细胞焦亡在胎盘早剥患者外周血和胎盘组织中的表达及临床意义  

The expression and clinical significance of pyroptosis in peripheral blood and placental tissues of patients with placental abruption

作　　者：唐雨帆 宋鹏书 李英 龙俊青[1] TANG Yufan;SONG Pengshu;LI Ying;LONG Junqing(Department of Obstetrics,Xinyang Hospital,Maternity and Child Health Care of Guangxi Zhuang Autonomous Region,Nanning,Guangxi 530005,China)

机构地区：[1]广西壮族自治区妇幼保健院新阳院区产二科,南宁530005

出　　处：《重庆医学》2023年第19期2947-2952,共6页Chongqing medicine

基　　金：广西卫生健康委员会自筹经费科研课题(Z-A20220253)。

摘　　要：目的探讨妊娠期胎盘早剥孕妇外周血炎症因子及胎盘组织细胞焦亡因子的表达情况及其临床意义。方法选取2021年7月至2023年3月在该院产科诊断为胎盘早剥的孕妇40例作为胎盘早剥组,另选取同期健康孕妇40例作为对照组,收集两组孕妇的临床资料和妊娠期并发症发生情况。采集孕妇分娩前外周血标本,ELISA检测肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1β及IL-18表达水平;剪取胎盘组织,通过透射电镜观察是否有细胞焦亡现象发生;苏木素-伊红(HE)染色观察胎盘早剥孕妇的胎盘组织病理学特点;Western blot和实时荧光定量逆转录PCR(RT-qPCR)检测caspase-1、Gasdermin D(GSDMD)和NOD样受体蛋白3(NLRP3)及其mRNA在两组孕妇胎盘组织中的表达差异。结果胎盘早剥组腹痛、出血、胎膜早破、子痫前期发生率均明显高于对照组(P<0.05)。胎盘早剥组外周血清炎症因子TNF-α[(36.50±7.25)pg/mL vs.(15.32±6.33)pg/mL]、IL-1β[(53.10±10.27)pg/mL vs.(24.46±6.52)pg/mL]和IL-18[(23.64±6.82)pg/mL vs.(12.66±2.75)pg/mL]表达水平均高于对照组,差异有统计学意义(P<0.05)。在透射电镜观察下发现,胎盘早剥孕妇胎盘组织中有焦亡小体存在;HE染色结果显示,胎盘早剥孕妇的胎盘组织内部血管堵塞和溶解。胎盘早剥组的胎盘组织中细胞焦亡分子caspase-1、NLRP3及其mRNA(7.26±1.04 vs.3.64±1.57,22.04±6.63 vs.5.38±1.15)表达水平均高于对照组,GSDMD及其mRNA(7.83±1.32 vs.12.42±1.74)表达水平低于对照组,差异有统计学意义(P<0.05)。结论胎盘早剥孕妇的外周血清中炎症因子和胎盘组织中细胞焦亡分子的表达水平明显高于妊娠期健康孕妇。Objective To investigate the expression of inflammatory factors in peripheral blood of patients with placental abruption and the expression of pyroptosis in placental tissue and its clinical significance.Methods A total of 40 pregnant women diagnosed with placental abruption admitted to the Department of Obstetrics of this hospital from July 2021 to March 2023 were selected and included in the placental abruption group,and 40 healthy pregnant women of the same period were selected and included in the control group.Clinical data and pregnancy complications of the two groups were collected.Peripheral blood samples of the pregnant women were collected before delivery,and the expressions of tumor necrosis factor-α(TNF-α),interleukin(IL)-1βand IL-18 were detected by ELISA.The placental tissue was clipped and the pyrodeath was observed by electron microscopy.Hematoxylin-eosin(HE)staining was used to observe the placental histopathological characteristics of pregnant women with placental abruption.Western blot and real-time fluorescence quantitative PCR(RT-qPCR)were used to detect the expressions of caspase-1,Gasdermin D(GSDMD)and NOD-like receptor protein 3(NLRP3)and their mRNA in placental tissues of the two groups.Results The incidence of abdominal pain,bleeding,premature rupture of membranes and preeclampsia in the placental abruption group was significantly higher than that in the control group.The expression levels of serum inflammatory factors TNF-α[(36.50±7.25)pg/mL vs.(15.32±6.33)pg/mL],IL-1β[(53.10±10.27)pg/mL vs.(24.46±6.52)pg/mL]and IL-18[(23.64±6.82)pg/mL vs.(12.66±2.75)pg/mL]in the placental abruption group were higher than those in the control group,and the differences were statistically significant(P<0.05).The presence of pyrodead bodies in placental tissue of patients with placental abruption was observed by transmission electron microscopy.HE staining showed blockage and rupture of blood vessels in placental tissues of patients with placental abruption.The expressions of caspase-1 and NLRP3

关 键 词：胎盘早剥 妊娠期 细胞焦亡 炎症因子 病理特征 

分 类 号：R714.433[医药卫生—妇产科学]