本文選題：妊娠 + 重度��； 參考：《河北醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:子癇前期(Preeclampsia,PE)是一種妊娠期所特有的嚴(yán)重的全身性疾病,在妊娠前血壓正常,妊娠20周后出現(xiàn)全身小動(dòng)脈痙攣,病情進(jìn)一步加重可發(fā)展為子癇,進(jìn)一步導(dǎo)致多臟器的功能衰竭,嚴(yán)重威脅母嬰的安全,是我國孕產(chǎn)婦和圍產(chǎn)兒死亡的重要病因之一[1,2]。目前,子癇前期并沒有一元論的病因和發(fā)病機(jī)制,根據(jù)不斷的研究總結(jié)出了子癇前期的發(fā)病機(jī)制與滋養(yǎng)細(xì)胞侵襲能力異常、氧化應(yīng)激和抗血管生成反應(yīng)變化等關(guān)系密切,其中以滋養(yǎng)細(xì)胞侵襲能力異常備受矚目及認(rèn)可。KLF-8是人們新近研究發(fā)現(xiàn)的可以影響滋養(yǎng)細(xì)胞侵襲能力進(jìn)而引發(fā)子癇前期發(fā)生的一個(gè)轉(zhuǎn)錄因子,本文通過檢測早發(fā)型和晚發(fā)型重度子癇前期孕婦與健康孕婦的胎盤組織中KLF-8的變化,探討KLF-8與子癇前期發(fā)病的關(guān)系。方法:1研究對(duì)象選取2015年9月至2016年03月在武安市第一人民醫(yī)院以剖宮產(chǎn)術(shù)分娩的重度子癇前期孕婦40例,其中早發(fā)型重度子癇前期孕婦20例(發(fā)病孕周34周),晚發(fā)型重度子癇前期孕婦20例(發(fā)病孕周≥34周),對(duì)照組選擇行擇期剖宮產(chǎn)術(shù)分娩的同期孕足月健康孕婦20例。所有研究對(duì)象均選擇頭胎、單胎、胎兒無畸形而且孕婦既往均無高血壓、心臟病、糖尿病、腎臟病及甲狀腺功能亢進(jìn)、貧血及自身免疫性疾病等病史,無吸煙及嗜酒史,無長期服用藥物史。入院時(shí)查肝腎功能及凝血功能正常,詳細(xì)記錄患者的年齡、月經(jīng)史、生育史及家族史等資料。三組孕婦的例數(shù)、年齡、孕產(chǎn)次、吸煙及嗜酒比較,均無統(tǒng)計(jì)學(xué)差異(P0.05)。2標(biāo)本采集所有研究對(duì)象均在本人簽署知情同意書后進(jìn)行標(biāo)本采集,胎盤組織娩出20min內(nèi)采取除外肉眼所見的病變區(qū)面積約1cm×1cm×1cm的3塊母體面胎盤組織,用磷酸鹽緩沖液(PBS)反復(fù)漂洗,一塊用4%多聚甲醛中固定,另外2塊放入液態(tài)氮中存于滅菌滅酶凍存管中后都放入-80℃冰箱中凍存待后測定。胎盤組織的KLF-8蛋白表達(dá)部位選用免疫組化SP法檢測,klf-8mrna的表達(dá)水平應(yīng)用熒光定量pcr檢測,klf-8蛋白的表達(dá)應(yīng)用蛋白印跡法檢測。3運(yùn)用spss21.0進(jìn)行數(shù)據(jù)分析。數(shù)據(jù)符合正態(tài)分布,結(jié)果采用均數(shù)±標(biāo)準(zhǔn)差(x±s)表示,組間比較采用獨(dú)立樣本t檢驗(yàn),以p0.05差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:1一般特征早發(fā)型重度子癇前期患者組的平均年齡是26.60±0.91歲,年齡分布在26~40歲;晚發(fā)型組的平均年齡為23.90±0.62歲,年齡分布在23~33歲,對(duì)照組平均年齡為24.48±0.71歲,年齡分布在22~34歲,三組之間年齡無統(tǒng)計(jì)學(xué)差異(p0.05)。三組患者均為g1p1,均無吸煙及嗜酒史。見table1。2三組孕婦胎盤組織中klf-8蛋白的表達(dá)部位三組胎盤組織中均可見到棕褐色陽性染色細(xì)胞,證明klf-8蛋白主要表達(dá)于胎盤合體滋養(yǎng)細(xì)胞的胞核和胞質(zhì)中。3三組孕婦胎盤組織中klf-8mrna表達(dá)水平的比較早發(fā)型重度子癇前期胎盤組織中klf-8mrna水平為0.65±0.07,晚發(fā)型組為0.96±0.09,對(duì)照組為0.98±0.06。早發(fā)型重度子癇前期胎盤組織中klf-8mrna水平明顯低于晚發(fā)型組,有統(tǒng)計(jì)學(xué)差異(p0.01);而晚發(fā)型組與對(duì)照組之間無統(tǒng)計(jì)學(xué)差異(p0.05)。見table2、table3。4三組孕婦胎盤組織中klf-8蛋白表達(dá)水平的比較三組胎盤組織中均可檢測到klf-8蛋白的表達(dá),早發(fā)型重度子癇前期組klf-8蛋白水平為0.61±0.05,晚發(fā)型為0.95±0.06,對(duì)照組為0.98±0.07。早發(fā)型子癇前期組明顯低于晚發(fā)型子癇前期組,差異有統(tǒng)計(jì)學(xué)意義(p0.01);而晚發(fā)型組與對(duì)照組無統(tǒng)計(jì)學(xué)差異(p0.05)。見table4、table5。結(jié)論:本研究結(jié)果提示早發(fā)型重度子癇前期孕婦胎盤組織中klf-8蛋白和mrna表達(dá)水平明顯低于晚發(fā)型組,而晚發(fā)型組與對(duì)照組間無明顯差異,說明早發(fā)型重度子癇前期與晚發(fā)型的發(fā)病機(jī)制不同,胎盤組織中klf-8蛋白和mrna表達(dá)的減少,影響了子宮螺旋動(dòng)脈重鑄和滋養(yǎng)細(xì)胞侵襲力,說明klf-8參與了早發(fā)型重度子癇前期的發(fā)病。
[Abstract]:Objective: Preeclampsia (PE) is a serious systemic disease endemic to pregnancy. The blood pressure is normal before pregnancy. After 20 weeks of pregnancy, systemic arteriospasm is found. Further aggravation can be developed into eclampsia, which further causes multiple organ failure and seriously threatens the safety of mother and infant. It is the death of pregnant and parturient women and perinatal death in China. [1,2]., one of the most important causes of death, has no monism in the preeclampsia. The pathogenesis of preeclampsia is closely related to the abnormal invasion ability of the trophoblast, the changes of oxidative stress and the change of anti angiogenesis. .KLF-8 is a new transcriptional factor that people recently found to affect the ability of trophoblast invasion to induce preeclampsia. By detecting the changes in KLF-8 in placental tissues of pregnant women with early onset and late onset severe preeclampsia and healthy pregnant women, the relationship between KLF-8 and preeclampsia was discussed. Methods: 1 Subjects selected 40 severe preeclampsia pregnant women with cesarean section from September 2015 to 03 2016 in the first people's Hospital of Wuan, including 20 cases of early onset severe preeclampsia (34 weeks of pregnancy), and 20 late onset severe preeclampsia (more than 34 weeks of pregnancy). The control group chose the same period of cesarean section for the same period of childbirth. 