本文選題：PEG10 + 遺傳印記　； 參考：《河北醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：妊娠期高血壓疾病(hypertensive disorder complicating pregnancy,HDCP)包括妊娠期高血壓、子癇前期、子癇、慢性高血壓并發(fā)子癇前期以及妊娠合并慢性高血壓，是產(chǎn)科最常見的合并癥。其中，子癇前期是妊娠期所特有的疾病之一。子癇前期（preeclampsia,PE）是一種全身性疾病，以妊娠20周以后出現(xiàn)Bp≥140/90mmHg,且尿蛋白≥300mg/24h或（+），伴或不伴上腹部不適、頭痛、視力模糊等癥狀為特征。而當(dāng)子癇前期患者血壓繼續(xù)升高，出現(xiàn)嚴(yán)重高血壓≥160/110mmHg，或尿蛋白≥2.0g/24h等，稱重度子癇前期（severe preeclampsia,SPE）。該病在國內(nèi)外發(fā)病率均較高，嚴(yán)重威脅著母嬰的健康。重度子癇前期病因至今尚未完全闡明，目前國外大多數(shù)學(xué)者認為其發(fā)病可歸納為兩個階段：胎盤形成不良和胎盤氧化應(yīng)激[1]。胎盤形成不良,主要為絨毛滋養(yǎng)細胞侵蝕不良。滋養(yǎng)細胞侵蝕不完全，子宮螺旋小動脈“血管重塑”異常，胎盤血流減少，缺血缺氧促使胎盤釋放相關(guān)因子，引起廣泛的系統(tǒng)炎性反應(yīng)。印跡基因（Imprintedgene）是一類單等位基因，根據(jù)親源性的不同，只表達來源父本或母本的一個拷貝。這類基因在大多數(shù)哺乳動物早期胚胎、胎盤以及胎兒的生長發(fā)育過程中扮演著著及其重要的角色。通常情況下，父源表達(母源印跡)的印跡基因促進營養(yǎng)的攝取和胚胎發(fā)育，而反之，母源表達(父源印跡)的印跡基因在營養(yǎng)的攝取以及胚胎發(fā)育方面的則起著抑制作用。父源性印記基因10(paternally expressed gene10,PEG10)是父源表達(母源印跡)基因成員之一，在成人的卵巢、腦組織、胎盤以及胚胎肝等組織上均有表達。該基因與脂肪細胞的早期分化以及多類腫瘤的發(fā)生、發(fā)展和轉(zhuǎn)移有著密切關(guān)系，在胎盤形成以及滋養(yǎng)層分化侵襲過程中也起著至關(guān)重要的作用。根據(jù)PEG10與細胞侵襲轉(zhuǎn)移的關(guān)系，推測其表達異�？赡芨淖冏甜B(yǎng)細胞的浸潤情況，在重度子癇前期的發(fā)生、發(fā)展中起重要作用。本課題的主要目的是通過對重度子癇前期患者胎盤組織中PEG10表達情況進行檢測，探討PEG10在重度子癇前期發(fā)病中的作用，以期為臨床尋找重度子癇前期的病因、發(fā)病機制提供依據(jù)。 方法：實驗標(biāo)本均選自2012年10月至2013年10月在河北醫(yī)科大學(xué)附屬第二醫(yī)院產(chǎn)科住院的正常妊娠婦女及SPE患者共120例，其中，早發(fā)型重度子癇前期(孕28-34周)孕婦30例為第一實驗組（早發(fā)組），同期孕周小于34周的30例健康孕婦（因胎兒畸形等原因引產(chǎn)者）為早期對照組；晚發(fā)型重度子癇前期（孕34-42周）孕婦30例為第二實驗組（晚發(fā)組），同期正常妊娠婦女30例為晚期對照組。重度子癇前期診斷按人民衛(wèi)生出版社出版，樂杰主編的《婦產(chǎn)科學(xué)》(第7版)的標(biāo)準(zhǔn)，所選孕婦均為第一胎，以剖宮產(chǎn)方式結(jié)束妊娠，各組年齡、孕齡差異無統(tǒng)計學(xué)意義（見附表），無原發(fā)性高血壓、糖尿病、心臟病及肝腎疾患、甲狀腺功能異常等病史。標(biāo)本均取材于胎盤母體面近臍帶根部的胎盤絨毛組織，并避開出血、壞死及鈣化區(qū)域。采用免疫組織化學(xué)的方法檢測胎盤組織中PEG10蛋白的表達情況。實驗數(shù)據(jù)均采用SPSS17.0軟件處理，計量資料以均數(shù)士標(biāo)準(zhǔn)差表示，兩組間差異用兩獨立樣本非參數(shù)檢驗進行比較，檢驗標(biāo)準(zhǔn)α=0.01, P0.05為差異具有統(tǒng)計學(xué)意義。 結(jié)果： 1PEG10蛋白在各組中均有表達，主要表達于合體滋養(yǎng)細胞和細胞滋養(yǎng)細胞，，合體滋養(yǎng)細胞表達量高于細胞滋養(yǎng)細胞。PEG10表達定位于細胞膜及細胞漿，細胞核未見表達。 2早發(fā)型重度子癇前期患者胎盤組織中PEG10蛋白表達量較對照組明顯升高，且差異有統(tǒng)計學(xué)意義(P0.01)。 3晚發(fā)型重度子癇前期患者胎盤組織中PEG10蛋白表達量較對照組明顯升高，且差異有統(tǒng)計學(xué)意義(P0.01)。 4早發(fā)型重度子癇前期患者胎盤組織中PEG10蛋白表達量較晚發(fā)型重度子癇前期組升高，差異無統(tǒng)計學(xué)意義(P0.05)。 結(jié)論：不論早發(fā)型還是晚發(fā)型，重度子癇前期患者胎盤組織中PEG10蛋白表達強度均明顯高于正常孕婦，提示胎盤組織中PEG10的表達增高可能與重度子癇前期的發(fā)生有關(guān)，PEG10可能影響滋養(yǎng)細胞遷移、浸潤等功能，導(dǎo)致胎盤淺著床，而引發(fā)重度子癇前期。早發(fā)型重度子癇前期和晚發(fā)型重度子癇前期患者胎盤組織中的PEG10的表達差異無統(tǒng)計學(xué)意義。
[Abstract]:Objective: hypertensive disorder complicating pregnancy (HDCP), including pregnancy induced hypertension, preeclampsia, eclampsia, chronic hypertension, preeclampsia and pregnancy with chronic hypertension, is the most common complication in obstetrics. Preeclampsia (pre) is one of the special diseases in pregnancy. (pre Eclampsia, PE) is a systemic disease. After 20 weeks of pregnancy, the symptoms of Bp > 140/90mmHg, urinary protein more than 300mg/24h or (+), with or without upper abdominal discomfort, headache, and blurred vision are characterized. And the blood pressure continues to rise in preeclampsia patients with severe high blood pressure, or more than 160/110mmHg, or urinary protein > 2.0g/24h and so on, and eclampsia in weighing degree. Severe preeclampsia (SPE). The incidence of the disease at home and abroad is high, which seriously threatens the health of mother and baby. The cause of severe preeclampsia has not been fully elucidated. Most scholars abroad believe that the disease can be summed up to two stages: placental malformation and placental oxidative stress [1]. placenta formation, mainly villous nourishing. The cell erosion is poor, the nutrient cell erosion is incomplete, the uterine spiral artery "vascular remodeling" is abnormal, the placental blood flow decreases, the ischemic anoxia causes the placenta releasing related factors and causes extensive systemic inflammatory response. The imprinted gene (Imprintedgene) is a kind of single allele, which only expresses the parent or mother parent according to the difference of parental origin. A copy. These genes play an important role in the growth and development of most early embryos, placentas and foetuses in most mammals. Usually, the imprinted gene of the parent source (mother source blot) promotes nutrient uptake and embryonic development, whereas the mother source (parent blot) imprinted gene is nutritious. Uptake and embryonic development