脂氧素A4、肿瘤坏死因子α与子痫前期的关系研究

发布时间：2018-12-14 08:48

【摘要】：目的:探讨脂氧素A4(LXA4)、肿瘤坏死因子α(TNFα)及LXA4/TNFα比值与子痫前期(PE)发生发展的关系。方法:准备在天津医科大学第二医院产科分娩的健康孕妇200例,于妊娠10~12周、16~20周及32~36周采集孕妇血清检测LXA4、TNFα水平及LXA4/TNFα比值,跟踪产检及妊娠结局。选取最终有完整产检资料及妊娠结局患者195例,分为发生PE 23例(研究组),未发生PE 172例(对照组),进一步将两组中在我院行剖宫产分娩的患者分为PE组17例及PE对照组20例,剖宫产后取胎盘组织,采用实时荧光定量聚合酶链反应法检测各组胎盘中TNFαmRNA及LXA4受体(FPR2/ALX)mRNA的表达,ELISA方法测定孕妇剖宫产前及新生儿脐血LXA4、TNFα及LXA4/TNFα比值水平。对胎盘组织中TNFαmRNA及FPR2/ALX mRNA的表达与血清中TNFα及LXA4水平进行相关性分析。结果:研究组、对照组孕妇血清LXA4及TNFα水平均随着妊娠进展呈上升趋势(P0.05),研究组妊娠中、晚期LXA4及TNFα水平明显高于对照组(P0.05);研究组妊娠中、晚期LXA4/TNFα比值明显低于对照组,且随着孕周的增加比值明显下降(P0.05)。妊娠中期LXA4≥2.8 ng/ml、TNFα≥3.7 ng/ml,LXA4/TNFα≤0.7时预测PE的约登指数分别为0.76、0.72、0.81。PE组胎盘组织中TNFαmRNA、FPR2/ALXmRNA的表达及新生儿脐血TNFα水平明显升高;孕妇外周血TNFα、LXA4水平与胎盘TNFαmRNA、FPR2/ALXmRNA表达水平均呈正相关。结论:PE患者体内存在LXA4及其受体的相对缺乏,LXA4/TNFα比值降低可预测PE发生发展。推测适当激活胎盘中更多的LXA4受体或外源性补充LXA4可能是治疗PE的新途径。
[Abstract]:Objective: to investigate the relationship between the ratio of lipoxygenin A 4 (LXA4), tumor necrosis factor 伪 (TNF 伪) and LXA4/TNF 伪 and the occurrence and development of (PE) in preeclampsia. Methods: a total of 200 healthy pregnant women were enrolled in the second Hospital of Tianjin Medical University. The serum levels of LXA4,TNF 伪 and LXA4/TNF 伪 were measured at 10 ~ 12 weeks, 16 ~ 20 weeks and 32 ~ 36 weeks of pregnancy. One hundred and fifty-five patients with complete prenatal examination and pregnancy outcome were divided into two groups: 23 cases of PE (study group) and 172 cases of no PE (control group). The two groups were divided into PE group (n = 17) and PE control group (n = 20). The expression of TNF 伪 mRNA and LXA4 receptor (FPR2/ALX) mRNA in placenta was detected by real-time fluorescence quantitative polymerase chain reaction. The ratio of LXA4,TNF 伪 and LXA4/TNF 伪 in umbilical cord blood of pregnant women and newborns before cesarean section was measured by ELISA method. The correlation between the expression of TNF 伪 mRNA and FPR2/ALX mRNA in placenta and the levels of TNF 伪 and LXA4 in serum was analyzed. Results: in the study group, the serum LXA4 and TNF 伪 levels of pregnant women in the control group showed an upward trend with the progress of pregnancy (P0.05). The levels of LXA4 and TNF 伪 in the late pregnancy in the study group were significantly higher than those in the control group (P0.05). In the study group, the ratio of LXA4/TNF 伪 in late pregnancy was significantly lower than that in control group, and decreased with the increase of gestational week (P0.05). When LXA4 鈮，

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