妊娠期高血压和子痫前期患者HLA⁃Ⅰ类分子的表达及与妊娠结局的关系  

Significance of the expression of HLA⁃class I molecules in patients with gestational hypertension and preeclampsia and its relationship with pregnancy outcome

作　　者：陆玮 朱媛媛 仇菊[1] 吴小妹 丁丽云 LU Wei;ZHU Yuanyuan;QIU Ju;WU Xiaomei;DING Liyun(Obstetrics Department,Rugao People's Hospital,Rugao,Jiangsu,China,226599)

机构地区：[1]如皋市人民医院产科,江苏如皋226599

出　　处：《分子诊断与治疗杂志》2024年第11期2107-2111,共5页Journal of Molecular Diagnostics and Therapy

基　　金：江苏省南通市卫生和计划生育委员会科研课题(QB2020016)。

摘　　要：目的分析妊娠期高血压(PIH)和子痫前期患者人白细胞抗原Ⅰ类分子(HLA⁃Ⅰ)类分子的表达及其与妊娠结局的关系。方法选取2019年1月至2023年1月如皋市人民医院收诊的PIH患者100例,根据是否合并子痫分为PIH组(40例),子痫前期组(60例),另选择正常到院体检孕产妇37名为对照组,采用ELISA法检测三组人可溶性白细胞抗原⁃Ⅰ(sHLA⁃Ⅰ)类分子,并对胎盘组织行免疫组化处理,分析患者sHLA⁃Ⅰ类分子水平及阳性细胞率;对比PIH组、子痫早期组不良妊娠结局;并根据妊娠结局分组,采用单因素分析血压、sHLA⁃Ⅰ类分子对不良妊娠结局的影响,对有统计学意义的指标进行Logistic回归分析,观察sHLA⁃Ⅰ类分子与妊娠结局的关系。结果sHLA⁃Ⅰ水平、HLA⁃E、HLA⁃F、HLA⁃G水平及阳性细胞率:子痫早期组<PIH组<对照组,差异有统计学意义(P<0.05);PIH组不良结局率低于子痫前期组,差异有统计学意义(P<0.05);妊娠结局不良组sHLA⁃Ⅰ水平、HLA⁃E、HLA⁃F、HLA⁃G水平、收缩压、舒张压均显著低于妊娠结局正常组,差异均有统计学意义(P<0.05);Logistic多因素回归分析显示,舒张压、血清sHLA⁃Ⅰ水平是PIH患者妊娠结局不良的独立影响因素(P<0.05)。结论sHLA⁃Ⅰ类分子能准确预测PIH及子痫前期患者的妊娠结局,有利于患者尽早确诊和接受针对性治疗。Objective To analyze the expression of human leukocyte antigen class I molecules(HLA⁃I)class I molecules in patients with gestational hypertension(PIH)and preeclampsia and their relationship with pregnancy outcome.Methods 100 cases of PIH patients admitted to Rugao People's Hospital from January 2019 to January 2023 were selected.They were divided into two groups:the PIH group(40 cases)and the preeclampsia group(60 cases)based on whether they were combined with eclampsia.Additionally,37 normal pregnant women who came to the hospital for a physical examination were selected as the control group.Blood was taken from the umbilical cord vein and sHLA⁃I molecules were detected using the ELISA method.Immunohistochemistry was performed on placental tissues to analyze the levels of sHLA⁃I molecules and the rate of positive cells in the patients.The study aimed to compare adverse pregnancy outcomes in the PIH group and the early eclampsia group,analyze the effects of blood pressure and sHLA⁃I molecules on adverse pregnancy outcomes based on pregnancy outcome grouping,and conduct logistic regression analysis on statistically significant indexes to observe the relationship between the sHLA⁃I molecules and pregnancy out-comes.Results Results showed that sHLA⁃I levels,HLA⁃E,HLA⁃F,and HLA⁃G levels,as well as the proportion of positive cells,were in the following order:early eclampsia group<PIH group<control group,the differences were statistically significant(P<0.05).The rate of poor outcomes was lower in the PIH group compared to the pre⁃eclampsia group,and the difference was also statistically significant(P<0.05).Patients in the group with a poor pregnancy outcome exhibited lower sHLA⁃I levels,HLA⁃E,and HLA⁃G levels,as well as lower systolic and diastolic blood pressure,compared to those with a normal outcome.HLA⁃F,HLA⁃G levels,systolic blood pressure,and diastolic blood pressure were significantly lower in the group with a poor pregnancy outcome compared to those with a normal outcome,and these

关 键 词：HLA⁃Ⅰ 妊娠期高血压 子痫前期 母婴结局 

分 类 号：R714.246[医药卫生—妇产科学]