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目的:探讨子痫前期患者在临床症状出现之前血浆中胎源性非甲基化丝氨酸蛋白酶抑制剂B5(serpin peptidase inhibitor,clade B,member 5,SERPINB5)基因含量的变化及其与该病发生的相关性。方法:选取孕妇325例,分别在其孕7～12周、孕13～18周及孕19～24周抽取外周血,提取血浆游离DNA,采用Taqman探针结合甲基化特异性PCR(methylationspecific PCR,MSP)技术检测各模板DNA经亚硫酸氢盐修饰后非甲基化SERPINB5基因的含量,代表胎儿游离DNA水平,同时监测孕妇血压、尿蛋白值及临床表现,将最终发展为子痫前期的孕妇列入观察组,从正常孕妇中随机选取30例列入对照组,回顾性分析两组孕妇血浆中非甲基化SERPINB5基因水平的差异。结果:325例孕妇中26例发展为子痫前期患者,妊娠7～12周血浆中非甲基化SERPINB5基因含量与对照组差异无统计学意义(P>0.05);妊娠13～18周实验组该基因平均含量为139.56copies/ml,正常妊娠组为101.04copies/ml,差异具有统计学意义(P<0.05);妊娠19～24周实验组该基因含量为对照组的2.06倍。结论:妊娠中期孕妇血浆中非甲基化SERPINB5基因水平的异常变化有望实现子痫前期的早期预测。
OBJECTIVE: To investigate the changes of the gene expression of fetal unmethylated serine protease inhibitor B5 (serpin B, member 5, SERPINB5) in patients with preeclampsia before the onset of clinical symptoms, Correlation. Methods: Peripheral blood samples were collected from 325 pregnant women at 7-12 weeks of gestation, 13-18 weeks of gestation and 19-24 weeks of gestation. Plasma free DNA was extracted and analyzed by Taqman probe combined with methylationspecific PCR , MSP) technique to detect the content of unmethylated SERPINB5 gene after bisulfite modification on each template DNA to represent the free DNA level of the fetus, and to monitor the blood pressure, urinary protein value and clinical manifestations of pregnant women, which will eventually develop into preeclampsia Pregnant women were included in the observation group. Thirty randomly selected normal pregnant women were enrolled in the control group. The differences of the plasma levels of unmethylated SERPINB5 gene between the two groups were retrospectively analyzed. Results: Among 325 pregnant women, 26 cases progressed to preeclampsia. The plasma levels of unmethylated SERPINB5 in the 7th to 12th week of pregnancy were not significantly different from those in the control group (P> 0.05) The average content of this gene was 139.56 copies / ml, the normal pregnancy group was 101.04copies / ml, the difference was statistically significant (P <0.05). The gene content in the experimental group was 2.06 times of the control group at 19-24 weeks gestation. CONCLUSIONS: Abnormal changes in plasma levels of unmethylated SERPINB5 in the second trimester of pregnancy are expected to lead to early prediction of preeclampsia.