【摘要】：目的：子癇前期（Preeclampsia，PE）是妊娠期常見的特發(fā)性疾病，是造成孕產(chǎn)婦及胎嬰兒死亡的重要原因。至今病因不明。Su等在研究離體滋養(yǎng)細(xì)胞時(shí)發(fā)現(xiàn)，XIAP在缺氧組滋養(yǎng)細(xì)胞中的表達(dá)較常氧組顯著減少，其抗凋亡作用減弱，導(dǎo)致滋養(yǎng)細(xì)胞的過度凋亡，可能與子癇前期的發(fā)病有關(guān)。其中XIAP是IAP家族中最有調(diào)控潛力的抑制凋亡蛋白。因此，，本論文的研究目的主要是研究抑制凋亡蛋白XIAP在胎盤滋養(yǎng)細(xì)胞中的表達(dá)，探討XIAP與胎盤滋養(yǎng)細(xì)胞凋亡的關(guān)系及在子癇前期發(fā)病過程中的作用。 方法：選取2013年4月～2013年12月于山西醫(yī)科大學(xué)第二臨床醫(yī)院婦產(chǎn)科住院分娩的孕婦，其中25例子癇前期重度患者作為研究組，另外選取25例正常晚期妊娠婦女作為正常對(duì)照組，收集患者全部臨床資料和分娩時(shí)的胎盤組織。用免疫組織化學(xué)二步法檢測(cè)XIAP在胎盤組織中的定位及表達(dá)，并用BI-2000醫(yī)學(xué)圖像分析系統(tǒng)對(duì)圖片進(jìn)行處理；用Western-blot方法檢測(cè)XIAP在胎盤組織中的表達(dá)量。統(tǒng)計(jì)分析采用SPSS17.0兩獨(dú)立樣本t檢驗(yàn)進(jìn)行統(tǒng)計(jì)學(xué)處理。 結(jié)果： 1.兩組臨床資料的比較：研究組與正常對(duì)照組在年齡及孕齡上無顯著性差異（P＞0.05）；在收縮壓、舒張壓、新生兒出生體重有顯著性差異（P＜0.05）。 2.免疫組化檢測(cè)結(jié)果：研究組和正常對(duì)照組在胎盤滋養(yǎng)細(xì)胞的胞質(zhì)中均可見XIAP的陽性表達(dá)，且在子癇前期組胎盤滋養(yǎng)細(xì)胞中XIAP的表達(dá)(OD:0.227±0.032)顯著低于正常對(duì)照組(OD:0.341±0.037)，差異有顯著性(t＝-11.12,P＜0.01)。 3. Western-blot檢測(cè)結(jié)果：子癇前期組胎盤滋養(yǎng)細(xì)胞中XIAP的表達(dá)(灰度值：0.357±0.142)低于正常對(duì)照組(灰度值:0.96±0.428)，差異有顯著性（t＝-3.004,P＜0.05）。 結(jié)論： 1.XIAP表達(dá)于胎盤滋養(yǎng)細(xì)胞的胞質(zhì)中； 2.XIAP在子癇前期重度患者胎盤滋養(yǎng)細(xì)胞的胞質(zhì)中的表達(dá)下調(diào)，提示XIAP作為一種抑制凋亡蛋白，可能與子癇前期的發(fā)病有關(guān)。
[Abstract]:Objective: preeclampsia (PreeclampsiaPE) is a common idiopathic disease in pregnancy and an important cause of maternal and infant mortality. The expression of XIAP in trophoblastic cells in hypoxia group was significantly lower than that in normoxic group, and its anti-apoptotic effect was weakened, leading to excessive apoptosis of trophoblast, which may be related to the pathogenesis of preeclampsia. XIAP is the most potential inhibitor of apoptosis in the IAP family. Therefore, the purpose of this study is to study the expression of XIAP in placental trophoblast, and to explore the relationship between XIAP and apoptosis of placental trophoblast and its role in the pathogenesis of preeclampsia. Methods: from April 2013 to December 2013, 25 pregnant women with severe preeclampsia were selected as study group, who were hospitalized and delivered in Department of Gynecology and Obstetrics, second Clinical Hospital of Shanxi Medical University. In addition, 25 normal late pregnant women were selected as normal control group to collect all clinical data and placental tissue during delivery. The localization and expression of XIAP in placenta tissue were detected by immunohistochemical two-step method, the image was processed by BI-2000 medical image analysis system, and the expression of XIAP in placental tissue was detected by Western-blot method. Statistical analysis was performed by SPSS17.0 two independent samples t test. Results: 1. Comparison of clinical data between the two groups: there was no significant difference in age and gestational age between the study group and the normal control group (P > 0.05), but there was significant difference in systolic blood pressure, diastolic blood pressure and neonatal birth weight (P < 0.05). Immunohistochemical results: the positive expression of XIAP was found in the cytoplasm of placental trophoblastic cells in both the study group and the normal control group. The expression of XIAP in placental trophoblast in preeclampsia group (OD:0.227 鹵0.032) was significantly lower than that in normal control group (OD:0.341 鹵0.037). Western-blot results showed that the expression of XIAP in placental trophoblast of preeclampsia group (grayscale: 0.357 鹵0.142) was lower than that of normal control group (grayscale: 0.96 鹵0.428), and the difference was significant (t = 3.004, P < 0. 05). Conclusion: 1.XIAP is expressed in the cytoplasm of placental trophoblast, and 2.XIAP is down-regulated in the cytoplasm of placental trophoblast in severe preeclampsia, suggesting that XIAP is a kind of inhibitor of apoptosis protein. It may be associated with preeclampsia.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R714.244

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