are inhibited. Parent imprinted gene 10 (paternally expressed gene10, PEG10) is a member of the parent source expression (mother source blot) gene, expressed in adult ovary, brain tissue, placenta, and embryonic liver tissues. This gene is early differentiated from adipocytes and multiple types of tumor hair. There is a close relationship between birth, development and metastasis, and plays a vital role in the formation of placenta and the differentiation and invasion of trophoblast. According to the relationship between PEG10 and cell invasion and metastasis, it is presumed that the abnormal expression of the trophoblast may change the infiltration of trophoblastic cells, which plays an important role in the occurrence and development of severe preeclampsia. The purpose of this study is to detect the expression of PEG10 in the placental tissues of patients with severe preeclampsia and to explore the role of PEG10 in the pathogenesis of severe preeclampsia, in order to provide a basis for finding the etiology of severe preeclampsia and the pathogenesis of the severe preeclampsia.
Methods: all the experimental specimens were selected from October 2012 to October 2013 in 120 normal pregnant women and SPE patients in the Second Affiliated Hospital of Hebei Medical University. Among them, 30 pregnant women with early onset severe preeclampsia (28-34 weeks pregnant) were the first experimental group (early onset group), and 30 healthy pregnant women with pregnancy less than 34 weeks (due to fetal malformation). As early control group), 30 cases of pregnant women with late onset severe preeclampsia (34-42 weeks of pregnancy) were second experimental groups (late onset group), and 30 cases of normal pregnancy women were late control group. The diagnosis of severe preeclampsia was published by people's Health Press and the standard of Obstetrics and gynecology (Seventh Edition), compiled by Le Jie, was the first child. There was no significant difference in age and gestational age between each group (see attached table), no primary hypertension, diabetes, heart disease, liver and kidney disease, abnormal thyroid function and other diseases. The specimens were obtained from the placental hair tissue of the placental maternal surface near the umbilical cord and avoided the hemorrhage, necrosis and calcification area. The immunization group was used. The expression of PEG10 protein in placenta tissue was detected by the method of weave chemistry. The experimental data were treated with SPSS17.0 software, and the measurement data were represented by the standard deviation of the number of men. The difference between the two groups was compared with two independent sample nonparametric tests, and the standard alpha =0.01 was tested and the difference was statistically significant.
Result:
1PEG10 protein is expressed in all groups, mainly in syncytial trophoblast and cell trophoblast. The expression of chimeric trophoblast is higher than that of cell trophoblast.PEG10 expression in cell membrane and cytoplasm, and the nucleus is not expressed.
2 the expression of PEG10 protein in placenta tissue of early onset severe preeclampsia was significantly higher than that of the control group, and the difference was statistically significant (P0.01).
3 the expression of PEG10 protein in placenta tissues of late onset severe preeclampsia patients was significantly higher than that of the control group, and the difference was statistically significant (P0.01).
4 the expression of PEG10 protein in placenta tissue of early onset severe preeclampsia was higher than that in late onset severe preeclampsia group (P0.05).
Conclusion: the expression of PEG10 protein in placental tissues of patients with severe preeclampsia is significantly higher than that of normal pregnant women, suggesting that the increased expression of PEG10 in placental tissue may be related to the occurrence of severe preeclampsia, and PEG10 may affect the migration and infiltration of trophoblast, which may lead to placental superficial implantation. In severe preeclampsia, there was no significant difference in the expression of PEG10 in placenta tissues between early onset severe preeclampsia and late-onset severe preeclampsia.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R714.245

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