TNF-α、Fas／FasL 在子痫前期胎盘中表达的研究

摘要

目的：通过联合检测正常晚期妊娠和子痫前期胎盘中TNF-α及Fas、FasL的表达，探讨子痫前期的相关病因及发病机制。方法选择剖宫产分娩的产妇80例，其中子痫前期轻度组28例，子痫前期重度组22例，正常妊娠（对照组）30例。调查3组孕产妇的孕周、新生儿体重以及胎盘重量等。胎盘娩出后30 min内取胎盘母体面中央绒毛组织固定、常规脱水石蜡包埋连续切片，常规行苏木素-伊红染色。利用免疫组化方法对切片组织行TNF-α及Fas、FasL特殊染色。结果轻度、重度子痫前期组与正常晚孕组孕妇孕周差异无统计学意义（ P ＞0．05）。随着子痫前期病情加重，新生儿体重和胎盘重量明显降低（ P ＜0．05）。子痫前期患者胎盘组织TNF-α的表达明显的高于对照组，差异有统计学意义（ P ＜0．05）。在胎盘滋养细胞和底蜕膜细胞中，轻、重度子痫前期组Fas的表达明显高于对照组（ P ＜0．05）。轻、重度子痫前期组胎盘滋养细胞、底蜕膜细胞上FasL着色较对照组组减弱（ P ＜0．01），并且随着子痫前期的病情加重，FasL表达水平逐渐减弱。结论胎盘中TNF-α及Fas/FasL表达异常在子痫前期的发病过程中扮演着重要的角色。%Objective To observe the expression of TNF-αand Fas/FasL in placenta of patients with pre-eclampsia and normal late pregnancy women ,and to explore related cause of disease and pathogenesis of pre -eclampsia.Methods Eighty puerperas who underwent cesarean section including 28 cases mild pre-eclampsia (mild pre-eclampsia group),22 cases of severe pre-eclampsia (severe pre-eclampsia group ),30 cases of normal pregnancy (control group ) were enrolled in the study.The gestational weeks,neonate’ s weight and placental weight were detected for three groups .The placenta specimens within 30min after placental expulsion were collected and fixed in 10% neutral formaldehyde for 24h for serial section,then stained with HE .The expression of TNF-α and Fas/FasL in placenta specimens was detected by immunohistochemistry .Results There were no significant differences in the gestational weeks among mild pre -eclampsia group,severe pre-eclampsia group,control group ( P >0.05).The neonate’s weight and placental weight were decreased with the aggravation of pathogeneticcondition of pre-eclampsia ( P <0.05).The expression levels of TNF-α in placenta tissue of patients with pre-eclampsia weresignificantly higher than those of control group ( P <0.05).The expression levels of Fas in placenta trophocyte and deciduasbasalis cells of patients with mild and severe pre -eclampsia were significantly higher than those in control group ( P <0.05).The coloring of FasL in placenta trophocyte and decidua basalis cells of patients with mild and severe pre -eclampsia wasattenuated,as compared with that in control group ( P <0.01),moreover,the expression levels of FasL were further decreasedwith the aggravation of pathogenetic condition of pre -eclampsia.Conclusion The abnormal expression of TNF-α and Fas/FasLin placenta may play an important role in the pathogenesis of pre -eclampsia.