妊娠期糖尿病孕妇胎盘母体面与胎儿面中炎性因子和脂肪因子水平的变化及其临床意义

发布时间：2019-06-03 08:14

【摘要】：目的： 通过检测正常葡萄糖耐量妊娠孕妇、葡萄糖耐量受损孕妇及妊娠期糖尿病孕妇胎盘母体面与胎儿面中炎性因子（肿瘤坏死因子-α和白细胞介素-6）和脂肪因子（瘦素和脂联素）蛋白阳性表达强度及蛋白含量水平的变化，探讨炎性因子和脂肪因子在妊娠期糖尿病的发病中所起的重要作用及其临床意义。 方法： 收集我院2013年6月至2014年8月生产的孕妇100例，分为正常葡萄糖耐量妊娠组（A组）24例、GDM饮食可控制组（B组）31例及GDM胰岛素控制组（C组）45例。三组孕妇均于分娩后立即采集胎盘的胎儿面和母体面，一部分冻存，一部分固定于4%多聚甲醛液中。采用免疫组织化学方法检测三组胎盘胎儿面和母体面中肿瘤坏死因子-α（TNF-α）、白细胞介素-6(IL-6)、瘦素和脂联素的蛋白阳性表达强度。采用酶联免疫法（ELISA法）检测三组胎盘胎儿面和母体面中肿瘤坏死因子-α（TNF-α）、白细胞介素-6(IL-6)、瘦素和脂联素蛋白含量的水平。 结果： 1.各组胎盘炎性因子（TNF-α和IL-6）蛋白阳性强度表达的比较 与A组比较，，B组、C组胎儿面和母体面胎盘中TNF-α、IL-6蛋白阳性强度表达均升高且GDM组高于IGT组，差异有显著性（P0.01）；两组的母体面TNF-α、IL-6表达均显著高于胎儿面有统计学意义（P0.01）。 2.各组胎盘脂肪因子（瘦素和脂联素）蛋白阳性强度表达的比较与A组比较，B组、C组胎儿面和母体面胎盘中瘦素蛋白阳性强度表达均升高且C组高于B组，脂联素蛋白阳性表达水平均降低且C组低于B组，差异显著有统计学意义（P0.01）；两组的母体面瘦素的表达均显著高于胎儿面（P0.01），母体面脂联素的表达低于胎儿面有统计学意义（P0.05）。 3.各组胎盘炎性因子（TNF-α和IL-6）蛋白含量的结果 与A组比较，B组、C组胎儿面和母体面胎盘中TNF-α、IL-6蛋白含量均升高且C组高于B组，差异显著有统计学意义（P0.01）；两组的母体面TNF-α、IL-6的表达均显著高于胎儿面有统计学意义（P0.01）。 4.各组胎盘脂肪因子（瘦素和脂联素）蛋白含量的结果 与A组比较，B组、C组胎儿面和母体面胎盘中瘦素蛋白含量均升高且C组高于B组，脂联素蛋白含量均降低且C组低于B组，差异显著有统计学意义（P0.01）；两组的母体面瘦素的表达均显著高于胎儿面（P0.01），母体面脂联素的表达低于胎儿面有统计学意义（P0.05）。 结论： 1.妊娠期糖尿病可上调胎盘组织中TNF-α、IL-6、瘦素的表达及下调脂联素的表达，且两组的母体面TNF-α、IL-6、瘦素的表达均显著高于胎儿面，脂联素的表达低于胎儿面。 2. TNF-α、IL-6、瘦素的上调及脂联素的下调表达，可能参与了GDM的发生、发展过程，在GDM的发病中起重要作用。
[Abstract]:Objective: to detect normal glucose tolerant pregnant women. The positive expression of placental maternal decent and fetal inflammatory factors (tumor necrosis factor-伪 and IL-6) and adiponectin (leptin and adiponectin) in pregnant women with impaired glucose tolerance and gestational diabetes mellitus Changes in degree and protein content, To investigate the important role and clinical significance of inflammatory factors and fat factors in the pathogenesis of gestational diabetes mellitus (GDM). Methods: from June 2013 to August 2014, 100 pregnant women were divided into normal glucose tolerance pregnancy group (group A, n = 24), GDM diet controllable group (group B, n = 31) and GDM insulin control group (group C, n = 45). The fetal and maternal faces of placenta were collected immediately after delivery, some of which were frozen and some were fixed in 4% polyformaldehyde solution. The positive expression of tumor necrosis factor-伪 (TNF- 伪), IL-6 (IL-6), leptin and adiponectin in fetal and maternal surfaces of placenta was detected by immunohistochemistry. The levels of TNF- 伪, IL-6, leptin and adiponectin in fetal and maternal surfaces of placenta were measured by enzyme-linked immunosorbent assay (ELISA). Result: 1. The positive expression of placental inflammatory factor (TNF- 伪 and IL-6) protein in each group was compared with that in group A, group B, group C and group C, TNF- 伪 in fetal face and maternal placenta. The positive expression of IL-6 protein in GDM group was significantly higher than that in IGT group (P 0.01). The expression of maternal decent TNF- 伪 and IL-6 in both groups was significantly higher than that in fetal surface (P 0.01). two銆

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