）in fetal cord blood were bothsignificantly higher in severe preeclampsia group. LPL concentrations in fetal cord serum was negatively correlated with insulin concentration（ r = -0. 370, P = 0. 004）and insulin resistance（ r= -0. 389, P =0. 002）in fetal cord blood. Conclusions= LPL may play an important role in the pathogenesis of preeclampsia and has long-term effects to fetus. Elevated lipids and insulin resistance are found in fetal cord blood with severe preeclampsia and these babies have a high incidence of metabolic syn- drome risk later.

关 键 词：重度子痫前期 脂蛋白酯酶 胎盘 脐血 代谢综合征 

分 类 号：R711.244[医药卫生—妇产科学]