胎盘组织中牙周细菌对子痫前期孕妇妊娠结局的影响  

Effects of placental periodontal pathogens on preeclampsia outcomes

作　　者：吕莉娟[1] 叶宁[2] 李心悦[2] 牛建民[1] 温济英[1] 林小红[1] 武丽[3] 

机构地区：[1]广东省妇幼保健院妇产科,广州511400 [2]广东省妇幼保健院口腔科,广州511400 [3]广东省妇幼保健院保健部,广州511400

出　　处：《中华妇幼临床医学杂志（电子版）》2015年第2期64-70,共7页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：广东省医学科研基金(B2014025)~~

摘　　要：目的探讨子痫前期(PE)合并牙周炎患者血清C反应蛋白(CRP)水平、胎盘组织中牙龈卟啉单胞菌(Pg)、伴放线放线杆菌(An)、具核梭杆菌(Fn)、直肠弯曲菌(Cr)4种牙周细菌的表达及胎盘组织中一氧化氮(NO)含量变化的意义。方法选择2012年1月至2013年10月于广东省妇幼保健院诊断为PE并住院分娩的25例孕妇为研究对象,并纳入PE组。此外,随机选择同期于本院建卡、定期接受产前检查并住院分娩的健康孕妇27例纳入对照组。按照是否合并牙周炎,进一步将PE组和对照组分别分为PE合并牙周炎亚组(PE-A亚组,n=16)、PE未合并牙周炎亚组(PE-B亚组,n=9)与正常妊娠合并牙周炎亚组(对照-A亚组,n=10)、正常妊娠未合并牙周炎亚组(对照-B亚组,n=17)。4组受试者的年龄构成比、体质量、孕前体质指数(BMI)等一般临床病历资料比较,差异无统计学意义(P>0.05)。本研究遵循的程序符合广东省妇幼保健院人体试验委员会制定的伦理学标准,得到该委员会批准,分组征得受试对象的知情同意,并与之签署临床研究知情同意书。分别使用免疫透射比浊法、PCR、Western blotting、Griess法对孕妇血清CRP水平、胎盘组织中牙周细菌DNA、内皮细胞型一氧化氮合成酶(eNOS)表达水平及胎盘组织中NO含量进行检测,分析组间表达水平的差异。结果 1PE组和对照组孕妇的牙周炎患病率、PD、CAL和BOP比较,差异均无统计学意义(P>0.05)。2PE-A亚组孕妇的平均收缩压(MSBP)、平均舒张压(MDBP)、早产率和胎儿宫内受限发生率显著高于对照-A亚组和对照-B亚组,并且差异均有统计学意义(MSBP:P<0.05;MDBP:P<0.05;早产率:P<0.05;胎儿宫内受限发生率:P<0.05)。3PE-B亚组孕妇的MSBP、MDBP、早产率和胎儿宫内受限发生率亦显著高于对照-A亚组和对照-B亚组,并且差异均有统计学意义(MSBP:P<0.05;MDBP:P<0.05;早产率:P<0.05;胎儿宫内受限发生率:P<0.05)。4PE-A亚组胎儿窘�Objective To investigate the expressions of serum C reactive protein （CRP）, four common periodontal pathogens, porph yromonas gingivalis （ Pg ） , actinobacillus actinorn ycetemcomitans （An）, fusobacterium nucleatum （Fn）, campylobacter rectus （Cr） and the alteration of NO formation in the placenta tissue of preeclampsia （PE） combined with periodontitis. Methods A total of 25 pregnant women who visited Guangdong Women and Children Hospital from January 2012 to October 2013 were included in this study （PE group）. Meanwhile, another 27 healthy pregnant women were collected into control group. PE group and control group were both further divided into two sub-groups respectivley, PE group combined with periodontitis （PE-A sub-group, n= 16）, PE sub-group combined with no periodontitis （PE-B sub- group, n = 9）, control group combined with periodontitis （control-A sub-group, n = 17）, and control group combined with no periodontitis （control-B sub-group, n= 10）. There were no significant differences on age ratio, body weight, and body mass index （BMI） among four groups （P〉0.05）. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Guangdong Women and Children Hospital. Informed consent was obtained from the parent of each participates. CRP was tested by immunological transmission turbidimetry. Four periodontal pathogens in the placenta tissues were tested by PCR. The levels of endothelial nitric oxide synthase （eNOS） and nitric oxide （NO） in placenta tissues were tested by Western blotting and Griess assay, respectively. Results ①There were no significant differences on the incidence rate of periodontitis, PD, CAL and BOP between PE group and control group （P〉0.05）. ②There were significant differences on MSBP, MDBP, incidence rate of premature labor, and IUGR between PE-A sub-group and control-A sub-group, PE-A sub-group and control-B sub-group （MSBP：P〈 0.05;MDBP： P〈0. 05;incidence of premature delive

关 键 词：先兆子痫 牙周炎 C反应蛋白质 一氧化氮合酶 

分 类 号：R714.244[医药卫生—妇产科学]