NGAL在子癇前期患者血液、尿液及胎盤組織中的表達(dá)及臨床意義
發(fā)布時(shí)間：2018-08-02 13:21
【摘要】：目的:妊娠期高血壓疾病(hypertensive disorders complicating pregnancy,HDP)是妊娠期間伴隨血壓升高的一組疾病,包括妊娠期高血壓、子癇前期、子癇以及慢性高血壓并發(fā)子癇前期和慢性高血壓合并妊娠。其發(fā)病機(jī)制到目前為止還不確定,普遍認(rèn)為是由于多種因素和多種途徑共同導(dǎo)致妊娠期高血壓疾病的發(fā)生,而母體機(jī)體彌漫性血管內(nèi)皮細(xì)胞的激活和(或)損傷是其發(fā)病的重要原因,但目前對(duì)內(nèi)皮細(xì)胞激活和損傷的機(jī)制尚不清楚,如果能通過血管內(nèi)皮細(xì)胞的損傷情況,來判斷妊娠期高血壓疾病發(fā)生和發(fā)展的程度,對(duì)臨床上防治妊娠期高血壓疾病是十分關(guān)鍵的。中性粒細(xì)胞明膠酶相關(guān)脂質(zhì)運(yùn)載蛋白(neutrophilgelatinase-associated lipoealin,NGAL)屬于脂蛋白(lipoealin)家族的成員之一,它對(duì)多種細(xì)胞的增殖、生長和分化具有促進(jìn)作用,可以降解組織中的膠原和蛋白成分,當(dāng)機(jī)體的局部組織出現(xiàn)炎癥或腫瘤時(shí),NGAL的含量會(huì)明顯增加,有研究表明NGAL是評(píng)價(jià)因炎癥或腫瘤形成而導(dǎo)致內(nèi)皮損傷嚴(yán)重程度的重要標(biāo)志物。許多研究也顯示NGAL是早期檢測腎功能衰竭和急性炎癥的重要指標(biāo),具有高度的敏感性和特異度;此外研究表明NGAL在高血壓患者體內(nèi)的含量比正常人體內(nèi)的含量明顯升高。但對(duì)于妊娠期高血壓早發(fā)型和晚發(fā)型子癇前期患者的血液、尿液以及胎盤中NGAL蛋白量的表達(dá)情況如何,目前尚無研究。本研究通過檢測妊娠期高血壓早發(fā)型和晚發(fā)型子癇前期患者的血液和尿液中NGAL的含量,以及胎盤組織中NGAL的表達(dá)水平,并與同期正常對(duì)照組患者的血液、尿液以及胎盤組織中NGAL的表達(dá)水平相比較,探求NGAL在子癇前期的發(fā)生和發(fā)展中的作用,為進(jìn)一步研究子癇前期發(fā)病機(jī)制提供基礎(chǔ)的理論基礎(chǔ)。方法:1標(biāo)本的收集選取2013年12月-2014年11月在邯鄲市第二醫(yī)院產(chǎn)科檢查并住院分娩的早發(fā)型子癇前期患者、晚發(fā)型子癇前期患者以及同期我院孕檢的正常孕婦各20例。孕婦均為單胎妊娠,無不良孕產(chǎn)史,沒有經(jīng)過輔助生殖技術(shù)治療,除外妊娠期糖尿病、妊娠合并其它合并癥如糖尿病、高血壓疾病、心臟病等。2 ELISA法檢測孕產(chǎn)婦血液和尿液中NGAL的含量實(shí)驗(yàn)分六組:A組:早發(fā)型子癇前期組:年齡20-35歲,孕周20-34周(包括20周,不包括34周)。B組:晚發(fā)型子癇前期組:年齡20-35歲,孕周34-37周(包括34周,不包括37周)。C組:晚發(fā)型子癇前期組:年齡20-35歲,孕周37周以后(包括37周)。D組:34周正常孕婦組:年齡為20-29歲,孕周20-34周(包括20周,不包括34周)。E組:34-37周正常孕婦組:年齡21-30歲,孕周34-37周(包括34周,不包括37周)。F組:37周正常孕婦組:年齡20-36歲,孕周37-42周(包括37周,包括42周)。六組孕產(chǎn)婦均于入院后24小時(shí)內(nèi)抽空腹肘靜脈血3ml,晨尿液3ml,采用ELISA法檢測孕產(chǎn)婦血液和尿液中NGAL的含量。3免疫組織化學(xué)法檢測胎盤組織中NGAL的表達(dá)實(shí)驗(yàn)分三組:早發(fā)型子癇前期組:年齡20-35歲,孕周20-34周(包括20周,不包括34周)。晚發(fā)型子癇前期組:年齡20-35歲,孕周34周以后(包括34周)。正常孕婦組:年齡20-36歲,孕周37-42周(包括37周,包括42周)。三組孕產(chǎn)婦均于分娩后2分鐘內(nèi)取胎盤母面臍根部胎盤組織,大小為2.0cm×1.0cm×1.0cm。用生理鹽水反復(fù)清洗3遍后,放入含有固定液的病理袋做好標(biāo)記備用。以上均在無菌條件下操作。4應(yīng)用SPSS 13.0軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。組間比較采用χ2檢驗(yàn),P0.05有統(tǒng)計(jì)學(xué)差異。