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目的:通过分析子痫前期患者胎盘与正常晚孕妇女胎盘组织中肝细胞生长因子(HGF)、基质金属蛋白酶-9(MMP-9)的表达,探讨其在妊娠期高血压疾病(HDCP)发病中的作用。方法:选择晚孕期正常组孕妇35例、子痫前期组71例(包括轻度子痫前期组37例;重度子痫前期组34例)作为研究对象。两组均在临产前行剖宫产术,胎盘娩出后30 min内取胎盘母面中央绒毛组织块约1×1×1 cm,避开钙化区及坏死区,留取胎盘组织。生理盐水充分清洗,10%中性福尔马林溶液固定24 h以上,常规石蜡包埋4μm连续切片。免疫组织化学SP法检测胎盘组织中HGF、MMP-9的表达强度,根据细胞内染色强度和阳性细胞数分级。应用SPSS12.0统计软件进行数据处理。结果:①正常晚孕组胎盘组织中HGF、MMP-9表达均呈强阳性,阳性表达率分别为71.43%、80.00%;轻度子痫前期组胎盘组织中HGF、MMP-9表达均呈阳性,阳性表达率分别为64.86%、72.97%;重度子痫前期组胎盘组织中HGF、MMP-9阳性颗粒均明显减少,阳性表达率为35.29%、32.35%。②子痫前期组胎盘组织中HGF、MMP-9表达与正常晚孕组比较均有明显差异(P<0.05);重度子痫前期组胎盘组织HGF、MMP-9表达与对照组比较均有显著差异(P<0.01);轻度子痫前期组胎盘组织HGF、MMP-9表达与重度子痫前期组比较也有显著差异(P<0.05);轻度子痫前期组胎盘组织HGF、MMP-9表达与对照组比较无明显差异(P>0.05)。③重度子痫前期组HGF和MMP-9的表达水平存在正相关性(r=0.5663P<0.01)。结论:正常妊娠胎盘绒毛表达HGF及MMP-9子痫前期病情严重程度和此两种因子的表达密切相关,提示可能因HGF和(或)MMP-9表达减少、滋养细胞侵袭受限而引起胎盘生理性血管重铸障碍,导致胎盘缺血,引起一系列子痫前期临床症状发生。
OBJECTIVE: To investigate the expression of hepatocyte growth factor (HGF) and matrix metalloproteinase-9 (MMP-9) in placenta of preeclampsia and normal pregnant women, and to explore its role in the pathogenesis of HDCP In the role. Methods: 35 pregnant women in normal pregnancy group, 71 pregnant women in preeclampsia group (including 37 in mild preeclampsia group and 34 in severe preeclampsia group) were selected as the study subjects. Cesarean section was performed in both groups before labor. Within 30 minutes after the delivery of the placenta, the central placenta tissue of the mother’s placenta was about 1 × 1 × 1 cm, avoiding the calcification and necrosis areas and taking the placenta tissue. Saline full cleaning, 10% neutral formalin solution fixed more than 24 h, conventional paraffin embedded 4μm serial sections. The expression of HGF and MMP-9 in placenta was detected by immunohistochemical SP method. The intensity of staining and the number of positive cells were graded. Application SPSS12.0 statistical software for data processing. Results: ①The positive expression rates of HGF and MMP-9 in placenta of normal pregnancy group were 71.43% and 80.00%, respectively. The positive expression of HGF and MMP-9 in placenta of mild preeclampsia group was positive , The positive expression rates were 64.86% and 72.97% respectively. The positive expression rates of HGF and MMP-9 in placental tissue of severe preeclampsia were significantly decreased, the positive rates were 35.29% and 32.35% respectively. ② The expression of HGF and MMP-9 in placental tissue of preeclampsia group were significantly different from those in normal pregnancy group (P <0.05); The levels of HGF and MMP-9 in placental tissue of severe preeclampsia group were significantly higher than those in control group (P <0.01). The expression of HGF and MMP-9 in placental tissue of mild preeclampsia group was also significantly different from that in severe preeclampsia group (P <0.05). The levels of HGF and MMP-9 in placental tissue of mild preeclampsia There was no significant difference between the two groups (P> 0.05). ③ The expression of HGF and MMP-9 in severe preeclampsia group had a positive correlation (r = 0.5663P <0.01). Conclusion: The expression of HGF and MMP-9 in preeclampsia of placental villi in normal pregnancy is closely related to the expression of these two factors, which may be due to the decreased expression of HGF and / or MMP-9 and the restricted of trophoblast invasion Physiological vascular recasting disorders, resulting in placental ischemia, causing a series of clinical symptoms of preeclampsia occurred.