小剂量阿司匹林对子痫前期高危孕妇预防作用的分子机制  

Molecular Mechanism of Low Dose Aspirin on Preventive Effects in High-Risk Preeclampsia Pregnant Women

作　　者：孙红霞[1] 蔡娱飞[2] 马哲[2] 袁捷[2] 张立梅 杨贺 马奎丽[2] 沈营营 SUN Hongxia;CAI Yufei;MA Zhe;YUAN Jie;ZHANG Limei;YANG He;MA Kuili;SHEN Yingying(School of Pharmacy,Beihua University,Jilin 132013,China;Affiliated Hospital of Beihua University,Jilin 132011,China)

机构地区：[1]北华大学药学院,吉林吉林132013 [2]北华大学附属医院,吉林吉林132011

出　　处：《北华大学学报（自然科学版）》2020年第4期493-497,共5页Journal of Beihua University（Natural Science）

基　　金：吉林省教育厅科学技术研究项目(JJKH20190659KJ).

摘　　要：目的观察小剂量阿司匹林(low dose aspirin,LDA)对有子痫前期(preeclampsia,PE)高危因素孕妇的预防作用及可能的作用机制.方法选择孕周16~22周且有PE高危因素的孕妇112例,采用随机数字表法分为研究组(Research,R)54例和对照组(Control,C)58例,对照组给予安慰剂,研究组给予LDA治疗,75 mg/d,睡前服药,直至分娩.观察两组PE发生率、发病孕周、分娩孕周和胎儿出生体质量、分娩方式、围生儿结局;比色法检测两组血液中超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)活性和丙二醛(MDA)水平,酶联免疫(ELISA)法检测两组血液中氧化低密度脂蛋白(ox-LDL)的表达和活性氧(ROS)水平;免疫印迹(WB)法检测两组胎盘组织中硫氧还蛋白还原酶(TRX)、核蛋白因子-κB(NF-κB)、血栓素A-2(TXA-2)表达水平.结果研究组PE发生率(22.2%)显著低于对照组(62.1%),研究组早产发生率(14.8%)显著低于对照组(50.0%),两组比较差异均具有统计学意义(P<0.05).研究组与对照组比较,分娩孕周延长,新生儿出生体质量增加,早产率减少,足月产率增加,围生儿结局得到改善,差异具有统计学意义(P<0.05);LDA能明显降低血液中MDA和ROS含量,降低ox-LDL表达,提高SOD和GSH-Px活性,提高胎盘组织中TRX的水平,降低NF-κB和TXA-2的表达水平,与对照组比较差异显著(P<0.01或P<0.001).结论LDA可有效预防高危孕妇发生PE,可能与其具有调节TRX-NF/κB-TXA-2通路、提高机体抗氧化能力、减轻氧化应激损伤、抑制炎症反应作用有关.Objective To observe the effect of low dose aspirin(LDA)on preventive effects in high-risk preeclampsia of pregnant women and its possible mechanism.Method PE pregnancy risk factors of 112 pregnant women with 16~22 weeks were randomly divided into research group(Research,R)for 54 patients and control group(Control,C)for 58 cases,the control group was given placebo treatment,the research group was treated with LDA,75 mg/d,medication before sleep until delivery.PE incidence,gestational week for PE onset,gestational age,birth weight,mode of delivery and perinatal outcome in two groups were observed;Colorimetric detection of SOD,glutathione peroxidase(GSH-Px)activity and MDA level in serum,ELISA method for detection of oxidation low density lipoprotein(ox-LDL)and reactive oxygen species(ROS)level in serum;Expression level in placenta tissue of thioredoxin reductase(TRX),nuclear factor kappa B(NF-κB)and cyclooxygenase(COX-2)were detected by western blot.Results The incidence of PE in research group(22.2%)was significantly lower than the control group(62.1%),incidence of preterm birth(14.8%)in the research group was significantly lower than the control group(50%),with significant differences between the two groups(P<0.05).Compared with the control group,the gestational ages last longer,neonatal birth weight increased,preterm birth rate decreased,the term yield increased,perinatal outcomes improved in the research group,the difference was statistically significant(P<0.05);LDA can significantly reduce serum level of MDA and ROS and the expression of ox-LDL,enhance SOD and GSH-Px activity,increase the expression of TRX,reduced the expression of NF-κB and TXA-2 in placental tissue.There were significant difference comparing with control group(P<0.01 or P<0.001).Conclusion LDA can effectively prevent the occurrence of PE in high-risk pregnant women,which is possibly related to regulation of TRX-NF/κB-TXA-2 signalling pathways,improving the capability of antioxidation,alleviating oxidative stress injury,blocking inflammat

关 键 词：小剂量阿司匹林 子痫前期 高危孕妇 分子机制 

分 类 号：R714[医药卫生—妇产科学]