NGAL在子痫前期患者血液、尿液及胎盘组织中的表达及临床意义
发布时间：2018-08-02 13:21
【摘要】：目的:妊娠期高血压疾病(hypertensive disorders complicating pregnancy,HDP)是妊娠期间伴随血压升高的一组疾病,包括妊娠期高血压、子痫前期、子痫以及慢性高血压并发子痫前期和慢性高血压合并妊娠。其发病机制到目前为止还不确定,普遍认为是由于多种因素和多种途径共同导致妊娠期高血压疾病的发生,而母体机体弥漫性血管内皮细胞的激活和(或)损伤是其发病的重要原因,但目前对内皮细胞激活和损伤的机制尚不清楚,如果能通过血管内皮细胞的损伤情况,来判断妊娠期高血压疾病发生和发展的程度,对临床上防治妊娠期高血压疾病是十分关键的。中性粒细胞明胶酶相关脂质运载蛋白(neutrophilgelatinase-associated lipoealin,NGAL)属于脂蛋白(lipoealin)家族的成员之一,它对多种细胞的增殖、生长和分化具有促进作用,可以降解组织中的胶原和蛋白成分,当机体的局部组织出现炎症或肿瘤时,NGAL的含量会明显增加,有研究表明NGAL是评价因炎症或肿瘤形成而导致内皮损伤严重程度的重要标志物。许多研究也显示NGAL是早期检测肾功能衰竭和急性炎症的重要指标,具有高度的敏感性和特异度;此外研究表明NGAL在高血压患者体内的含量比正常人体内的含量明显升高。但对于妊娠期高血压早发型和晚发型子痫前期患者的血液、尿液以及胎盘中NGAL蛋白量的表达情况如何,目前尚无研究。本研究通过检测妊娠期高血压早发型和晚发型子痫前期患者的血液和尿液中NGAL的含量,以及胎盘组织中NGAL的表达水平,并与同期正常对照组患者的血液、尿液以及胎盘组织中NGAL的表达水平相比较,探求NGAL在子痫前期的发生和发展中的作用,为进一步研究子痫前期发病机制提供基础的理论基础。方法:1标本的收集选取2013年12月-2014年11月在邯郸市第二医院产科检查并住院分娩的早发型子痫前期患者、晚发型子痫前期患者以及同期我院孕检的正常孕妇各20例。孕妇均为单胎妊娠,无不良孕产史,没有经过辅助生殖技术治疗,除外妊娠期糖尿病、妊娠合并其它合并症如糖尿病、高血压疾病、心脏病等。2 ELISA法检测孕产妇血液和尿液中NGAL的含量实验分六组:A组:早发型子痫前期组:年龄20-35岁,孕周20-34周(包括20周,不包括34周)。B组:晚发型子痫前期组:年龄20-35岁,孕周34-37周(包括34周,不包括37周)。C组:晚发型子痫前期组:年龄20-35岁,孕周37周以后(包括37周)。D组:34周正常孕妇组:年龄为20-29岁,孕周20-34周(包括20周,不包括34周)。E组:34-37周正常孕妇组:年龄21-30岁,孕周34-37周(包括34周,不包括37周)。F组:37周正常孕妇组:年龄20-36岁,孕周37-42周(包括37周,包括42周)。六组孕产妇均于入院后24小时内抽空腹肘静脉血3ml,晨尿液3ml,采用ELISA法检测孕产妇血液和尿液中NGAL的含量。3免疫组织化学法检测胎盘组织中NGAL的表达实验分三组:早发型子痫前期组:年龄20-35岁,孕周20-34周(包括20周,不包括34周)。晚发型子痫前期组:年龄20-35岁,孕周34周以后(包括34周)。正常孕妇组:年龄20-36岁,孕周37-42周(包括37周,包括42周)。三组孕产妇均于分娩后2分钟内取胎盘母面脐根部胎盘组织,大小为2.0cm×1.0cm×1.0cm。用生理盐水反复清洗3遍后,放入含有固定液的病理袋做好标记备用。以上均在无菌条件下操作。4应用SPSS 13.0软件进行统计学分析。组间比较采用χ2检验,P0.05有统计学差异。结果:1早发型子痫前期组、晚发型子痫前期组与同期正常对照组血液中NGAL蛋白量的检测A组血液中NGAL蛋白量为1.635±0.1004g/L,C组血液中NGAL蛋白量为0.723±0.1124g/L;两组血液中NGAL蛋白量比较有显著性差异(P0.01),B组血液中NGAL蛋白量为1.290±0.0845g/L,E组血液中NGAL蛋白量为0.725±0.0539g/L;两组血液中NGAL蛋白量比较有显著性差异(P0.01);C组血液中NGAL蛋白量为1.269±0.1173g/L,F组血液中NGAL蛋白量为:0.705±0.1094g/L;两组血液中NGAL蛋白量比较有显著性差异(P0.01);A组血液中NGAL蛋白量与B组、C组血液中NGAL蛋白量相比均有显著性差异(P0.05);但是B组、C组血液中NGAL蛋白量相比无明显差异(P0.05)。2早发型子痫前期组、晚发型子痫前期组与同期正常对照组尿液中NGAL蛋白量的检测A组尿液中NGAL蛋白量为0.470±0.069g/L,D组尿液中NGAL蛋白量为:0.141±0.024g/L;两组尿液中NGAL蛋白量比较有显著性差异(P0.01),B组尿液中NGAL蛋白量为0.258±0.042g/L,E组尿液中NGAL蛋白量为0.102±0.006g/L;两组尿液中NGAL蛋白量比较有显著性差异(P0.01);C组尿液中NGAL蛋白量为0.249±0.041g/L,F组尿液中NGAL蛋白量为0.116±0.020g/L;两组尿液中NGAL蛋白量比较有显著性差异(P0.01);A组尿液中NGAL蛋白量与B组、C组尿液中NGAL蛋白量相比均有显著性差异(P0.05);但是B组、C组尿液中NGAL蛋白量相比无明显差异(P0.05)。3早发型子痫前期组、晚发型子痫前期组与正常对照组胎盘组织中NGAL蛋白表达水平的检测。在胎盘组织的绒毛合体滋养细胞的胞质中可见NGAL蛋白的阳性表达,颜色为棕黄色。正常对照组、早发型子痫前期组和晚发型子痫前期组的胎盘组织中NGAL蛋白表达光密度值分别为:10.15±0.86g/L,50.90±7.60g/L和30.51±4.16g/L,早发型和晚发型子痫前期组胎盘组织中NGAL蛋白表达光密度值均比正常对照组胎盘组织中NGAL蛋白表达光密度值增高,其差异均有统计学意义(P0.01)。早发型子痫前期组胎盘组织中NGAL蛋白表达光密度值比晚发型子痫前期组胎盘组织中NGAL蛋白表达光密度值增加,其差异有统计学意义(P0.05)。结论:1早发型和晚发型子痫前期组患者比同期正常对照组血液和尿液中NGAL蛋白含量均增多,并且早发型NGAL蛋白含量增多显著。2早发型和晚发型子痫前期组患者比正常对照组胎盘组织中NGAL蛋白表达水平均升高,并且早发型NGAL蛋白表达水平升高显著。
[Abstract]:Objective: hypertensive disorders complicating pregnancy (HDP) is a group of diseases associated with elevated blood pressure during pregnancy, including pregnancy induced hypertension, preeclampsia, eclampsia, and chronic hypertension combined with preeclampsia and chronic hypertension. The pathogenesis is so far uncertain and is generally recognized. The pathogenesis of pregnancy induced hypertension is caused by a variety of factors and ways, and the activation and / or damage of the mother body diffuse vascular endothelial cells are important reasons. However, the mechanism of the activation and injury of endothelial cells is not clear. The occurrence and development of hypertensive disorders in pregnancy are crucial to the prevention and treatment of hypertensive disorders in pregnancy. The neutrophil gelatinase related lipid carrier protein (neutrophilgelatinase-associated lipoealin, NGAL) is one of the members of the