PEG10在重度子痫前期患者胎盘组织中的表达及意义

发布时间：2018-07-04 19:32

本文选题：PEG10 + 遗传印记　；参考：《河北医科大学》2014年硕士论文

【摘要】：目的：妊娠期高血压疾病(hypertensive disorder complicating pregnancy,HDCP)包括妊娠期高血压、子痫前期、子痫、慢性高血压并发子痫前期以及妊娠合并慢性高血压，是产科最常见的合并症。其中，子痫前期是妊娠期所特有的疾病之一。子痫前期（preeclampsia,PE）是一种全身性疾病，以妊娠20周以后出现Bp≥140/90mmHg,且尿蛋白≥300mg/24h或（+），伴或不伴上腹部不适、头痛、视力模糊等症状为特征。而当子痫前期患者血压继续升高，出现严重高血压≥160/110mmHg，或尿蛋白≥2.0g/24h等，称重度子痫前期（severe preeclampsia,SPE）。该病在国内外发病率均较高，严重威胁着母婴的健康。重度子痫前期病因至今尚未完全阐明，目前国外大多数学者认为其发病可归纳为两个阶段：胎盘形成不良和胎盘氧化应激[1]。胎盘形成不良,主要为绒毛滋养细胞侵蚀不良。滋养细胞侵蚀不完全，子宫螺旋小动脉“血管重塑”异常，胎盘血流减少，缺血缺氧促使胎盘释放相关因子，引起广泛的系统炎性反应。印迹基因（Imprintedgene）是一类单等位基因，根据亲源性的不同，只表达来源父本或母本的一个拷贝。这类基因在大多数哺乳动物早期胚胎、胎盘以及胎儿的生长发育过程中扮演着着及其重要的角色。通常情况下，父源表达(母源印迹)的印迹基因促进营养的摄取和胚胎发育，而反之，母源表达(父源印迹)的印迹基因在营养的摄取以及胚胎发育方面的则起着抑制作用。父源性印记基因10(paternally expressed gene10,PEG10)是父源表达(母源印迹)基因成员之一，在成人的卵巢、脑组织、胎盘以及胚胎肝等组织上均有表达。该基因与脂肪细胞的早期分化以及多类肿瘤的发生、发展和转移有着密切关系，在胎盘形成以及滋养层分化侵袭过程中也起着至关重要的作用。根据PEG10与细胞侵袭转移的关系，推测其表达异常可能改变滋养细胞的浸润情况，在重度子痫前期的发生、发展中起重要作用。本课题的主要目的是通过对重度子痫前期患者胎盘组织中PEG10表达情况进行检测，探讨PEG10在重度子痫前期发病中的作用，以期为临床寻找重度子痫前期的病因、发病机制提供依据。方法：实验标本均选自2012年10月至2013年10月在河北医科大学附属第二医院产科住院的正常妊娠妇女及SPE患者共120例，其中，早发型重度子痫前期(孕28-34周)孕妇30例为第一实验组（早发组），同期孕周小于34周的30例健康孕妇（因胎儿畸形等原因引产者）为早期对照组；晚发型重度子痫前期（孕34-42周）孕妇30例为第二实验组（晚发组），同期正常妊娠妇女30例为晚期对照组。重度子痫前期诊断按人民卫生出版社出版，乐杰主编的《妇产科学》(第7版)的标准，所选孕妇均为第一胎，以剖宫产方式结束妊娠，各组年龄、孕龄差异无统计学意义（见附表），无原发性高血压、糖尿病、心脏病及肝肾疾患、甲状腺功能异常等病史。标本均取材于胎盘母体面近脐带根部的胎盘绒毛组织，并避开出血、坏死及钙化区域。采用免疫组织化学的方法检测胎盘组织中PEG10蛋白的表达情况。实验数据均采用SPSS17.0软件处理，计量资料以均数士标准差表示，两组间差异用两独立样本非参数检验进行比较，检验标准α=0.01, P0.05为差异具有统计学意义。结果： 1PEG10蛋白在各组中均有表达，主要表达于合体滋养细胞和细胞滋养细胞，，合体滋养细胞表达量高于细胞滋养细胞。PEG10表达定位于细胞膜及细胞浆，细胞核未见表达。 2早发型重度子痫前期患者胎盘组织中PEG10蛋白表达量较对照组明显升高，且差异有统计学意义(P0.01)。 3晚发型重度子痫前期患者胎盘组织中PEG10蛋白表达量较对照组明显升高，且差异有统计学意义(P0.01)。 4早发型重度子痫前期患者胎盘组织中PEG10蛋白表达量较晚发型重度子痫前期组升高，差异无统计学意义(P0.05)。结论：不论早发型还是晚发型，重度子痫前期患者胎盘组织中PEG10蛋白表达强度均明显高于正常孕妇，提示胎盘组织中PEG10的表达增高可能与重度子痫前期的发生有关，PEG10可能影响滋养细胞迁移、浸润等功能，导致胎盘浅着床，而引发重度子痫前期。早发型重度子痫前期和晚发型重度子痫前期患者胎盘组织中的PEG10的表达差异无统计学意义。
[Abstract]:Objective: hypertensive disorder complicating pregnancy (HDCP), including pregnancy induced hypertension, preeclampsia, eclampsia, chronic hypertension, preeclampsia and pregnancy with chronic hypertension, is the most common complication in obstetrics. Preeclampsia (pre) is one of the special diseases in pregnancy. (pre Eclampsia, PE) is a systemic disease. After 20 weeks of pregnancy, the symptoms of Bp > 140/90mmHg, urinary protein more than 300mg/24h or (+), with or without upper abdominal discomfort, headache, and blurred vision are characterized. And the blood pressure continues to rise in preeclampsia patients with severe high blood pressure, or more than 160/110mmHg, or urinary protein > 2.0g/24h and so on, and eclampsia in weighing degree. Severe preeclampsia (SPE). The incidence of the disease at home and abroad is high, which seriously threatens the health of mother and baby. The cause of severe preeclampsia has not been fully elucidated. Most scholars abroad believe that the disease can be summed up to two stages: placental malformation and placental oxidative stress [1]. placenta formation, mainly villous nourishing. The cell erosion is poor, the nutrient cell erosion is incomplete, the uterine spiral artery "vascular remodeling" is abnormal, the placental blood flow decreases, the ischemic anoxia causes the placenta releasing related factors and causes extensive systemic inflammatory response. The imprinted gene (Imprintedgene) is a kind of single allele, which only expresses the parent or mother parent according to the difference of parental origin. A copy. These genes play an important role in the growth and development of most early embryos, placentas and foetuses in most mammals. Usually, the imprinted gene of the parent source (mother source blot) promotes nutrient uptake and embryonic development, whereas the mother source (parent blot) imprinted gene is nutritious. Uptake and embryonic development are inhibited. Parent imprinted gene 10 (paternally expressed gene10, PEG10) is a member of the parent source expression (mother source blot) gene, expressed in adult ovary, brain tissue, placenta, and embryonic liver