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目的:研究子痫前期患者脐血中AnnexinⅤ、ET-1、vWF的表达水平及与胎儿生长受限相关性。方法:采用ELISA方法检测子痫前期患者84例(轻度29例、早发重度型27例、晚发重度型28例)及同期无内外科合并症、因产科和社会因素行剖宫产健康产妇(对照组)29例脐血中AnnexinⅤ、ET-1、vWF的表达水平,评估其与终止妊娠前1日的胎儿脐动脉的S/D比值、新生儿出生体重以及胎盘重量的相关性。结果:1子痫前期各组脐血中annexinⅤ的蛋白表达水平均低于对照组,分别比较差异均有统计学意义(P<0.01);早发重度、晚发重度、轻度组两两分别比较差异均有统计学意义(P<0.01)。2子痫前期各组ET-1水平均明显高于对照组,分别比较差异均有统计学意义(P<0.01);轻度组与早发、晚发重度组比较差异均有统计学意义(P<0.01),但早发重度组与晚发重度组比较差异无统计学意义(P>0.05)。3子痫前期各组vWF浓度均明显高于对照组,分别比较差异均有统计学意义(P<0.01);早发重度组与晚发重度、轻度组比较差异有统计学意义(P<0.01)。4子痫前期孕妇脐血中AnnexinⅤ水平与脐动脉S/D比值呈明显负相关(P<0.01),与新生儿出生体重呈正相关(P<0.01),与胎盘重量呈正相关(P<0.01)。子痫前期孕妇脐血中ET-1水平与脐动脉S/D比值呈明显正相关(P<0.01),与新生儿出生体质量呈负相关(P<0.01),与胎盘质量呈负相关(P<0.01)。子痫前期孕妇脐血中vWF水平与脐动脉S/D比值呈明显正相关(P<0.01),与新生儿出生体质量呈负相关(P<0.01),与胎盘质量呈负相关(P<0.01)。结论:患者脐血中AnnexinⅤ、ET-1、vWF的表达可能与子痫前期发病机制有关,通过影响胎盘中凝血-纤溶系统及血管内皮系统参与子痫前期及胎儿生长受限发生、发展的病理生理过程。
Objective: To study the expression of AnnexinⅤ, ET-1 and vWF in umbilical cord blood of preeclampsia patients and their correlation with fetal growth restriction. Methods: Eighty-four patients with preeclampsia (29 with mild, 27 with early-onset severe, and 28 with severe late onset) and no intra-and-surgical complications were detected by ELISA. Results of obstetric and social factors for cesarean section The levels of AnnexinⅤ, ET-1 and vWF in 29 cases of uterus from the maternal (control) group were evaluated for their correlation with S / D ratio, birth weight and placental weight of fetal umbilical artery before the first trimester of pregnancy. Results: 1 The protein expression levels of annexinⅤ in cord blood of preeclampsia groups were lower than that of the control group (P <0.01). The levels of annexinⅤ in severe preeclampsia, The differences were statistically significant (P <0.01). The level of ET-1 in preeclampsia group was significantly higher than that in control group (P <0.01). There was significant difference in ET-1 level between mild group and early-onset and late-onset severe group P <0.01), but there was no significant difference between early-onset severe group and late-onset severe group (P> 0.05). The levels of vWF in preeclampsia group were significantly higher than those in control group (P <0.01), and those in preeclampsia severe group and late-onset severe group were significantly different (P < 0.01). The level of AnnexinⅤ in umbilical cord blood of pregnant women with preeclampsia was negatively correlated with the S / D ratio of umbilical artery (P <0.01), positively correlated with the birth weight of neonates (P <0.01), and positively correlated with the weight of placenta (P <0.01) . The level of ET-1 in umbilical blood of pregnant women with preeclampsia was positively correlated with the S / D ratio of umbilical artery (P <0.01), negatively correlated with birth weight (P <0.01) and negatively correlated with the quality of placenta P <0.01). The level of vWF in umbilical cord blood of pregnant women with preeclampsia was positively correlated with the S / D ratio of umbilical artery (P <0.01), negatively correlated with birth weight of neonates (P <0.01), and negatively correlated with the quality of placenta (P < 0.01). Conclusions: The expression of Annexin V, ET-1 and vWF in umbilical cord blood may be related to the pathogenesis of preeclampsia, which may affect the development of preeclampsia and fetal growth by affecting the coagulation-fibrinolytic system and vascular endothelial system in the placenta Pathophysiological process.