Objective To observe the expression changes of high mobility group box 1 (HMGB1)and receptor for ad-vanced g1ycation end products (RAGE)in the placenta,maternal serum and cord serum in patients with early-onset severe preeclampsia (PE)and HELLP syndrome,and to analyze the correlation of HMGB1 and RAGE with the pathogenesis of ear-ly-onset severe PE and HELLP syndrome.Methods Thirty patients with early-onset severe preeclampsia (early-onset severe PE group),12 patients with HELLP syndrome (HELLP group)and 30 healthy pregnant women (control group)were recrui-ted in the study.Immunohistochemistry and Western blotting were used to investigate the locations and expression of HMGB1 and RAGE protein in the placentas.Real-time PCR was used to investigate the expression of HMGB1 and RAGE mRNA in the placentas.ELISA was further used to detect the levels of HMGB1 and RAGE protein in maternal and cord serums of the three groups.Results A low level of positive immunostaining for HMGB1 was observed in syncytiotrophoblast cells in pla-centas of control group,the level was significantly increased in syncytiotrophoblast and vascular endothelial cells in placentas of early-onset severe PE group,besides,in the placentas of HELLP group,positive HMGB1 cells were mainly syncytiotropho-blast,macrophage and vascular endothelial cells.A small amount of positive immunostaining for RAGE was observed in syn-cytiotrophoblast and vascular endothelial cells in placentas of the control group,the distribution of positive cells in placentas of the early-onset severe PE group was consistent with that of the control group,what's more,in the placentas of HELLP group,the positive RAGE cells were mainly syncytiotrophoblast and macrophage cells (immunoreactive cells and the expres-sion intensity were significantly higher than those in the early-onset of severe PE group).Compared with the control group, the protein and mRNA levels of HMGB1 and RAGE were increased in the placentas of early-onset PE and HELLP groups, furthermore,the levels of them in HELLP group were even higher than those in the early-onset severe PE group (all P <0.05).In addition,the levels of HMGB1 and RAGE in the maternal serum of early-onset severe PE and HELLP groups were higher than those of the control group,besides,the levels of them in the HELLP group were even higher than those in the ear-ly-onset severe PE group (all P <0.05).However,there were no statistically significant differences in the levels of HMGB1 and RAGE in the cord serum among the three groups (all P >0.05).Conclusion The levels of HMGB1 and RAGE protein increase significantly in the maternal and cord serums of patients with early-onset severe PE and HELLP syndrome,both of which may participate the occurrence and development of early-onset severe PE and HELLP syndrome.%目的：观察早发重度子痫前期（PE）及 HELLP 综合征患者胎盘组织、母血、脐血中高迁移率族蛋白1（HMGB1）和晚期糖基化终末产物受体（RAGE）的表达变化，探讨其与早发重度 PE 及 HELLP 综合征发病的关系。方法30例早发重度 PE 患者（早发重度 PE 组）、12例 HELLP 综合征患者（HELLP 组）、30例正常孕妇（对照组），分别采用免疫组化法、Western blotting 法对三组胎盘组织中的 HMGB1蛋白和 RAGE 蛋白进行定位及定量检测，采用实时定量 PCR 法对三组胎盘组织中 HMGB1 mRNA 和 RAGE mRNA 进行检测，采用 ELISA 对三组母血、脐血中的HMGB1蛋白和 RAGE 蛋白进行检测。结果对照组胎盘组织中仅有极少量 HMGB1阳性合体滋养细胞，早发重度PE 组 HMGB1阳性细胞主要为合体滋养细胞和血管内皮细胞且阳性细胞数量明显增多，HELLP 组 HMGB1阳性细胞主要为合体滋养细胞、单核巨噬细胞、血管内皮细胞；对照组胎盘组织可见少量 RAGE 阳性合体滋养细胞、血管内皮细胞，早发重度 PE 组 RAGE 阳性细胞分布与对照组一致，HELLP 组 RAGE 阳性细胞主要为合体滋养细胞、单核巨噬细胞（阳性细胞数量和表达强度均明显高于早发重度 PE 组）。早发重度 PE 组和 HELLP 组胎盘组织中HMGB1、RAGE 的蛋白及 mRNA 表达明显高于对照组（P 均＜0．05），且 HELLP 组高于早发重度 PE 组（P 均＜0．05）。早发重度 PE 组和 HELLP 组母血 HMGB1、RAGE 蛋白水平明显高于对照组（P 均＜0．05），且 HELLP 组高于早发重度 PE 组（P 均＜0．05）。三组脐血 HMGB1、RAGE 蛋白水平相比，P 均＞0．05。结论 HMGB1、RAGE 在早发重度 PE 及 HELLP 综合征患者胎盘组织及母血中的表达明显升高，二者可能共同参与了早发重度 PE 及HELLP 综合征的发生发展过程。
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