tissues. This gene is early differentiated from adipocytes and multiple types of tumor hair. There is a close relationship between birth, development and metastasis, and plays a vital role in the formation of placenta and the differentiation and invasion of trophoblast. According to the relationship between PEG10 and cell invasion and metastasis, it is presumed that the abnormal expression of the trophoblast may change the infiltration of trophoblastic cells, which plays an important role in the occurrence and development of severe preeclampsia. The purpose of this study is to detect the expression of PEG10 in the placental tissues of patients with severe preeclampsia and to explore the role of PEG10 in the pathogenesis of severe preeclampsia, in order to provide a basis for finding the etiology of severe preeclampsia and the pathogenesis of the severe preeclampsia.
Methods: all the experimental specimens were selected from October 2012 to October 2013 in 120 normal pregnant women and SPE patients in the Second Affiliated Hospital of Hebei Medical University. Among them, 30 pregnant women with early onset severe preeclampsia (28-34 weeks pregnant) were the first experimental group (early onset group), and 30 healthy pregnant women with pregnancy less than 34 weeks (due to fetal malformation). As early control group), 30 cases of pregnant women with late onset severe preeclampsia (34-42 weeks of pregnancy) were second experimental groups (late onset group), and 30 cases of normal pregnancy women were late control group. The diagnosis of severe preeclampsia was published by people's Health Press and the standard of Obstetrics and gynecology (Seventh Edition), compiled by Le Jie, was the first child. There was no significant difference in age and gestational age between each group (see attached table), no primary hypertension, diabetes, heart disease, liver and kidney disease, abnormal thyroid function and other diseases. The specimens were obtained from the placental hair tissue of the placental maternal surface near the umbilical cord and avoided the hemorrhage, necrosis and calcification area. The immunization group was used. The expression of PEG10 protein in placenta tissue was detected by the method of weave chemistry. The experimental data were treated with SPSS17.0 software, and the measurement data were represented by the standard deviation of the number of men. The difference between the two groups was compared with two independent sample nonparametric tests, and the standard alpha =0.01 was tested and the difference was statistically significant.
Result:
1PEG10 protein is expressed in all groups, mainly in syncytial trophoblast and cell trophoblast. The expression of chimeric trophoblast is higher than that of cell trophoblast.PEG10 expression in cell membrane and cytoplasm, and the nucleus is not expressed.
2 the expression of PEG10 protein in placenta tissue of early onset severe preeclampsia was significantly higher than that of the control group, and the difference was statistically significant (P0.01).
3 the expression of PEG10 protein in placenta tissues of late onset severe preeclampsia patients was significantly higher than that of the control group, and the difference was statistically significant (P0.01).
4 the expression of PEG10 protein in placenta tissue of early onset severe preeclampsia was higher than that in late onset severe preeclampsia group (P0.05).
Conclusion: the expression of PEG10 protein in placental tissues of patients with severe preeclampsia is significantly higher than that of normal pregnant women, suggesting that the increased expression of PEG10 in placental tissue may be related to the occurrence of severe preeclampsia, and PEG10 may affect the migration and infiltration of trophoblast, which may lead to placental superficial implantation. In severe preeclampsia, there was no significant difference in the expression of PEG10 in placenta tissues between early onset severe preeclampsia and late-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】：2014
【分类号】：R714.245

【参考文献】