妊娠期慢性静脉疾病增加胎盘绒毛血管和淋巴管生成及绒毛细胞凋亡  

Chronic venous disease increases placental villous angiogenesis and lymphangiogenesis and villous cell apoptosis

作　　者：吴海艳 WU Haiyan(Department of Obstetrics,Northwest Women’s and Children’s Hospital,Xi’an 710003,China)

机构地区：[1]西北妇女儿童医院产一科,陕西西安710003

出　　处：《细胞与分子免疫学杂志》2021年第6期538-545,共8页Chinese Journal of Cellular and Molecular Immunology

摘　　要：目的探究妊娠期慢性静脉疾病(CVD)中胎盘绒毛血管和淋巴管等相关关键因子的变化.方法根据临床-病因学-解剖学-病理生理学(CEAP)分类标准收集CVD患者的组织样本,并分为对照组和CVD组.实时定量PCR检测胎盘组织的CD31、D2-40、fms相关酪氨酸激酶1(FLT-1)、胎盘生长因子(PlGF)和低氧诱导因子1α(HIF-1α)的mRNA表达水平;免疫组织化学染色检测胎盘绒毛血管和淋巴管组织CD31、D2-40、FLT-1、PlGF、HIF-1α、B细胞淋巴瘤相关因子2(Bcl2)、Bcl2相关X蛋白(BAX)、胱天蛋白酶3(caspase-3)和caspase-9的蛋白表达水平;通过光学显微镜和透射电子显微镜观察胎盘绒毛组织中平均合体滋养层细胞结的数量变化;通过高碘酸希夫(PAS)染色检测胎盘绒毛中PAS阳性物质.结果与对照组相比,CVD组胎盘平均绒毛数量、平均合体滋养层细胞结数量、平均合体滋养层细胞结/绒毛数量和合体滋养层细胞绒毛间连接桥显著提高,而平均纤维蛋白样坏死数量无显著变化.与对照组相比,CVD组CD31、D2-40、FLT-1、PlGF、HIF-1α的mRNA表达水平显著提高,BAX、caspase-3和caspase-9阳性的绒毛细胞百分比显著增加,而Bcl2阳性的绒毛细胞无明显变化.与对照组相比,CVD组CD31、D2-40、FLT-1和PlGF阳性的血管数量显著增加,合体滋养层细胞、细胞滋养层细胞和胎儿毛细血管绒毛中的HIF-1α表达水平显著提高,CVD组绒毛中带有PAS阳性物质的胎盘所占百分比显著提高.结论CVD患者胎盘绒毛中血管和淋巴管生成增加,绒毛细胞凋亡增加;同时CVD患者的胎盘绒毛功能受损,并阻碍母婴气体交换.Objective To investigate the changes of key factors such as placental villi and lymph vessels in chronic venous disease(CVD) during pregnancy. Methods According to the CEAP classification criteria, tissues of CVD patients were collected, and was divided into control group and CVD group. Real-time quantitative PCR was used to detect mRNA level of CD31, D2-4, fms-related tyrosine kinase 1(FLT-1), placental growth factor(PlGF) and hypoxia-inducible factor-1(HIF-1α) in placental tissues. Immohistochemical staining was performed to measure the expression level of CD31, D2-40, FLT-1, PlGF, HIF-1α, B-cell lymphoma 2(Bcl2), Bcl2-related X protein(BAX), caspase 3 and caspase-9. The change in average number of syncytiotrophoblast cell nodes in placental villi was observed by optical microscope and transmission electron microscope. Periodic acid Schiff(PAS) staining was used to detect the PAS-positive substances in placental villi. Results Compared with the control group, the average numbers of placenta villi, syncytiotrophoblast cell nodes, syncytiotrophoblast cell nodes/villi and the connection bridges between villi of the average syncytrotrophoblast cells increased significantly in the CVD group, while the average number of fibrinoid necrosis showed no significant changes. The mRNA levels of CD31, D2-40, FLT-1, PlGF, and HIF-1α in the CVD group also increased significantly, and the proportion of villi cells positive of BAX, caspase-3 and caspase-9 rose significantly, while that of villi cells positive positive of Bcl2 showedno obvious change. CVD group also reported a marked increase in the number of blood vessels positive of CD31, D2-40, FLT-1 and PlGF. The expression level of HIF-1α in syncytiotrophoblast cells, cytotrophoblast cells and fetal capillary villi increased significantly in the CVD group. The percentage of placenta with PAS positive substances observed an increase in the villi, in comparison to the control group. Conclusion The production of blood vessels and lymph vessels increased in the placental vil

关 键 词：妊娠期慢性静脉疾病(CVD) 血管生成因子 促凋亡因子 免疫组织化学染色 

分 类 号：R543.6[医药卫生—心血管疾病] R392-33[医药卫生—内科学]