前白蛋白在孕妇血清及胎盘组织的表达与妊娠期高血压疾病严重程度的关系  

Expression of prealbumin in maternal serum and placenta tissue of pregnant women and its relation with severity of hypertensive disorder complicating pregnancy

作　　者：金艳荣[1] 马红梅[1] 张震宇[2] 刘崇东[2] 罗玫 刘彤[3] Jin Yanrong;Ma Hongmei;Zhang Zhenyu;Liu Chongdong;Luo Mei;Liu Tong(Department of Obstetrics and Gynecology,Beijing Luhe Hospital, Capital MedicalUniversity, Beijing 101149, China;Departmentof Obstetrics and Gynecology, Beijing Chao-YangHospital, Capital Medical University, Beijing 100020, China;Department of Pathology, BeijingLuhe Hospital, Capital Medical University,Beijing 101149, China)

机构地区：[1]首都医科大学附属北京潞河医院妇产科,101149 [2]首都医科大学附属北京朝阳医院妇产科,100020 [3]首都医科大学附属北京潞河医院病理科,101149

出　　处：《中华妇幼临床医学杂志（电子版）》2019年第3期245-252,共8页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：国家科技部对外合作项目(2015DFR31070)~~

摘　　要：目的探讨在妊娠期高血压疾病、子痫前期(PE)、PE合并胎儿宫内生长受限(FGR)的孕妇血清及胎盘组织中,前白蛋白(PBA)表达及其临床意义。方法选择2014年1月至2016年1月,在首都医科大学附属北京潞河医院进行常规产前检查,并采取剖宫产术分娩的98例罹患不同程度妊娠期高血压疾病的单胎妊娠孕妇为研究对象。其中,被诊断为妊娠期高血压疾病者为31例、单纯PE者为33例、PE合并FGR者为34例,将其分别纳入妊娠期高血压疾病组、单纯PE组、PE合并FGR组。单纯PE组与PE合并FGR组的67例孕妇中,早发型PE为30例,晚发型PE为37例。选择同期于收集上述病例的同一家医院进行常规产前检查,并采取剖宫产术分娩的36例正常足月单胎妊娠孕妇作为研究对照,纳入对照组。分别采用酶联免疫吸附试验法与免疫组化法,对分娩前4组孕妇的血清及胎盘组织PBA表达进行检测。4组孕妇血清PBA比较,采用单因素方差分析,进一步两两比较,采用最小显著性差异(LSD)法。4组孕妇胎盘组织PBA表达呈阴性、弱阳性、中度阳性、较强阳性、强阳性率比较,采用Kruskal-WallisH秩和检验,进一步两两比较,采用Mann-WhitneyU检验,并采用Bonferroni法调整检验水准(α′=0.05/6=0.008)。本研究遵循的程序符合首都医科大学附属北京潞河医院人体试验委员会制定的标准,经过该伦理委员会批准(批准文号:2018LH-KS-025),并与所有受试者签署临床研究知情同意书。结果①4组孕妇年龄、孕次、产次、孕前人体质量指数(BMI)等一般临床资料比较,差异均无统计学意义(P>0.05)。②4组孕妇平均动脉压、24h尿蛋白定量、分娩孕龄、新生儿出生体重、血清PBA比较,差异均有统计学意义(F=233.773、222.081、113.597、214.420、90.147,P<0.001)。对4组孕妇血清PBA进一步进行两两比较的结果显示,妊娠期高血压疾病组、单纯PE组、PE合并FGR组孕妇血清PBA,均显著�Objective To investigate the expressions of prealbumin (PBA) in maternal serum and placenta tissue of pregnant women with hypertensive disorder complicating pregnancy, preeclampsia (PE) and PE with fetal growth restriction (FGR) and its clinical significance. Methods A total of 98 cases of singleton pregnancy women with different degrees of hypertensive disorder complicating pregnancy who had routine prenatal examination and delivered by cesarean section in Beijing Luhe Hospital, Capital Medical University from January 2014 to January 2016 were selected as research subjects. Among them, 31 pregnant women with hypertensive disorder complicating pregnancy, 33 cases with PE, and 34 cases with PE and FGR were divided into hypertensive disorder complicating pregnancy group, simple PE group and PE with FGR group, respectively. There were 30 cases of early-onset PE and 37 cases of late-onset PE among 67 pregnant women in simple PE group and PE with FGR group. Another 36 cases of normal full-term singleton pregnancy women who had routine prenatal examination and delivered by cesarean section in the same hospital during the same period were included into control group. Enzyme linked immunosorbent assay and immunohistochemical method were applied to detect the serum PBA levels and the expressions of PBA in placenta tissues of pregnant women before delivery. The serum PBA levels of 4 groups were compared by one-way ANOVA method, and further pairwise comparison was conducted by least-significant difference (LSD) method. Rates of negative, weakly positive, moderately positive, less strongly positive and strongly positive PBA expressions in placenta tissues of pregnant women in 4 groups were compared by Kruskal-Wallis H rank sum test, and Mann-Whitney U test was used for further pairwise comparison by adjusting size of test with Bonferroni method (α′=0.05/6=0.008). The procedures followed in this study were in accordance with the standards established by the Committee of Investigation in Human Beings Beijing Luhe Hospital,

关 键 词：高血压 妊娠性 子痫前期 胎儿生长迟缓 前白蛋白 孕妇 

分 类 号：R714.246[医药卫生—妇产科学]