肝素治疗对重度子痫前期孕妇胎盘中肿瘤坏死因子-α和白细胞介素6含量的影响

摘要

目的 观察小剂量肝素对重度子痫前期孕妇胎盘中肿瘤坏死因子-α(TNF-α)和白细胞介素6(IL-6)的阳性细胞数的影响,探讨肝素治疗重度子痫前期的杭感染机制.方法 重度子痫前期孕妇179例分为治疗组94例和治疗对照组85例,治疗组连续7d每日静脉滴注250 g·L-1硫酸镁60 mL+肝素25 mg,治疗对照组连续7d每日静脉滴注250g·L-1硫酸镁60 mL,另选择同期正常晚期妊娠孕妇90例作为正常对照组.胎盘正常娩出后,采用免疫组织化学法检测各组孕妇胎盘中TNF-α、IL-6的阳性细胞数.结果 正常对照组、治疗组、治疗对照组胎盘中TNF-α阳性细胞数分别为(1.9±0.6)、(18.0±3.2)、(27.1±6.3)mm-2,正常对照组、治疗组、治疗对照组胎盘中IL-6阳性细胞数分别为(1.0±0.5)、(16.4±3.7)、(27.6±5.4) mm-2.治疗组、治疗对照组胎盘中TNF-α阳性细胞数、IL-6阳性细胞数与正常对照组比较明显升高,差异有统计学意义(P＜0.01)；而治疗组胎盘中TNF-α阳性细胞数、IL-6阳性细胞数明显低于治疗对照组,差异有统计学意义(P＜0.01).结论 TNF-α、IL-6介导的炎症反应在重度子痫前期的发病中起一定作用,肝素可通过抗感染机制降低重度子痫前期孕妇胎盘中炎性细胞因子的表达.%Objective To explore the mechanism of heparin on severe pre-eclampsia by observing the effect of low-dose heparin on the positive cell counts of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) of placenta in pregnant women with severe pre-eclampsia. Methods One hundred and seventy-nine pregnant women with severe pre-eclampsia were divided into treatment group (n = 94) and treatment control group (re =85). The patients in treatment group were treated with 60 mL MgSO4(250 g ·L-1) and 25 mg heparin everyday for seven days,while the patients in treatment control group were treated with 60 mL MgSO4(250 g·L-1) everyday for seven days. Ninety normal late pregnancy pregnant women in the same period were chosed as normal control group. After normal expulsion of placenta, the positive cells of TNF-α and IL-6 in placenta were detected by immunohistochemical method. Results The number of positive cell of TNF-α in normal control group, treatment group and treatment control group was 1.9 ±0.6,18.0 ±3.2 and 27.1 ±6.3 per quadratmillimeter,respectively,and the number of positive cell of IL-6 was 1.0 ±0.5,16.4 ±3.7 and 27.6 ±5.4 per quadratmillimeter, respectively. The number of positive cell of TNF-α and IL-6 in treatment group and treatment control group was significantly higher than that in normal control group( P <0.01) ,and the number of positive cell of TNF-α and IL-6 in treatment group was significantly lower than that in treatment control group( P < 0.01). Conclusion TNF-α and IL-6 mediated inflammation may play a role in the incidence of severe pre-eclarapsia. Heparin can reduce the expression of inflammatory cytokines by anti-inflammatory mechanism.