NGF、VEGF与早期复发性流产的相关性研究

发布时间：2018-04-09 15:38

本文选题：复发性流产　切入点：NGF　出处：《山西医科大学》2014年硕士论文

【摘要】：目的：通过测定NGF、VEGF在正常早孕妇女和有复发性流产史的早孕妇女绒毛、蜕膜组织中的表达及在血清中的水平,了解两个因子与妊娠的相关性。方法：随机选择2012年7月到2013年7月期间来山西医科大学第一医院妇产科门诊就诊的复发性流产妇女25例作为流产组,经详询病史,结合其相关的检查和化验,被诊断为不明原因的复发性流产者,随机选取同一时期行人工流产自愿终止妊娠的正常健康早孕妇女25例作为对照组,这些早孕妇女既往无不良生育史,至少有一胎正常足月分娩史,分别抽取两组妊娠妇女空腹外周肘静脉血,收集两组妊娠妇女行人工流产后新鲜的绒毛组织和蜕膜组织,应用酶联免疫吸附试验(ELISA)测定两组妊娠妇女血清中NGF、VEGF水平；免疫组化法测定NGF、VEGF在两组妊娠妇女绒毛、蜕膜组织中的表达,采用SPSS17.0统计软件对所得资料进行分析,计量资料以均数±标准差(X±S)表示,组间比较采用方差分析和t检验,相关资料采用pearson相关分析,P0.05为差异具有统计学意义。结果：1.对照组绒毛结构排列整齐,胞核小且有多个,胞浆呈毛玻璃样的为合体滋养细胞,细胞之间边界清楚,胞核圆呈小泡状的为细胞滋养细胞,合体滋养细胞和细胞滋养细胞分别排列于绒毛的外层和内层,绒毛间质可见小血管(见附录图1和图5),蜕膜细胞呈多边形或圆形排列,细胞间隙较大,胞核较小,可见到乳头状结构的腺体,蜕膜间质可见小血管(见附录图3和图7)。而流产组绒毛结构形态不规则、排列紊乱,合体滋养细胞、细胞滋养细胞减少,细胞萎缩变性,绒毛间质水肿,血管减少,可见淋巴细胞、中性粒细胞浸润(见附录图2和图6),蜕膜细胞被挤压变形,腺体结构紊乱、血管淤血(见附录图4和图8)。 2.在两组妊娠妇女绒毛、蜕膜组织中均可发现NGF、VEGF表达的阳性颗粒,NGF、VEGF主要表达在绒毛滋养细胞的胞膜、胞浆,胞核未见明显着色,且相对流产组而言,对照组染色程度深(见附录图1-8)。 3.NGF、VEGF在流产组孕妇绒毛、蜕膜组织中的表达及在血清中的水平均较对照组降低,两组间比较,p均0.05,差异均有统计学意义(见表1和表2)。 4.NGF、VEGF在流产组和对照组血清中的水平呈正相关(rl=0.965,r2=0.733,p均0.05),绒毛和蜕膜组织中的表达不存在相关性(r3=0.378, r4=-0.049,r5=0.542, r6=-0.175,p均0.05)(见图A-F)。结论：1.在两组妊娠妇女绒毛、蜕膜组织中均可见到NGF、VEGF的阳性表达,血清里均可检测到NGF、VEGF的浓度,说明NGF、VEGF与胎盘血管生成有关。 2.NGF、VEGF在流产组孕妇绒毛、蜕膜组织中的表达及在血清中的水平均较对照组降低,提示NGF、VEGF在绒毛、蜕膜组织中表达下降,血清中的水平下降,可能是导致复发性流产的原因之一。 3、NGF、VEGF在血清中水平呈正相关,提示NGF可能通过促进VEGF的表达,而间接促成血管的生成。
[Abstract]:Objective: to determine the expression of NGF- VEGF in villi and decidua of normal early pregnant women and women with recurrent abortion, and to investigate the relationship between the two factors and pregnancy.Methods: from July 2012 to July 2013, 25 women with recurrent abortion were randomly selected as abortion group from the first Hospital of Shanxi Medical University, Department of Gynecology and Obstetrics and Obstetrics and Obstetrics.A total of 25 normal and healthy early pregnant women with voluntary termination of pregnancy during the same period were randomly selected as the control group, who were diagnosed as unexplained recurrent abortions. These early pregnant women had no history of adverse birth.With at least one normal full-term delivery history, the fasting peripheral cubitus vein blood was drawn from two groups of pregnant women, and fresh chorionic and decidua tissues were collected from the two groups of pregnant women after induced abortion.The serum levels of NGF #en1# in two groups of pregnant women were determined by Elisa, and the expression of VEGF in chorionic villi and decidua of the two groups were detected by immunohistochemical method. The data were analyzed by SPSS17.0 software.The measurement data were expressed as mean 卤standard deviation X 卤S, the analysis of variance and t test were used in the comparison between groups, and the correlation data were analyzed by pearson correlation analysis (P0.05).The result is 1: 1.In the control group, the chorionic villi were arranged neatly, the nuclei were small and multiple, the cytoplasm was glass-like syncytiotrophoblast, the boundary between the cells was clear, and the round of the nucleus was cytotrophoblastic.Syncytiotrophoblast and cytotrophoblast were arranged in the outer layer and inner layer of villi, respectively. Small vessels were found in the stroma of villi (see figure 1 and figure 5 of the appendix). Decidual cells were arranged in polygon or circle, with large intercellular space and small nucleus.Small vessels can be seen in decidual stroma and papillary glands (see figure 3 in appendix and figure 7 in figure 7).In the abortion group, the structure of villi was irregular, the arrangement was disordered, syncytiotrophoblast, cytotrophoblast decreased, cell atrophy, villous stroma edema, vascular decrease, lymphocyte,Neutrophil infiltration (see Appendix Fig. 2 and Fig. 6), decidual cells squashed and deformed, glandular structure disordered, and vascular congestion (see Appendix Fig. 4 and Fig. 8).2.In the villi of the two groups of pregnant women, the positive granules of NGF- VEGF expression were found in the villus, cytoplasm and nucleus of the chorionic trophoblastic cells, and the expression of NGF- VEGF was not found in the villus trophoblastic cells, and the expression of NGF- VEGF in decidual tissues was not obvious compared with that in the abortion group.The degree of staining in the control group was deep (see figure 1-8 in the appendix).3. The expression of NGF- VEGF in villi and decidua of pregnant women in abortion group was lower than that in control group, and the difference between the two groups was statistically significant (see Table 1 and Table 2).Conclusion 1.In both groups, the positive expression of VEGF in decidua and the concentration of VEGF in serum could be detected, which indicated that the expression of VEGF in placenta was related to the angiogenesis of placenta.2. The expression of VEGF in villi, decidua and serum of pregnant women with abortion was lower than that of control group, suggesting that the expression of VEGF in villi, decidual tissues and serum might be one of the causes of recurrent abortion.(3) the level of NGF in serum was positively correlated, suggesting that NGF may promote angiogenesis indirectly by promoting the expression of VEGF.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.21

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