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目的探讨妊娠期糖尿病孕妇血清及胎盘组织中肿瘤坏死因子-α(TNF-α)、核转录因子p65(NF-κBp65)以及纤溶酶原激活物抑制因子-1(PAI-1)的表达情况及其临床意义,为揭示妊娠期糖尿病的发病机制提供实验室依据。方法收集2015年1-12月该院收治的281例妊娠期糖尿病孕妇为病例组,并同期收集200例健康孕妇为对照组。采用酶联免疫吸附法测定两组产前血清TNF-α、NF-κBp65及PAI-1水平,采用免疫组化法测定产后胎盘组织TNF-α、NF-κBp65及PAI-1的表达水平。结果病例组血清TNF-α、NF-κBp65及PAI-1水平均高于对照组(P=0.000)。病例组孕妇血清TNF-α与NF-κBp65、PAI-1,NF-κBp65与PAI-1均呈正相关(r=0.683、0.839、0.615;P=0.002、0.011、0.006)。病例组胎盘组织中TNF-α、NF-κBp65、PAI-1的阳性表达率(91.10%、99.64%、94.66%)分别显著高于对照组(8.50%、12.50%、19.00%),且病例组的阳性表达强度均高于对照组(P=0.000)。结论妊娠期糖尿病孕妇血清及胎盘组织中TNF-α、NF-κBp65及PAI-1呈高表达状态,三者对妊娠期糖尿病的发生及发展具有协同促进作用。
Objective To investigate the expression of tumor necrosis factor-α (TNF-α), nuclear transcription factor (NF-κBp65) and plasminogen activator inhibitor-1 (PAI-1) in serum and placenta of pregnant women with gestational diabetes And its clinical significance, to provide a laboratory basis for revealing the pathogenesis of gestational diabetes mellitus. Methods A total of 281 pregnant women with gestational diabetes admitted to our hospital from January to December in 2015 were selected as the case group and 200 healthy pregnant women were collected as control group. The levels of TNF-α, NF-κBp65 and PAI-1 in prenatal serum of the two groups were measured by enzyme-linked immunosorbent assay. The expression of TNF-α, NF-κBp65 and PAI-1 in postpartum placenta were detected by immunohistochemistry. Results The levels of serum TNF-α, NF-κBp65 and PAI-1 in the patients were higher than those in the control group (P = 0.000). Serum levels of TNF-α were positively correlated with PAI-1, NF-κBp65, PAI-1 and NF-κBp65 in pregnant women in the case group (r = 0.683,0.839,0.615; P = 0.002,0.011,0.006). The positive rates of TNF-α, NF-κBp65 and PAI-1 in case group were significantly higher than those in control group (91.10%, 99.64%, 94.66% The positive expression intensity was higher than the control group (P = 0.000). Conclusions The levels of TNF-α, NF-κBp65 and PAI-1 in the serum and placenta of pregnant women with gestational diabetes mellitus are highly expressed. The three of them have a synergistic effect on the occurrence and development of gestational diabetes mellitus.