妊娠期糖尿病孕妇胎盘组织中低氧诱导因子-1α与促红细胞生成素的表达及意义

发布时间：2018-10-29 16:19

【摘要】：目的研究低氧诱导因子-1α (HIF-1α)和促红细胞生成素(EPO)在妊娠期糖尿病(GDM)孕妇胎盘组织中的表达与孕妇血糖控制情况及胎儿体重参数的关系。方法在2012年9月至2013年10月期间,选取在青岛大学附属医院产科行择期剖宫产的64例GDM孕妇作为GDM组,包括血糖控制不满意者22例(A组),血糖控制满意者42例(B组)；同期选择糖耐量正常孕妇37例设为对照组(C组)。测量两组孕妇空腹血糖水平以及餐后血糖水平时,利用葡萄糖氧化酶法。在胎盘组织中检测HIF-I α及EPO蛋白的表达时,利用SP免疫组化方法,；利用半定量逆转录聚合酶链技术,即(RT-PCR)技术,来检测HIF-1α mRNA和EPOmRNA在胎盘中的表达。同时对GDM组孕妇胎盘组织中HIF-1α、EPO蛋白及mRNA表达和孕妇血糖控制水平的相关性进行分析。结果(1)HIF-1α和EPO在GDM胎盘组织中细胞滋养细胞,血管内皮细胞及绒毛间质细胞中呈现强表达(棕色染色),二者在对照组中表达位置相同但呈弱阳性。 (2) GDM组胎盘HIF-1α及EPO蛋白阳性表达率分别为85.9%(55/64)和89.1%(57/64),与对照组32.4%(12/37)和35.1%(13/37)比较差异具有统计学意义(P均0.05)。 (3) GDM组胎盘组织HIF-1α mRNA和EPOmRNA表达水平分别为(0.88±0.12)和(0.93±0.27),显著高于对照组的(0.47±0.11)和(0.43±0.14),两组比较,差异具有统计学意义(P均0.05)； (4)A、B、C组胎盘HIF-1α和EPO蛋白的阳性表达率分别为90.9%、73.8%、32.4%和100%、88.1%、35.1%,组间比较差异有统计学意义(P0.05)；A、B、C组胎盘HIF-1α mRNA和EPOmRNA表达水平分别为(0.9±0.13)、(0.7±0.12)、(0.47±0.11)和(0.96±0.23)、(0.75±0.27)、(0.43±0.14),组间比较差异有统计学意义(P0.05)。 (5)GDM巨大儿组新生儿出生体重与HIF-1α及EPO表达均呈正相关性(r=0.662、0.475,P均0.05)。结论GDM胎盘组织中存在HIF-1α和EPO基因的高表达,其表达水平与孕妇血糖控制状况和GDM巨大儿的发生相关,HIF-1α的高表达可能是EPO表达上调的机制之一。积极控制母体血糖有助于改善母婴结局。
[Abstract]:Objective to study the relationship between the expression of hypoxia inducible factor-1 伪 (HIF-1 伪) and erythropoietin (EPO) (EPO) in placenta of pregnant women with gestational diabetes mellitus (GDM) (GDM) and the control of maternal blood glucose and fetal weight parameters. Methods from September 2012 to October 2013, 64 pregnant women with GDM underwent elective cesarean section in Department of Obstetrics, Qingdao University Hospital as GDM group, including 22 patients with unsatisfactory blood glucose control (group A) and 42 patients with satisfactory blood glucose control (group B). At the same time, 37 pregnant women with normal glucose tolerance were selected as control group (group C). Fasting blood glucose level and postprandial blood glucose level were measured by glucose oxidase method. The expression of HIF-I 伪 and EPO protein in placenta was detected by SP immunohistochemical method, and the expression of HIF-1 伪 mRNA and EPOmRNA in placenta was detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). The correlation between the expression of HIF-1 伪, EPO protein and mRNA in placenta of pregnant women in GDM group and the control level of blood glucose in pregnant women was analyzed. Results (1) HIF-1 伪 and EPO were strongly expressed in trophoblast cells, vascular endothelial cells and villous stromal cells in placenta of GDM (brown staining). (2) the positive expression rates of HIF-1 伪 and EPO protein in placenta of GDM group were 85.9% (55 / 64) and 89.1% (57 / 64), respectively. The difference was statistically significant (P 0.05) compared with 32.4% (12 / 37) and 35.1% (13 / 37) of the control group. (3) the expression levels of HIF-1 伪 mRNA and EPOmRNA in placenta of GDM group were (0.88 卤0.12) and (0.93 卤0.27), significantly higher than those of control group (0.47 卤0.11) and (0.43 卤0.14), respectively. The difference was statistically significant (P 0.05). (4) the positive expression rates of HIF-1 伪 and EPO protein in placental placenta of group A and B C were 90.9% and 73.83.83.4%, respectively. The positive rate of HIF-1 伪 and EPO protein in group A were 32.4% and 88.01%, respectively. The difference between the two groups was statistically significant (P0.05). The expression levels of HIF-1 伪 mRNA and EPOmRNA were (0.9 卤0.13), (卤0.12), (0.47 卤0.11) and (0.96 卤0.23), (0.75 卤0.27), (0.43 卤0.14), respectively. The difference between groups was statistically significant (P0.05). (5) there was a positive correlation between birth weight and the expression of HIF-1 伪 and EPO in GDM macrosomia group. Conclusion there is high expression of HIF-1 伪 and EPO gene in placenta of GDM. The expression level of HIF-1 伪 is related to the blood glucose control status of pregnant women and the occurrence of GDM macrosomia. The high expression of HIF-1 伪 may be one of the mechanisms of up-regulation of EPO expression. Active control of maternal blood sugar helps improve maternal outcomes.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.256

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