脂氧素A4、肿瘤坏死因子及其比值与子痫前期发生发展的相关性研究

摘要

目的 探讨脂氧素A4(LXA4)、肿瘤坏死因子(TNF-α)在子痫前期(PE)中的表达及意义.方法 选取2016年2月至2017年2月在海南省人民医院分娩的PE产妇78例,其中轻度PE产妇45例,重度PE产妇33例,同时选取正常产妇50例作为对照组,采用ELISA法检测产妇血清LXA4、TNF-α表达,采用免疫组化法检测胎盘组织LXA4受体和TNF-α表达.结果 轻度PE组和重度PE组胎盘组织中LXA4受体蛋白阳性表达率为55.55%、60.61%,明显低于对照组(χ2值分别为19.077、14.246,均P<0.05),而TNF-α蛋白阳性表达率为80.00%和81.82%,明显高于对照组(χ2值分别为25.688、23.035,均P<0.05).轻度PE组血清LXA4为(176.55±43.21)ng/L,明显高于对照组和重度PE组(t值分别为12.163、10.476,均P<0.05);轻度PE组和重度PE组TNF-α分别为(18.03±1.43)ng/mL和(18.22±2.03)ng/mL,明显高于对照组(t值分别为48.500、37.304,均P<0.05);重度PE组LXA4/TNF-α为(5.02±1.10),明显低于对照组和轻度PE组(t值分别为25.271、16.106,均P<0.05);轻度PE组LXA4/TNF-α为(9.80±1.42),明显低于对照组(t=16.970,P<0.05).轻度PE组和重度PE组血清LXA4与TNF-α呈负相关(r值分别为-0.522、-0.413,均P<0.05);对照组和重度PE组胎盘组织LXA4受体和TNF-α表达呈负相关(rs值分别为-0.344、-0.321,均P<0.05);LXA4/TNF-α与PE患者病情呈负相关(rs=-0.412,P<0.05).结论 PE患者血清LXA4、TNF-α及胎盘组织LXA4受体、TNF-α表达异常,可能与疾病的发生发展有关,其中LXA4/TNF-α比值可一定程度反映患者病情程度.%Objective To investigate the expression and significance of lipoxin A4 (LXA4) and tumor necrosis factor (TNF-) in preeclampsia (PE).Methods Totally 78 cases of PE delivering in Hainan Provincial People''s Hospital during the period of February 2016 to February 2017 were selected, including 45 cases of mild PE (mild PE group) and 33 cases of severe PE (severe PE group).And 50 normal pregnant women were selected as control group.The expression of serum LXA4 and TNF-were detected by ELISA method, and immunohistochemistry was used to detect the placenta LXA4 receptor and TNF-expression.Results The positive expression rate of placenta LXA4 receptor in mild PE group and severe PE group was 55.55% and 60.61%, respectively, which was significantly lower than in the control group (χ2 value was 19.077 and 14.246,respectively, both P<0.05), while the positive expression rate of TNF-protein was 80.00% and 81.82%, respectively, which was significantly higher than in the control group (χ2 value was 25.688 and 23.035,respectively, both P<0.05).In mild PE group serum LXA4 was 176.55±43.21ng/L, which was significantly higher than in the control group and severe PE group (t value was 12.163 and 10.476,respectively, both P<0.05).In mild PE group and severe PE group TNF-was 18.03±1.43ng/mL and 18.22±2.03ng/mL, which was significantly higher than in the control group (t value was 48.500 and 37.304,respectively, both P<0.05).LXA4/TNF-in severe PE group was 5.02±1.10, and it was significantly lower than in the control group and mild PE group (t value was 25.271 and 16.106, respectively, both P<0.05), while that in mild PE group was 9.80±1.42 and it was significantly lower than in the control group (t=16.970,P<0.05).In mild PE group and severe PE group serum LXA4 and TNF-were negatively correlated (r value was-0.522 and-0.413, respectively, both P<0.05).Placenta LXA4 receptor was negatively correlated with TNF-in the control group and severe PE group (rs value was-0.344 and-0.321, respectively, both P<0.05).LXA4/TNF-a was negatively correlated with PE patient condition (rs=-0.412,P<0.05).Conclusion The expressions of serum LXA4 and TNF-and placenta LXA4 receptor and TNF-of PE patients are abnormal, and they may be related to the occurrence and development of disease, in which LXA4/TNF-can reflect the degree of disease to some extent.