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目的探讨妊娠期高血压疾病患者胎盘组织中细胞外钙受体(CASR)mRNA及蛋白表达水平变化及其意义。方法采用免疫组化方法和免疫荧光及RT-PCR技术分别检测妊娠期高血压疾病患者65例(妊娠期高血压组22例,子痫前期轻度组24例,重度组19例)及健康足月孕妇30例(对照组)胎盘组织中CASR的定位、mRNA及蛋白表达水平。结果(1)CASR主要位于胎盘细胞滋养细胞、绒毛滋养细胞及血管内皮细胞上。(2)妊娠期高血压组患者胎盘组织中CASR的mRNA表达水平与对照组比较,差异有统计学意义(q=7.07,P=0.0004)。子痫前期轻度组和子痫前期重度组,两组比较,差异也有统计学意义(q=20.96,P<0.0001)。(3)CASR的蛋白在妊娠期高血压组患者胎盘组织中表达水平为59.0532±8.039,对照组为54.8585±4.3035,两组比较,差异无显著性(q=0.08,P=0.7759)。而子痫前期轻度组、子痫前期重度组两组比较,差异有统计学意义(q=16.18,P<0.0001)。结论妊娠期高血压疾病患者胎盘组织中CASR的mRNA表达激活及CASR的蛋白异常表达,导致妊娠期高血压疾病的发病和胎盘病理改变的发生发展。
Objective To investigate the changes of extracellular calcium receptor (CASR) mRNA and protein expression in placenta of patients with gestational hypertension and its significance. Methods Immunohistochemical methods and immunofluorescence and RT-PCR were used to detect 65 cases of hypertensive disorder complicating pregnancy (gestational hypertension in 22 cases, mild preeclampsia in 24 cases, severe cases in 19 cases) and healthy foot CASR localization, mRNA and protein expression in placenta of 30 pregnant women (control group). Results (1) CASR is mainly located in placental cells, villous trophoblasts and vascular endothelial cells. (2) Compared with the control group, the mRNA expression of CASR in placental tissue of gestational hypertension group was significantly different (q = 7.07, P = 0.0004). Preeclampsia mild group and severe preeclampsia group, the difference between the two groups was also statistically significant (q = 20.96, P <0.0001). (3) CASR protein expression in placental tissue of patients with gestational hypertension was 59.0532 ± 8.039, while that of the control group was 54.8585 ± 4.3035. There was no significant difference between the two groups (q = 0.08, P = 0.7759). There was significant difference between the mild preeclampsia group and the severe preeclampsia group (q = 16.18, P <0.0001). Conclusion The activation of CASR mRNA and the abnormal expression of CASR protein in placenta of patients with gestational hypertension cause the development of hypertensive disorder complicating pregnancy and the pathological changes of placenta.