子痫前期患者胎盘中KLF-8的研究

发布时间：2018-06-07 20:13

本文选题：妊娠 + 重度　；参考：《河北医科大学》2017年硕士论文

【摘要】：目的:子痫前期(Preeclampsia,PE)是一种妊娠期所特有的严重的全身性疾病,在妊娠前血压正常,妊娠20周后出现全身小动脉痉挛,病情进一步加重可发展为子痫,进一步导致多脏器的功能衰竭,严重威胁母婴的安全,是我国孕产妇和围产儿死亡的重要病因之一[1,2]。目前,子痫前期并没有一元论的病因和发病机制,根据不断的研究总结出了子痫前期的发病机制与滋养细胞侵袭能力异常、氧化应激和抗血管生成反应变化等关系密切,其中以滋养细胞侵袭能力异常备受瞩目及认可。KLF-8是人们新近研究发现的可以影响滋养细胞侵袭能力进而引发子痫前期发生的一个转录因子,本文通过检测早发型和晚发型重度子痫前期孕妇与健康孕妇的胎盘组织中KLF-8的变化,探讨KLF-8与子痫前期发病的关系。方法:1研究对象选取2015年9月至2016年03月在武安市第一人民医院以剖宫产术分娩的重度子痫前期孕妇40例,其中早发型重度子痫前期孕妇20例(发病孕周34周),晚发型重度子痫前期孕妇20例(发病孕周≥34周),对照组选择行择期剖宫产术分娩的同期孕足月健康孕妇20例。所有研究对象均选择头胎、单胎、胎儿无畸形而且孕妇既往均无高血压、心脏病、糖尿病、肾脏病及甲状腺功能亢进、贫血及自身免疫性疾病等病史,无吸烟及嗜酒史,无长期服用药物史。入院时查肝肾功能及凝血功能正常,详细记录患者的年龄、月经史、生育史及家族史等资料。三组孕妇的例数、年龄、孕产次、吸烟及嗜酒比较,均无统计学差异(P0.05)。2标本采集所有研究对象均在本人签署知情同意书后进行标本采集,胎盘组织娩出20min内采取除外肉眼所见的病变区面积约1cm×1cm×1cm的3块母体面胎盘组织,用磷酸盐缓冲液(PBS)反复漂洗,一块用4%多聚甲醛中固定,另外2块放入液态氮中存于灭菌灭酶冻存管中后都放入-80℃冰箱中冻存待后测定。胎盘组织的KLF-8蛋白表达部位选用免疫组化SP法检测,klf-8mrna的表达水平应用荧光定量pcr检测,klf-8蛋白的表达应用蛋白印迹法检测。3运用spss21.0进行数据分析。数据符合正态分布,结果采用均数±标准差(x±s)表示,组间比较采用独立样本t检验,以p0.05差异有统计学意义。结果:1一般特征早发型重度子痫前期患者组的平均年龄是26.60±0.91岁,年龄分布在26~40岁;晚发型组的平均年龄为23.90±0.62岁,年龄分布在23~33岁,对照组平均年龄为24.48±0.71岁,年龄分布在22~34岁,三组之间年龄无统计学差异(p0.05)。三组患者均为g1p1,均无吸烟及嗜酒史。见table1。2三组孕妇胎盘组织中klf-8蛋白的表达部位三组胎盘组织中均可见到棕褐色阳性染色细胞,证明klf-8蛋白主要表达于胎盘合体滋养细胞的胞核和胞质中。3三组孕妇胎盘组织中klf-8mrna表达水平的比较早发型重度子痫前期胎盘组织中klf-8mrna水平为0.65±0.07,晚发型组为0.96±0.09,对照组为0.98±0.06。早发型重度子痫前期胎盘组织中klf-8mrna水平明显低于晚发型组,有统计学差异(p0.01);而晚发型组与对照组之间无统计学差异(p0.05)。见table2、table3。4三组孕妇胎盘组织中klf-8蛋白表达水平的比较三组胎盘组织中均可检测到klf-8蛋白的表达,早发型重度子痫前期组klf-8蛋白水平为0.61±0.05,晚发型为0.95±0.06,对照组为0.98±0.07。早发型子痫前期组明显低于晚发型子痫前期组,差异有统计学意义(p0.01);而晚发型组与对照组无统计学差异(p0.05)。见table4、table5。结论:本研究结果提示早发型重度子痫前期孕妇胎盘组织中klf-8蛋白和mrna表达水平明显低于晚发型组,而晚发型组与对照组间无明显差异,说明早发型重度子痫前期与晚发型的发病机制不同,胎盘组织中klf-8蛋白和mrna表达的减少,影响了子宫螺旋动脉重铸和滋养细胞侵袭力,说明klf-8参与了早发型重度子痫前期的发病。
[Abstract]:Objective: Preeclampsia (PE) is a serious systemic disease endemic to pregnancy. The blood pressure is normal before pregnancy. After 20 weeks of pregnancy, systemic arteriospasm is found. Further aggravation can be developed into eclampsia, which further causes multiple organ failure and seriously threatens the safety of mother and infant. It is the death of pregnant and parturient women and perinatal death in China. [1,2]., one of the most important causes of death, has no monism in the preeclampsia. The pathogenesis of preeclampsia is closely related to the abnormal invasion ability of the trophoblast, the changes of oxidative stress and the change of anti angiogenesis. .KLF-8 is a new transcriptional factor that people recently found to affect the ability of trophoblast invasion to induce preeclampsia. By detecting the changes in KLF-8 in placental tissues of pregnant women with early onset and late onset severe preeclampsia and healthy pregnant women, the relationship between KLF-8 and preeclampsia was discussed. Methods: 1 Subjects selected 40 severe preeclampsia pregnant women with cesarean section from September 2015 to 03 2016 in the first people's Hospital of Wuan, including 20 cases of early onset severe preeclampsia (34 weeks of pregnancy), and 20 late onset severe preeclampsia (more than 34 weeks of pregnancy). The control group chose the same period of cesarean section for the same period of childbirth. 