20 pregnant full term healthy pregnant women. All the subjects selected first, single, fetal and pregnant women had no history of hypertension, heart disease, diabetes, kidney disease and hyperthyroidism, anemia and autoimmune diseases, no smoking and alcohol history, no history of long term use of drugs. Normal, detailed records of the patient's age, menstrual history, birth history and family history. There were no statistical differences between the three groups of pregnant women, age, pregnancy and birth, smoking and alcohol comparison (P0.05) all the subjects of.2 samples were collected after signing the informed consent book, and the placental tissue was delivered in 20min, except for the naked eye. 3 matrix surface placenta tissues of 1cm * 1cm x 1cm were seen in the lesion area, and were rinsed with phosphate buffer solution (PBS), one was fixed in 4% polyformaldehyde, and the other 2 were stored in liquid nitrogen in the sterilization and extinguishing cryopreservation tube and stored in -80 fridge for determination. The KLF-8 protein expression site of fetal disc tissue was selected by immunohistochemical S The expression level of klf-8mrna was detected by P method. The expression of klf-8 protein was detected by PCR, and the expression of klf-8 protein was detected by Western blot. The data was in normal distribution, and the results were expressed with mean standard deviation (x + s), and the independent sample t test was used in the group. The difference of P0.05 was statistically significant. The results were 1 general. The average age of the group with early onset severe preeclampsia was 26.60 + 0.91 years, the age distribution was 26~40 years, the average age of the late onset group was 23.90 + 0.62 years, the age distribution was 23~33 years, the average age of the control group was 24.48 + 0.71 years, the age distribution was 22~34 years, and the age of three groups was not statistically different (P0.05). The three groups were all g1p1, No smoking and alcohol history. See the expression of klf-8 protein in the placental tissue of table1.2 three groups of pregnant women, the three groups of placental tissues can see Brown stained positive staining cells. It is proved that the klf-8 protein is mainly expressed in the nucleus and cytoplasm of the placental syncytial cells and the expression level of klf-8mrna in the placental tissue of the.3 three groups of pregnant women is relatively early hair weight. The level of klf-8mrna in placental tissue in preeclampsia was 0.65 + 0.07, the late onset group was 0.96 + 0.09, and the level of klf-8mrna in the placental tissue of the control group was 0.98 + 0.06. early onset severe preeclampsia. There was a significant difference (P0.01) in the placental tissue of the placental tissue of the early onset severe preeclampsia, but there was no statistical difference between the late onset group and the control group (P0.05). Table2, table3.4 three groups The expression of klf-8 protein in placental tissue was compared in three groups of placental tissues, the expression of klf-8 protein could be detected. The level of klf-8 protein in the early onset severe preeclampsia group was 0.61 + 0.05, the late hairstyle was 0.95 + 0.06, the control group was 0.98 + 0.07. early onset preeclampsia group was significantly lower than the late preeclampsia group, the difference was statistically significant There was no statistical difference between the late hairstyle group and the control group (P0.05). See table4, table5. conclusion: the results of this study suggest that the expression of klf-8 protein and mRNA in placental tissues of pregnant women with early onset severe preeclampsia is significantly lower than that in the late onset group, but there is no significant difference between the late onset group and the control group, indicating early onset severe preeclampsia and late onset and late onset. The pathogenesis of hairstyle is different. The decrease of klf-8 protein and mRNA expression in placenta tissue affects the uterine spiral artery recasting and the invasiveness of trophoblast, indicating that klf-8 is involved in the onset of early onset severe preeclampsia.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R714.244

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