子痫前期患者胎盘色素上皮衍生因子和血管内皮生长因子的表达

摘要

目的 探讨胎盘组织中色素上皮衍生因子(PEDF)和血管内皮生长因子(VEGF)的表达与子痫前期发病的关系.方法 选择2011年10月至2012年10月于南方医科大学南方医院住院分娩的子痫前期患者36例为研究对象,其中轻度子痫前期(MPE) 20例,重度子痫前期(SPE) 16例.同期分娩的健康孕妇30例作为对照组.用免疫荧光组织化学双重标记方法检测所有研究对象胎盘组织中PEDF、VEGF的表达,并计数胎盘微血管密度(MVD),进行相关性分析.结果 (1)子痫前期患者胎盘组织中PEDF阳性表达明显高于正常对照组(P＜0.05),SPE组PEDF阳性表达明显高于MPE组(P＜0.05).(2)与正常对照组相比,子痫前期患者胎盘组织中VEGF表达减少(P＜0.05),MPE与SPE组VEGF表达差异无统计学意义(P＞0.05).(3)正常对照组、MPE组、SPE组MVD依次递减(P＜0.05).(4)子痫前期组和正常对照组胎盘中PEDF表达与VEGF表达及MVD呈负相关(r=-0.272,P＜0.05;r=-0.418,P＜0.01),VEGF表达与MVD数值的变化则呈正相关(r=0.443,P＜0.05).结论 PEDF与VEGF在胎盘的滋养层细胞和血管内皮细胞中表达位置大体相同.子痫前期患者胎盘组织中PEDF表达升高,而VEGF表达及MVD下降,后两者均与PEDF表达呈负相关,可能与子痫前期的发病及病情严重程度相关.%Objective To investigate the relationship between the expression of pigment epithelium-derived factor (PEDF) and vascular endothelia-growth factor (VEGF) in the placenta tissue and preeclampsia disease.Methods A study was performed in 36 cases of pregnant women with preeclampsia in the obstetrical department of Nanfang Hospital between Octorber 2011 and October 2012,in which 20 cases were mild preeclampsia(MPE) and 16 cases were severe preeclampsia(SPE).30 normal pregnant women who also be hospitalized and delivered at the same time were selected as control group.The expression to PEDF,VEGF were assayed by using fluorescence immunohistochemical double labeling method in placentas of all the study objects,while the microvessel density was count by fluorescence immunohistochemistry,then their relationship were analyzed.Results (1) the positive expression of PEDF in preeclampsia group obviously increased (P ＜ 0.05),which was significantly higher in severe preeclampsia group than that in mild preeclampsia group (P ＜ 0.05).(2) compared to normal group,VEGF expression in preeclampsia group was significantly lower (P ＜0.05),but there was no difference between mild preeclampsia group and severe preeclampsia group (P ＞ 0.05).(3) The microvessel density (MVD) in the normal group,the mild preeclampsia group and the severe preeclampsia group were significantly reduced by turns (P ＜ 0.05).(4) The expression of PEDF was negatively correlated with the expression of VEGF and MVD in all of groups (r =-0.272,P ＜0.05 ;r =-0.418,P ＜0.01),and the expression of VEGF was positively correlated with the expression of MVD(r--0.443,P ＜ 0.05).Conclusion PEDF and VEGF were together expressed in the trophocyte and vascular endothelial cell of the placenta.The expression of PEDF in preeclampsia placenta was increased,while VEGF and MVD expression were reduced,both of which were negatively correlated with PEDF.It indicates that PEDF may be involved in the pathogenesis of preeclampsia,and affect the degree of disease condition.