20 pregnant full term healthy pregnant women. All the subjects selected first, single, fetal and pregnant women had no history of hypertension, heart disease, diabetes, kidney disease and hyperthyroidism, anemia and autoimmune diseases, no smoking and alcohol history, no history of long term use of drugs. Normal, detailed records of the patient's age, menstrual history, birth history and family history. There were no statistical differences between the three groups of pregnant women, age, pregnancy and birth, smoking and alcohol comparison (P0.05) all the subjects of.2 samples were collected after signing the informed consent book, and the placental tissue was delivered in 20min, except for the naked eye. 3 matrix surface placenta tissues of 1cm * 1cm x 1cm were seen in the lesion area, and were rinsed with phosphate buffer solution (PBS), one was fixed in 4% polyformaldehyde, and the other 2 were stored in liquid nitrogen in the sterilization and extinguishing cryopreservation tube and stored in -80 fridge for determination. The KLF-8 protein expression site of fetal disc tissue was selected by immunohistochemical S The expression level of klf-8mrna was detected by P method. The expression of klf-8 protein was detected by PCR, and the expression of klf-8 protein was detected by Western blot. The data was in normal distribution, and the results were expressed with mean standard deviation (x + s), and the independent sample t test was used in the group. The difference of P0.05 was statistically significant. The results were 1 general. The average age of the group with early onset severe preeclampsia was 26.60 + 0.91 years, the age distribution was 26~40 years, the average age of the late onset group was 23.90 + 0.62 years, the age distribution was 23~33 years, the average age of the control group was 24.48 + 0.71 years, the age distribution was 22~34 years, and the age of three groups was not statistically different (P0.05). The three groups were all g1p1, No smoking and alcohol history. See the expression of klf-8 protein in the placental tissue of table1.2 three groups of pregnant women, the three groups of placental tissues can see Brown stained positive staining cells. It is proved that the klf-8 protein is mainly expressed in the nucleus and cytoplasm of the placental syncytial cells and the expression level of klf-8mrna in the placental tissue of the.3 three groups of pregnant women is relatively early hair weight. The level of klf-8mrna in placental tissue in preeclampsia was 0.65 + 0.07, the late onset group was 0.96 + 0.09, and the level of klf-8mrna in the placental tissue of the control group was 0.98 + 0.06. early onset severe preeclampsia. There was a significant difference (P0.01) in the placental tissue of the placental tissue of the early onset severe preeclampsia, but there was no statistical difference between the late onset group and the control group (P0.05). Table2, table3.4 three groups The expression of klf-8 protein in placental tissue was compared in three groups of placental tissues, the expression of klf-8 protein could be detected. The level of klf-8 protein in the early onset severe preeclampsia group was 0.61 + 0.05, the late hairstyle was 0.95 + 0.06, the control group was 0.98 + 0.07. early onset preeclampsia group was significantly lower than the late preeclampsia group, the difference was statistically significant There was no statistical difference between the late hairstyle group and the control group (P0.05). See table4, table5. conclusion: the results of this study suggest that the expression of klf-8 protein and mRNA in placental tissues of pregnant women with early onset severe preeclampsia is significantly lower than that in the late onset group, but there is no significant difference between the late onset group and the control group, indicating early onset severe preeclampsia and late onset and late onset. The pathogenesis of hairstyle is different. The decrease of klf-8 protein and mRNA expression in placenta tissue affects the uterine spiral artery recasting and the invasiveness of trophoblast, indicating that klf-8 is involved in the onset of early onset severe preeclampsia.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R714.244

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