产妇子宫平滑肌组织AngⅡ、ACE2表达与宫缩乏力性产后出血的相关性  

Correlation between the expression of AngⅡand ACE2 in uterine smooth muscle tissue of parturients and postpartum hemorrhage caused by uterine asthenia

作　　者：李岩[1] 南燕燕 高瑞雪 刘晓华 Li Yan;Nan Yanyan;Gao Ruixue;Liu Xiaohua(the Second Department of Obstetrics,the Second People’s Hospital of Hengshui,Hengshui Hebei 053000,P.R.China)

机构地区：[1]衡水市第二人民医院产二科,河北衡水053000

出　　处：《中国计划生育和妇产科》2021年第12期62-65,82,共5页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的探讨剖宫产孕妇子宫平滑肌组织血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)、血管紧张素转换酶2(angiotensin-converting enzyme 2,ACE2)与宫缩乏力性产后出血的相关性。方法选取2017年1月至2019年12月在衡水市第二人民医院接受剖宫产手术并确诊为宫缩乏力性产后出血的产妇102例为观察组,另选取90例同期接受剖宫产手术且未出现产后出血的产妇作为对照组,检测并记录子宫平滑肌组织标本收缩幅度、频率及活动力;酶联免疫吸附(ELISA)法检测子宫平滑肌组织AngⅡ、ACE2的表达;Pearson法分析观察组子宫平滑肌组织AngⅡ、ACE2与收缩活动力及术中、术后24 h出血量相关性;多因素Logistic回归模型分析影响产妇发生宫缩乏力性产后出血的因素。结果与对照组相比,观察组收缩幅度、收缩频率、收缩活动力均较低(P<0.001);与对照组相比,观察组子宫平滑肌组织AngⅡ表达显著降低,ACE2表达显著升高,二者在观察组中呈负相关(P<0.001);观察组子宫平滑肌组织AngⅡ表达与收缩活动力呈正相关,ACE2表达呈负相关(P<0.001);与对照组相比,观察组术中、术后24 h出血量均较高(P<0.001);观察组子宫平滑肌组织AngⅡ与术中、术后24 h出血量呈负相关,ACE2呈正相关(P<0.001);AngⅡ高水平是影响产妇发生宫缩乏力性产后出血的保护因素,ACE2高水平是危险因素(P<0.001)。结论宫缩乏力性产后出血患者子宫平滑肌组织AngⅡ、ACE2表达与子宫平滑肌收缩活动力和产后出血有关,二者在子宫平滑肌收缩中的作用机制可能是宫缩乏力性产后出血的潜在研究方向。Objective To explore the relationship between angiotensinⅡ(AngⅡ),angiotensin-converting enzyme 2(ACE2)and postpartum hemorrhage caused by uterine inertia in uterine smooth muscle tissue of pregnant women with cesarean section.Methods From January 2017 to December 2019,102 women who underwent cesarean section and were diagnosed with postpartum hemorrhage at the Second People’s Hospital of Hengshui were selected as the observation group,and other 90 cases who underwent cesarean section at the same time were selected as the observation group.The parturients without postpartum hemorrhage were used as the control group to detect and record the contraction amplitude,frequency and activity of the uterine smooth muscle tissue specimens;Enzyme-linked immunosorbent assay(ELISA)method to detect the expression of AngⅡand ACE2 in the uterine smooth muscle tissue;Pearson method to analyze the correlation between AngⅡand ACE2 of smooth muscle tissue and contractile activity and intraoperative and postoperative 24-hour blood loss of the observation group;multivariate Logistic regression model analyzed the factors influencing the occurrence of postpartum hemorrhage due to uterine inertia.Results Compared with the control group,the observation group’s contraction amplitude,contraction frequency and contraction activity were lower(P<0.001);Compared with the control group,the uterine smooth muscle tissue AngⅡexpression in the observation group was significantly reduced,and the ACE2 expression was significantly increased.In the observation group,there was a negative correlation(P<0.001);The expression of AngⅡin uterine smooth muscle tissue of the observation group was positively correlated with contractile activity,and the expression of ACE2 was negatively correlated(P<0.001);The blood loss at 24 h after operation was relatively high(P<0.001);The uterine smooth muscle tissue AngⅡin the observation group was negatively correlated with intraoperative and postoperative 24 h blood loss,and ACE2 was positively correlated

关 键 词：剖宫产 血管紧张素Ⅱ 血管紧张素转换酶2 宫缩乏力性产后出血 

分 类 号：R714.461[医药卫生—妇产科学]