不同临床发病特征子痫前期孕妇胎盘组织中LCHAD表达与氧化应激、炎性反应及血清游离脂肪酸和甘油三酯水平的相关性  

The changes of LCHAD in preeclampsia with different clinical features and the correlation with NADPH P47-phox, p38MAPK- α, COX-2 and serum FFA and TG

作　　者：李凤秋[1,2] 杨孜[1] 张爱青[3] 孙晓乐[1] 王伽略[1] 孟然[1] 

机构地区：[1]北京大学第三医院妇产科,100191 [2]北京市海淀区妇幼保健院产科,100080 [3]北京市海淀区妇幼保健院影像科

出　　处：《中华妇产科杂志》2015年第2期92-100,共9页Chinese Journal of Obstetrics and Gynecology

基　　金：国家自然科学基金（81370723）;北京市自然科学基金（7132215）

摘　　要：目的探讨不同临床发病特征的子痫前期孕妇胎盘组织中长链脂肪酸氧化酶表达与氧化应激、炎性反应及其与血清游离脂肪酸（FFA）、甘油三酯（TG）水平的相关性。方法采用前瞻性队列研究方法，选择2012年1月1日至5月31日在北京市海淀区妇幼保健院行产前检查的单胎孕妇，于孕22～24周行B超检查，发现有子宫动脉舒张早期切迹（简称切迹）的101例孕妇纳入有切迹组，无切迹的377例孕妇为无切迹组，随访两组孕妇的妊娠结局及妊娠期高血压疾病发病情况。检测两组孕早中期血清FFA、TG水平，采用实时荧光定量PCR技术和蛋白印迹法检测长链三羟基酰基辅酶A脱氢酶（LCHAD）、烟酰胺腺嘌呤二核苷酸磷酸氧化酶P47-phox亚基（NADPH P47-phox）、p38丝裂原活化蛋白激酶α（p38MAPK-α）和环氧合酶2（COX-2） mRNA和蛋白的表达；分析孕妇血清FFA、TG水平与胎盘组织中LCHAD、NADPH P47-phox、p38MAPK-α和COX-2 mRNA 和蛋白表达的相关性。结果（1）有切迹组发生早发型子痫前期9例，晚发型子痫前期15例，妊娠期高血压10例；无切迹组发生晚发型子痫前期8例，妊娠期高血压18例。随机选取两组孕妇中血压正常者各15例共计30例为对照组。（2）有切迹组早发型子痫前期、晚发型子痫前期及妊娠期高血压孕妇TG水平分别为（2.0±0.8）、（1.8±0.6）及（1.9±0.7）mmol/L，FFA水平分别为（0.68±0.26）、（0.52±0.10）及（0.52±0.17）mmol/L；无切迹组晚发型子痫前期及妊娠期高血压孕妇TG水平分别为（1.6±0.6）及（1.4±0.4）mmol/L，FFA水平分别为（0.49±0.11）及（0.48±0.05）mmol/L；对照组TG及FFA水平分别为（1.4±0.5）及（0.52±0.06）mmol/L；有切迹组孕妇TG水平均显著高于对照组（P〈0.05）；有切迹组早发型子痫前期孕妇FFA水平显著高于有切迹组晚发型子痫前期、无切迹组晚发型子痫前期及对照组（P〈0.05Objective To investigate the changes of fatty acid oxidase in the placenta of preeclampsia cases with different clinical features, and the relationship with oxidative stress and inflammatory response. To study the correlation of serum free fatty acid （FFA） and triglycerides （TG） level in early second trimester with the molecular changes of the long-chain fatty acid oxidase in the third trimester. Methods This was prospective cohort study, in which cases with singleton pregnancies who archived in Haidian Maternal and Children′s Hospital, Beijing, from January 1st 2012 to May 31st, with regular prenatal care were included. Doppler ultrasound was used for screening for the presence of early diastolic notch of uterine artery at 22-24 weeks of gestation. All the 101 cases with the early diastolic notch of uterine artery were included as the notch group, and 377 cases without the early diastolic notch of uterine artery were included as the non-notch group. The perinatal outcomes and the incidence of hypertensive disorders in pregnancy of the two groups were observed. The serum level of FFA and TG was tested, and the mRNA and protein expression of long-chain 3-hydroxyacyl-CoA dehydrogenase （LCHAD）, P47-phox subunit of nicotinamide adenine dinucleotide phosphate （NADPH） oxidase, p38 mitogen-activated protein kinase α （p38MAPK-α） and cyclooxygenase-2 （COX-2） were detected using real-time quantitative PCR and western blot. The relationship between serum level of FFA and TG and the mRNA and protein expression of LCHAD, NADPH P47-phox,p38MAPK-α and COX-2 of the placental tissue specimens were analyzed. Results （1） In the notch group, there were 9 cases of early-onset preeclampsia,15 cases of late-onset preeclampsia and 10 cases of gestational hypertension;and there were 8 cases of late-onset preeclampsia and 18 cases of gestational hypertension in the non-notch group. 15 cases with normal blood pressure in each group were randomly selected as the control group.（2）The serum level of TG of

关 键 词：先兆子痫 3-羟酰CoA脱氢酶类 NADPH氧化酶 脂肪酸类 非酯化 甘油三 酯类 氧化性应激 

分 类 号：R714.244[医药卫生—妇产科学]