早期妊娠丢失患者全身性和母-胎界面的氧化应激水平研究  

Levels of systemic and maternal-fetal interface oxidative stress in women with early pregnancy loss

作　　者：弓弦 王建梅[1] 孙丽[1] 黎小佩 张钰娟[1] Gong Xian;Wang Jianmei;Sun Li;Li Xiaopei;Zhang Yujuan(Department of Family Planning,the Second Hospital of Tianjin Medical University,Tianjin 300211,China)

机构地区：[1]天津医科大学第二医院计划生育科,300211

出　　处：《中华生殖与避孕杂志》2021年第7期631-637,共7页Chinese Journal of Reproduction and Contraception

基　　金：国家自然科学基金(81903276);天津医科大学第二医院中心实验室青年科研基金(2017YDEY02)。

摘　　要：目的了解早期妊娠妇女全身性与母-胎界面局部氧化应激状态的相关性及各氧化应激指标的影响因素,探究早期妊娠丢失(early pregnancy loss,EPL)与脂质过氧化及总抗氧化能力(total antioxidant capacity,T-AOC)生物标志物之间的关联。方法采用病例对照研究,于2017年12月至2018年7月期间在天津医科大学第二医院计划生育科招募EPL病例组和正常早期妊娠人工流产对照组为研究对象(每组各103例),检测两组患者血清及妊娠绒毛组织的丙二醛(malondialdehyde,MDA)和T-AOC水平(血清检测每组各103例,绒毛组织检测每组各60例)。分析各标志物的影响因素及其在血清和绒毛组织中含量的相关性,比较两组间各标志物水平的差异。结果病例组绒毛MDA、T-AOC及对照组绒毛MDA、T-AOC均与其血清标志物含量呈正相关,相关系数分别为r=0.744,P<0.001;r=0.312,P=0.015;r=0.712,P<0.001;r=0.650,P<0.001。除病例组绒毛MDA外,两组血清和对照组绒毛MDA及T-AOC均随妊娠时间的增加而升高。病例组的妊娠时间每增加1周,血清MDA增加8.3%(P=0.005),血清T-AOC增加4.2%(P=0.002),绒毛T-AOC增加2.6%(P=0.010),差异均有统计学意义;对照组的妊娠时间每增加1周,血清MDA增加11.3%(P=0.004),血清T-AOC增加5.4%(P=0.007),绒毛MDA增加18.7%(P=0.017),绒毛T-AOC增加8.4%(P=0.009)。调整妊娠时间后,病例组血清T-AOC比对照组低13.4%(P<0.001),绒毛T-AOC比对照组低33.7%(P<0.001),绒毛MDA比对照组高30.1%(P=0.012),两组血清MDA的差异无统计学意义。结论早期妊娠妇女全身性氧化应激状态与母-胎界面同步,妊娠时间是影响血清和绒毛组织氧化应激水平的重要因素,EPL与孕妇全身性和母-胎界面抗氧化能力降低以及母-胎界面脂质过氧化损伤有关。Objective To understand the correlation between systemic and local(at the maternal-fetal interface)oxidative stress in women with early pregnancy and the influencing factors of indicators,and to explore the associations between early pregnancy loss(EPL)and biomarkers of lipid peroxidation and total antioxidant capacity(T-AOC).Methods A case-control study was performed.From December 2017 to July 2018,cases of EPL and controls of normal early pregnant women requesting induced abortions due to unintended pregnancies were recruited in the Family Planning Department of the Second Hospital of Tianjin Medical University.The levels of malondialdehyde(MDA)and T-AOC in serum of 103 participants and chorionic villous tissue of 60 participants in each group were measured.The influencing factors and the correlations between the levels of each biomarker in serum and villous were analyzed.The differences in the levels of each biomarker between the two groups were compared.Results The levels of MDA and T-AOC in villi of case group and control group were both positively correlated with their serum markers,their correlation coefficients were r=0.744,P<0.001;r=0.312,P=0.015;r=0.712,P<0.001;r=0.650,P<0.001,respectively.Except for villus MDA in case group,serum and villus MDA and T-AOC increased with the increasing of gestational days in both groups.For each additional week of gestation in case group,serum MDA increased by 8.3%(P=0.005),serum T-AOC increased by 4.2%(P=0.002),villus T-AOC increased by 2.6%(P=0.010),all of which were statistically significant;in control group,the serum MDA,serum T-AOC,villus MDA and villus T-AOC increased by 11.3%(P=0.004),5.4%(P=0.007),18.7%(P=0.017)and 8.4%(P=0.009)respectively for each additional week of gestation.After adjusting the gestational days,the serum T-AOC of the case group was 13.4%lower than that of control group(P<0.001),the villus T-AOC was 33.7%lower than that of control group(P<0.001),while the villus MDA was 30.1%higher than that of control group(P=0.012).The serum MDA of the two gr

关 键 词：流产 稽留 流产 自然 氧化性应激 血清 绒毛膜绒毛 脂质过氧化 抗氧化能力 

分 类 号：R714.2[医药卫生—妇产科学]