lipoprotein (lipoealin) family. It is the proliferation, growth and differentiation of many cells. NGAL is an important marker for the severity of endothelial damage caused by inflammation or tumor formation. Many studies also suggest that NGAL is an early detection of renal failure. An important index of exhaustion and acute inflammation has a high sensitivity and specificity; in addition, studies have shown that the content of NGAL in hypertensive patients is significantly higher than that in normal human body. But how is the expression of NGAL protein in the blood, urine and placenta of patients with premature and late onset preeclampsia in pregnancy. In this study, the content of NGAL in the blood and urine of patients with early onset hypertension and late onset preeclampsia, and the expression of NGAL in the placental tissue were detected and compared with the levels of NGAL expression in the blood, urine and placenta tissue of the normal control group, and NGAL was explored in preeclampsia. The role of development and development provides a basis for further research on the pathogenesis of preeclampsia. Methods: 1 specimens were collected to select early onset preeclampsia, preeclampsia, late onset preeclampsia and normal pregnancy in the second hospital, Handan, December 2013, -2014, December 2013. There were 20 pregnant women. Pregnant women were single pregnancy, no bad pregnancy history, no assisted reproductive technology, except for gestational diabetes, pregnancy combined with other complications such as diabetes, hypertension, heart disease and other.2 ELISA tests of pregnant and lying in the blood and urine of NGAL in six groups: group A: early onset preeclampsia group: age 2 0-35 years of age (including 20 weeks, excluding 34 weeks) group.B: late onset preeclampsia group: age 20-35, 34-37 weeks of pregnancy (including 34 weeks, not including 37 weeks) group.C: late onset preeclampsia group: age 20-35, and 37 weeks of pregnancy (including 37 weeks).D: 34 Zhou Zhengchang group: age 20-29, week of pregnancy (including weeks, not included) Group.E: 34-37 Zhou Zhengchang pregnant women group: age 21-30, 34-37 weeks of pregnancy (including 34 weeks, not including 37 weeks) group.F: 37 weeks of normal pregnant women group: age 20-36, pregnancy week 37-42 weeks (including 37 weeks, including 42 weeks). The six groups of pregnant and lying in and lying in the hospital within 24 hours after admission to the empty belly of elbow vein blood 3ml, morning urine 3ml, use ELISA method to detect pregnant and lying in the blood and urine of pregnant and lying in lying in lying in lying in lying in lying in women NGAL content.3 immunohistochemical assay was used to detect the expression of NGAL in placenta tissue in three groups: early onset preeclampsia group: age 20-35, 20-34 weeks of pregnancy (including 20 weeks, not 34 weeks). Late onset preeclampsia group: age 20-35, 34 weeks after pregnancy (including 34 weeks). Normal pregnant women: 20-36 years of age, and 37-42 weeks of pregnancy (including 37 weeks,) The placental tissue of the placental maternal umbilical cord root was taken within 2 minutes after delivery, and the size of the three groups was 2.0cm x 1.0cm x 1.0cm. with physiological saline for 3 times, and then put into the pathological bag containing the fixed liquid to mark the spare. All of these were performed by SPSS 13 software with.4 under aseptic conditions. Using the chi 2 test, there were statistical differences in P0.05. Results: 1 early onset preeclampsia group, late onset preeclampsia group and normal control group, the blood NGAL protein content in the A group was 1.635 + 0.1004g/L, and the amount of NGAL protein in the C group