不对称性二甲基精氨酸在胎儿生长受限患者胎盘、外周血的表达及其意义  

Expression and significance of asymmetric dimethylarginine in fetal growth restriction

作　　者：陈秋玲[1] 曾候霖[1] 蔡敏[1] 姚兰[1] 杨晓红 李成敏[2] 

机构地区：[1]长沙市妇幼保健院妇产科,长沙410007 [2]中南大学湘雅医院 [3]贵州省铜仁市妇幼保健院

出　　处：《中国医师杂志》2015年第12期1813-1815,1819,共4页Journal of Chinese Physician

基　　金：中国疾病预防控制中心妇幼保健中心西部地区妇幼卫生能力提升项目（2015FYQ001）

摘　　要：目的通过检测胎儿生长受限（FGR）患者胎盘及血清中不对称性二甲基精氨酸（AD—MA）及一氧化氮（NO）水平的表达，探讨ADMA在FGR中的作用及可能机制。方法选择50例FGR患者为FGR组，正常晚期妊娠分娩孕妇50例为正常对照组，以酶联免疫吸附法（ELISA）检测两组孕妇胎盘、血清ADMA水平；用硝酸还原法检测孕妇血清一氧化氮（NO）浓度，并对胎盘组织切片进行病理形态学分析。结果FGR组胎盘光镜下见不同程度的绒毛发育不良，合体结节增多，终末绒毛缺乏，其发生率明显高于正常对照组[64．0％（32／50）VS12．0％（6／50），x^2=7．90，P〈0．01]；胎盘病理异常组中胎盘及血清中的ADMA浓度显著高于胎盘正常组[胎盘ADMA：（2．21±0．72）μmol／LVS（1．69±0．77）μmol／L，t=3．33，P〈0．01；血清ADMA：（2．01±0．70）μmol／LV8（1．18±0．54）μmol／L，t=6．66，P〈0．01]；FGR组胎盘组织匀浆液及血清中ADMA浓度均显著高于正常对照组[胎盘ADMA（2．24±0．81）μmol／LVS（1．53±0．59）μmol／L，t=5．00，P〈0．01；血清ADMA（1．89±0．75）μmol／LVS（1．10±0．43）μmol／L，t=6．45，P〈0．01]；而NO血清浓度明显低于正常对照组[（39．59±9．15）μmol／LVS（58．02±15．45）μmol／L，t=-7．26，P〈0．01]。FGR组血清ADMA水平与NO水平呈负相关（r=-0．693，P〈0．01）。结论ADMA参与了FGR的发生，其作用机制可能通过抑制NO合成，导致胎盘供血供氧不足。Objective To investigate the serum and placental expressions of asymmetric dimethylarginine （ADMA） and nitric oxide（NO） in fetal growth restriction （FGR）, and explore the biological role and mechanisms of ADMA in FGR. Methods Fifty patients with FGR （ FGR group） and 50 normal term pregnant women （ control group） were detected for the levels of ADMA in maternal sera and placentas with enzyme linked immunosorbent assay （ELISA）. The level of NO in maternal sera was analyzed with nitrate reductase method, and the placental tissue sections were analyzed with pathological morphologly. Results For FGR group, the main pathological changes were growth retardation of villi, increased syncytiotrophoblast nodules, and the lack terminal villi; and the incidence rate of pathological change of placental tissue was significantly higher than that in control group [64. 0% （32/50） vs 12. 0% （6/50）, x^2 = 7.90, P 〈 0. 01 ]. For the placental pathological change group, the concentrations of ADMA in the placentas and sera were significantly higher than the normal group [ placenta ADMA： （2. 21 ± 0. 72） μmol/L vs （ 1.69 ±0. 77 ） p, mol/L, t = 3.33, P 〈 0. 01 ; serum ADMA ： （2. 01±0.70） p, mol/L vs （ 1.18 ±0. 54） μmo]/L, t = 6. 66, P 〈 0. 01 ]. The expression of ADMA was up - regulated in maternal sera and placentas from FGR group compared to normal pregnancy [ placenta ADMA （ 2. 24±0. 81 ） p, mol/L vs （ 1.53 ± 0. 59） μ mol/L,t =5.00, P 〈0.01; serum ADMA （1.89±0.75） μmol/Lvs （1.10±0.43） μmol/L, t =6.45, P 〈 0. 011- The NO was extremely lower expressed in maternal sera with FGR than normal pregnancy [ （39. 59 - 9. 15 ） μmol/L vs （ 58.02 ± 15.45 ） μmol/L t = - 7.26, P 〈 0. 01 ） ]. For FGR group, a significant negative correlation was observed between ADMA and NO expressions in sera （ r = - 0. 693, P 〈 0.01 ）. Conclusions ADMA was associated with the occurrence and development of the FGR, and its mechanism maybe inhibits NO synth

关 键 词：精氨酸/代谢 胎儿生长迟缓/代谢 一氧化氮/代谢 

分 类 号：R714.5[医药卫生—妇产科学]