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目的检测子痫前期孕妇胎盘组织、血清及尿液中补体因子D(CFD)以及脂联素(ADPN)的水平,分析二者的相关性及其临床意义。方法选取2014年3~9月在重庆医科大学附属第一医院产科住院行剖宫产术的子痫前期孕妇29例(子痫前期组)和正常足月妊娠行择期剖宫产术的孕妇30例(正常妊娠组),采用Western blotting检测正常妊娠组和子痫前期组孕妇胎盘组织中CFD、ADPN的表达水平。采用ELISA方法检测两组孕妇血清及尿液中CFD、ADPN水平,计算2个指标的组间水平差异,并分析二者的相关性。结果 (1)胎盘组织中,与正常妊娠组比较,子痫前期组孕妇CFD表达水平显著升高,而ADPN水平显著下降,差异均有统计学意义(P<0.05或0.01)。(2)正常妊娠组孕妇血清及尿液中CFD水平为(0.67±0.04)μg/m L、(43.27±16.59)ng/m L,显著低于子痫前期组[(1.83±0.59)μg/m L、(174.95±23.61)ng/m L],差异均有统计学意义(P<0.01);正常妊娠组孕妇血清及尿液中ADPN水平[(80.68±1.27)、(9.29±1.33)ng/m L]显著高于子痫前期组[(13.16±2.01)、(2.40±0.86)ng/m L],差异均有统计学意义(P<0.05)。(3)在子痫前期组孕妇的胎盘组织、血清及尿液中,CFD、ADPN水平均呈显著负相关(r=-0.82、-0.78、-0.63,P<0.05)。结论子痫前期孕妇胎盘、血清和尿液中CFD、ADPN水平的异常变化与子痫前期发病有关,二者可能存在协同作用。联合检测孕妇血清和尿液中CFD、ADPN水平有望成为预测及诊断子痫前期的一种新手段。
Objective To detect the levels of complement factor D (CFD) and adiponectin (ADPN) in placenta, serum and urine of pregnant women with preeclampsia, and to analyze their correlation and clinical significance. Methods From March to September 2014, 29 pregnant women with preeclampsia (preeclampsia group) undergoing cesarean section in the obstetrics and gynecology department of the First Affiliated Hospital of Chongqing Medical University from March to September 2014 and 30 pregnant women with elective cesarean section under normal term pregnancy Cases (normal pregnancy group), Western blotting detection of placental tissue of normal pregnant women and preeclampsia group of placenta CFD, ADPN expression levels. The levels of CFD and ADPN in serum and urine of two groups of pregnant women were detected by ELISA. The difference between the two indexes was calculated and the correlation between them was analyzed. Results (1) Compared with normal pregnancy group, the level of CFD in placenta was significantly increased in pregnant women with preeclampsia and ADPN was significantly decreased (P <0.05 or 0.01). (2) The levels of CFD in serum and urine of pregnant women were (0.67 ± 0.04) μg / m L and (43.27 ± 16.59) ng / m L, respectively, which were significantly lower than those in preeclampsia group [(1.83 ± 0.59) μg / (P <0.01). The levels of ADPN in serum and urine of pregnant women with normal pregnancy were (80.68 ± 1.27), (9.29 ± 1.33) ng m L, (174.95 ± 23.61) ng / / m L] in preeclampsia group was significantly higher than that in preeclampsia group [(13.16 ± 2.01), (2.40 ± 0.86) ng / m L], the difference was statistically significant (P <0.05). (3) The levels of CFD and ADPN in the placenta, serum and urine of preeclampsia pregnant women were significantly negative correlated (r = -0.82, -0.78, -0.63, P <0.05). Conclusion The abnormal changes of CFD and ADPN in placenta, serum and urine of pregnant women with preeclampsia may play an important role in the pathogenesis of preeclampsia. There may be synergistic effects between them. Joint detection of serum and urine of pregnant women CFD, ADPN level is expected to become a new means of prediction and diagnosis of preeclampsia.