was 0.723 + 0.1124g/L, and the amount of NGAL protein in the two groups was significantly different (P0.01). The amount of NGAL protein in the blood of group B was 1.290 + 0.0845g/L, and the amount of NGAL protein in the blood of group E was 0.725 + 0.0539g/L, and the amount of NGAL protein in the blood of the two groups was significantly different (P0.01); the amount of NGAL protein in the C group was 1.269 + 0.1173g/L, and the amount of the protein in the blood of the F group was 0.705 +. The two groups had a significant difference in the amount of protein in the blood group. (P0.01): the amount of NGAL protein in blood of group A was significantly different from group B and NGAL protein in group C (P0.05), but there was no significant difference in the amount of NGAL protein in group B and C group (P0.05) in the early preeclampsia group of.2, and in the urine of the late onset preeclampsia group and the normal control group. The amount of NGAL protein in the urine of group D was 0.470 + 0.024g/L, and the amount of NGAL protein in the urine of the two groups was significantly different (P0.01), the amount of NGAL protein in the urine of the B group was 0.258 + 0.042g/L, and the NGAL protein in the urine of the E group was 0.102 + 0.006g/L. The two groups had a significant difference in the amount of protein in urine. The white amount was 0.249 + 0.041g/L, and the amount of NGAL protein in urine of group F was 0.116 + 0.020g/L, and there was a significant difference in the amount of NGAL protein in the urine of the two groups (P0.01). The amount of NGAL protein in the urine of the A group was significantly different from the B group and the NGAL protein in the urine of the C group (P0.05). The expression of NGAL protein in placental tissues of preeclampsia group, late onset preeclampsia group and normal control group. The positive expression of NGAL protein in the cytoplasm of villous chimeric trophoblast in placental tissue was found in brown yellow. Normal control group, N in early onset preeclampsia group and late onset preeclampsia group The light density values of GAL protein expression were 10.15 + 0.86g/L, 50.90 + 7.60g/L and 30.51 + 4.16g/L respectively. The density values of NGAL protein expression in placental tissues of early onset and late onset preeclampsia were all higher than those of normal controls (P0.01). The difference was statistically significant (P0.01). The light density value of the expression of NGAL protein in the disc tissue was higher than that in the placental tissue of the late preeclampsia group. The difference was statistically significant (P0.05). Conclusion: the levels of NGAL protein in the blood and urine of the 1 early onset and late preeclampsia group were higher than those in the normal control group, and the early onset NGAL protein was contained. The level of NGAL protein expression in the placental tissues of the early onset and late onset preeclampsia group increased significantly in.2 early onset and late onset preeclampsia, and the expression level of early onset NGAL protein increased significantly.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R714.244
本文编号：2159567
