维生素D联合硫酸镁与胰激肽释放酶对重症子痫前期患者胎盘滋养细胞自噬和母婴结局的影响  

Effects of vitamin D combined with magnesium sulfate and pancreatic kininogenase on autophagy of placental trophoblastic cells and maternal and infant outcomes in patients with severe preeclampsia

作　　者：朱佳栋 王星霞 ZHU Jia-dong;WANG Xing-xia(Department of Critical Care Medicine of the 93rd Hospital of the Joint Service Support Force of the Chinese People's Liberation Army,Hangzhou,Zhejiang 310000,China;不详)

机构地区：[1]中国人民解放军联勤保障部队第九○三医院重症医学科,浙江杭州310000 [2]中国人民解放军联勤保障部队第九○三医院肾内科,浙江杭州310000

出　　处：《中国妇幼保健》2025年第7期1165-1169,共5页Maternal and Child Health Care of China

基　　金：浙江省医药卫生科技计划项目(2024KY1426)。

摘　　要：目的 探讨维生素D联合硫酸镁与胰激肽释放酶对重症子痫前期(SPE)患者胎盘滋养细胞自噬和母婴结局的影响。方法 选取2022年1月—2024年1月中国人民解放军联勤保障部队第九〇三医院收治的SPE患者60例,采用随机数字表法分为两组,每组30例。对照组给予硫酸镁联合胰激肽释放酶治疗,观察组同时辅以维生素D治疗。比较两组疗效、血压、24 h尿蛋白水平、血清25-羟维生素D[25-(OH)D]水平、胎盘组织滋养细胞自噬相关蛋白微管相关蛋白1轻链3Ⅱ/Ⅰ(LC3Ⅱ/Ⅰ)比值、苄氯素-1(Beclin-1)、自噬相关基因7(ATG7)、核孔蛋白62(p62)相对表达量、不良反应及母婴结局。结果 观察组总有效率(96.67%)高于对照组(73.33%),差异有统计学意义(P<0.05)。治疗后,两组血压、24 h尿蛋白水平均降低,且观察组收缩压(SBP)为(123.40±9.72)mm Hg、舒张压(DBP)为(87.57±8.26)mm Hg、平均动脉压(MAP)为(102.41±10.49)mm Hg、24 h尿蛋白为(1.00±0.10)g,均分别低于对照组的(140.64±12.83)mm Hg、(96.60±8.42)mm Hg、(118.95±11.76)mm Hg、(2.19±0.23)g,差异均有统计学意义(均P<0.05)。治疗后,观察组血清25-(OH)D水平为(52.94±5.38)ng/ml,高于对照组的(25.07±2.56)ng/ml,差异有统计学意义(P<0.05)。治疗后,观察组胎盘组织滋养细胞自噬相关蛋白LC3Ⅱ/Ⅰ比值为(0.94±0.09)、Beclin-1相对表达量为(0.87±0.08)、ATG7相对表达量为(0.80±0.08),均分别高于对照组的(0.43±0.04)、(0.51±0.05)、(0.57±0.05),观察组p62相对表达量为(0.68±0.06),低于对照组的(1.57±0.15),差异有统计学意义(P<0.05)。观察组总不良反应发生率(36.67%)和对照组(26.67%)比较,差异无统计学意义(P>0.05)。观察组总不良母婴结局发生率(10.00%)低于对照组(33.33%),差异有统计学意义(P<0.05)。结论 维生素D联合硫酸镁与胰激肽释放酶治疗SPE患者可以提升疗效,降低血压和24 h尿蛋白水平,促进25-(OH)D合成,增加胎盘滋养细胞自噬水�Objective To investigate the effects of vitamin D combined with magnesium sulfate and pancreatic kininogenase on autophagy of placental trophoblastic cells and maternal and infant outcomes in patients with severe preeclampsia(SPE).Methods 60 SPE patients admitted to the 93rd Hospital of the Joint Service Support Force of the Chinese People's Liberation Army from January 2022 to January 2024 were divided into two groups by random number table method,with 30 cases in each group.The control group was treated with magnesium sulfate combined with pancreatic kininogenase,and the observation group was treated with vitamin D.The therapeutic effect,blood pressure,24h urinary protein level,serum 25-hydroxyvitaminD[25-(OH)D] level,the relative expression levels of autophagy associated protein[microtubule-associated protein 1 light chain 3II/I(LC3/I)ratio,Beclin-1,autophagy associated gene 7(ATG7)and nucleoporin 62(p62)] in placental trophoblast cells,adverse reactions and maternal and infant outcomes were compared.Results The total effective rate of observation group(96.67%)was higher than that of control group(73.33%)(P<0.05).After treatment,blood pressure and 24h urinary protein levels were decreased in both groups,and SBP,DBP,MAP and 24h urinary protein were(123.40+9.72)mm Hg,(87.57±8.26)mm Hg,(102.41±10.49)mm Hg,and(1.00±0.10)g in the observation group,which was lower than(140.64±12.83)mm Hg,(96.60±8.42)mm Hg,(118.95±11.76)mm Hg,(2.19±0.23)g in control group,respectively(P<0.05).After treatment,the serum 25-(OH)D level in the observation group was(52.94±5.38)ng/ml,which was higher than that in the control group(25.07±2.56)ng/ml(P<0.05).After treatment,the ratio of autophagy associated protein LC31/I,the relative expression of Bec-lin-1 and ATG7 were(0.94±0.09),(0.87±0.08)and(0.80±0.08)respectively in the observation group,which were higher than that of control group(0.43±0.04),(0.51±0.05)and(0.57±0.05),respectively(P<0.05).The relative expression of p62 in the observation group was(0.68±0.06),lower than

关 键 词：维生素D 硫酸镁 胰激肽释放酶 重症子痫前期 胎盘组织 滋养细胞 自噬水平 母婴结局 

分 类 号：R714.244[医药卫生—妇产科学]