[Abstract]:Objective: hypertensive disorders complicating pregnancy (HDP) is a group of diseases associated with elevated blood pressure during pregnancy, including pregnancy induced hypertension, preeclampsia, eclampsia, and chronic hypertension combined with preeclampsia and chronic hypertension. The pathogenesis is so far uncertain and is generally recognized. The pathogenesis of pregnancy induced hypertension is caused by a variety of factors and ways, and the activation and / or damage of the mother body diffuse vascular endothelial cells are important reasons. However, the mechanism of the activation and injury of endothelial cells is not clear. The occurrence and development of hypertensive disorders in pregnancy are crucial to the prevention and treatment of hypertensive disorders in pregnancy. The neutrophil gelatinase related lipid carrier protein (neutrophilgelatinase-associated lipoealin, NGAL) is one of the members of the lipoprotein (lipoealin) family. It is the proliferation, growth and differentiation of many cells. NGAL is an important marker for the severity of endothelial damage caused by inflammation or tumor formation. Many studies also suggest that NGAL is an early detection of renal failure. An important index of exhaustion and acute inflammation has a high sensitivity and specificity; in addition, studies have shown that the content of NGAL in hypertensive patients is significantly higher than that in normal human body. But how is the expression of NGAL protein in the blood, urine and placenta of patients with premature and late onset preeclampsia in pregnancy. In this study, the content of NGAL in the blood and urine of patients with early onset hypertension and late onset preeclampsia, and the expression of NGAL in the placental tissue were detected and compared with the levels of NGAL expression in the blood, urine and placenta tissue of the normal control group, and NGAL was explored in preeclampsia. The role of development and development provides a basis for further research on the pathogenesis of preeclampsia. Methods: 1 specimens were collected to select early onset preeclampsia, preeclampsia, late onset preeclampsia and normal pregnancy in the second hospital, Handan, December 2013, -2014, December 2013. There were 20 pregnant women. Pregnant women were single pregnancy, no bad pregnancy history, no assisted reproductive technology, except for gestational diabetes, pregnancy combined with other complications such as diabetes, hypertension, heart disease and other.2 ELISA tests of pregnant and lying in the blood and urine of NGAL in six groups: group A: early onset preeclampsia group: age 2 0-35 years of age (including 20 weeks, excluding 34 weeks) group.B: late onset preeclampsia group: age 20-35, 34-37 weeks of pregnancy (including 34 weeks, not including 37 weeks) group.C: late onset preeclampsia group: age 20-35, and 37 weeks of pregnancy (including 37 weeks).D: 34 Zhou Zhengchang group: age 20-29, week of pregnancy (including weeks, not included) Group.E: 34-37 Zhou Zhengchang pregnant women group: age 21-30, 34-37 weeks of pregnancy (including 34 weeks, not including 37 weeks) group.F: 37 weeks of normal pregnant women group: age 20-36, pregnancy week 37-42 weeks (including 37 weeks, including 42 weeks). The six groups of pregnant and lying in and lying in the hospital within 24 hours after admission to the empty belly of elbow vein blood 3ml, morning urine 3ml, use ELISA method to detect pregnant and lying in the blood and urine of pregnant and lying in lying in lying in lying in lying in lying in women NGAL content.3 immunohistochemical assay was used to detect the expression of NGAL in placenta tissue in three groups: early onset preeclampsia group: age 20-35, 20-34 weeks of pregnancy (including 20 weeks, not 34 weeks). Late onset preeclampsia group: age 20-35, 34 weeks after pregnancy (including 34 weeks). Normal pregnant women: 20-36 years of age, and 37-42 weeks of pregnancy (including 37 weeks,) The placental tissue of the placental maternal umbilical cord root was taken within 2 minutes after delivery, and the size of the three groups was 2.0cm x 1.0cm x 1.0cm. with physiological saline for 3 times, and then put into the pathological bag containing the fixed liquid to mark the spare. All of these were performed by SPSS 13 software with.4 under aseptic conditions. Using the chi 2 test, there were statistical differences in P0.05. Results: 1 early onset preeclampsia group, late onset preeclampsia group and normal control group, the blood NGAL protein content in the A group was 1.635 + 0.1004g/L, and the amount of NGAL protein in the C group was 0.723 + 0.1124g/L, and the amount of NGAL protein in the two groups was significantly different (P0.01). The amount of NGAL protein in the blood of group B was 1.290 + 0.0845g/L, and the amount of NGAL protein in the blood of group E was 0.725 + 0.0539g/L, and the amount of NGAL protein in the blood of the two groups was significantly different (P0.01); the amount of NGAL protein in the C group was 1.269 + 0.1173g/L, and the amount of the protein in the blood of the F group was 0.705 +. The two groups had a significant difference in the amount of protein in the blood group. (P0.01): the amount of NGAL protein in blood of group A was significantly different from group B and NGAL protein in group C (P0.05), but there was no significant difference in the amount of NGAL protein in group B and C group (P0.05) in the early preeclampsia group of.2, and in the urine of the late onset preeclampsia group and the normal control group. The amount of NGAL protein in the urine of group D was 0.470 + 0.024g/L, and the amount of NGAL protein in the urine of the two groups was significantly different (P0.01), the amount of NGAL protein in the urine of the B group was 0.258 + 0.042g/L, and the NGAL protein in the urine of the E group was 0.102 + 0.006g/L. The two groups had a significant difference in the amount of protein in urine. The white amount was 0.249 + 0.041g/L, and the amount of NGAL protein in urine of group F was 0.116 + 0.020g/L, and there was a significant difference in the amount of NGAL protein in the urine of the two groups (P0.01). The amount of NGAL protein in the urine of the A group was significantly different from the B group and the NGAL protein in the urine of the C group (P0.05). The expression of NGAL protein in placental tissues of preeclampsia group, late onset preeclampsia group and normal control group. The positive expression of NGAL protein in the cytoplasm of villous chimeric trophoblast in placental tissue was found in brown yellow. Normal control group, N in early onset preeclampsia group and late onset preeclampsia group The light density values of GAL protein expression were 10.15 + 0.86g/L, 50.90 + 7.60g/L and 30.51 + 4.16g/L respectively. The density values of NGAL protein expression in placental tissues of early onset and late onset preeclampsia were all higher than those of normal controls (P0.01). The difference was statistically significant (P0.01). The light density value of the expression of NGAL protein in the disc tissue was higher than that in the placental tissue of the late preeclampsia group. The difference was statistically significant (P0.05). Conclusion: the levels of NGAL protein in the blood and urine of the 1 early onset and late preeclampsia group were higher than those in the normal control group, and the early onset NGAL protein was contained. The level of NGAL protein expression in the placental tissues of the early onset and late onset preeclampsia group increased significantly in.2 early onset and late onset preeclampsia, and the expression level of early onset NGAL protein increased significantly.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R714.244
【引证文献】
相关硕士学位论文 前1条
1 戚洁;中性粒细胞明胶酶相关载脂蛋白（NGAL）与子痫前期的关系[D];吉林大学;2016年
，本文编号：2159567
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