結(jié)果:1早發(fā)型子癇前期組、晚發(fā)型子癇前期組與同期正常對(duì)照組血液中NGAL蛋白量的檢測A組血液中NGAL蛋白量為1.635±0.1004g/L,C組血液中NGAL蛋白量為0.723±0.1124g/L;兩組血液中NGAL蛋白量比較有顯著性差異(P0.01),B組血液中NGAL蛋白量為1.290±0.0845g/L,E組血液中NGAL蛋白量為0.725±0.0539g/L;兩組血液中NGAL蛋白量比較有顯著性差異(P0.01);C組血液中NGAL蛋白量為1.269±0.1173g/L,F組血液中NGAL蛋白量為:0.705±0.1094g/L;兩組血液中NGAL蛋白量比較有顯著性差異(P0.01);A組血液中NGAL蛋白量與B組、C組血液中NGAL蛋白量相比均有顯著性差異(P0.05);但是B組、C組血液中NGAL蛋白量相比無明顯差異(P0.05)。2早發(fā)型子癇前期組、晚發(fā)型子癇前期組與同期正常對(duì)照組尿液中NGAL蛋白量的檢測A組尿液中NGAL蛋白量為0.470±0.069g/L,D組尿液中NGAL蛋白量為:0.141±0.024g/L;兩組尿液中NGAL蛋白量比較有顯著性差異(P0.01),B組尿液中NGAL蛋白量為0.258±0.042g/L,E組尿液中NGAL蛋白量為0.102±0.006g/L;兩組尿液中NGAL蛋白量比較有顯著性差異(P0.01);C組尿液中NGAL蛋白量為0.249±0.041g/L,F組尿液中NGAL蛋白量為0.116±0.020g/L;兩組尿液中NGAL蛋白量比較有顯著性差異(P0.01);A組尿液中NGAL蛋白量與B組、C組尿液中NGAL蛋白量相比均有顯著性差異(P0.05);但是B組、C組尿液中NGAL蛋白量相比無明顯差異(P0.05)。3早發(fā)型子癇前期組、晚發(fā)型子癇前期組與正常對(duì)照組胎盤組織中NGAL蛋白表達(dá)水平的檢測。在胎盤組織的絨毛合體滋養(yǎng)細(xì)胞的胞質(zhì)中可見NGAL蛋白的陽性表達(dá),顏色為棕黃色。正常對(duì)照組、早發(fā)型子癇前期組和晚發(fā)型子癇前期組的胎盤組織中NGAL蛋白表達(dá)光密度值分別為:10.15±0.86g/L,50.90±7.60g/L和30.51±4.16g/L,早發(fā)型和晚發(fā)型子癇前期組胎盤組織中NGAL蛋白表達(dá)光密度值均比正常對(duì)照組胎盤組織中NGAL蛋白表達(dá)光密度值增高,其差異均有統(tǒng)計(jì)學(xué)意義(P0.01)。早發(fā)型子癇前期組胎盤組織中NGAL蛋白表達(dá)光密度值比晚發(fā)型子癇前期組胎盤組織中NGAL蛋白表達(dá)光密度值增加,其差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1早發(fā)型和晚發(fā)型子癇前期組患者比同期正常對(duì)照組血液和尿液中NGAL蛋白含量均增多,并且早發(fā)型NGAL蛋白含量增多顯著。2早發(fā)型和晚發(fā)型子癇前期組患者比正常對(duì)照組胎盤組織中NGAL蛋白表達(dá)水平均升高,并且早發(fā)型NGAL蛋白表達(dá)水平升高顯著。
[Abstract]:Objective: hypertensive disorders complicating pregnancy (HDP) is a group of diseases associated with elevated blood pressure during pregnancy, including pregnancy induced hypertension, preeclampsia, eclampsia, and chronic hypertension combined with preeclampsia and chronic hypertension. The pathogenesis is so far uncertain and is generally recognized. The pathogenesis of pregnancy induced hypertension is caused by a variety of factors and ways, and the activation and / or damage of the mother body diffuse vascular endothelial cells are important reasons. However, the mechanism of the activation and injury of endothelial cells is not clear. The occurrence and development of hypertensive disorders in pregnancy are crucial to the prevention and treatment of hypertensive disorders in pregnancy. The neutrophil gelatinase related lipid carrier protein (neutrophilgelatinase-associated lipoealin, NGAL) is one of the members of the lipoprotein (lipoealin) family. It is the proliferation, growth and differentiation of many cells. NGAL is an important marker for the severity of endothelial damage caused by inflammation or tumor formation. Many studies also suggest that NGAL is an early detection of renal failure. An important index of exhaustion and acute inflammation has a high sensitivity and specificity; in addition, studies have shown that the content of NGAL in hypertensive patients is significantly higher than that in normal human body. But how is the expression of NGAL protein in the blood, urine and placenta of patients with premature and late onset preeclampsia in pregnancy. In this study, the content of NGAL in the blood and urine of patients with early onset hypertension and late onset preeclampsia, and the expression of NGAL in the placental tissue were detected and compared with the levels of NGAL expression in the blood, urine and placenta tissue of the normal control group, and NGAL was explored in preeclampsia. The role of development and development provides a basis for further research on the pathogenesis of preeclampsia. Methods: 1 specimens were collected to select early onset preeclampsia, preeclampsia, late onset preeclampsia and normal pregnancy in the second hospital, Handan, December 2013, -2014, December 2013. There were 20 pregnant women. Pregnant women were single pregnancy, no bad pregnancy history, no assisted reproductive technology, except for gestational diabetes, pregnancy combined with other complications such as diabetes, hypertension, heart disease and other.2 ELISA tests of pregnant and lying in the blood and urine of NGAL in six groups: group A: early onset preeclampsia group: age 2 0-35 years of age (including 20 weeks, excluding 34 weeks) group.B: late onset preeclampsia group: age 20-35, 34-37 weeks of pregnancy (including 34 weeks, not including 37 weeks) group.C: late onset preeclampsia group: age 20-35, and 37 weeks of pregnancy (including 37 weeks).D: 34 Zhou Zhengchang group: age 20-29, week of pregnancy (including weeks, not included) Group.E: 34-37 Zhou Zhengchang pregnant women group: age 21-30, 34-37 weeks of pregnancy (including 34 weeks, not including 37 weeks) group.F: 37 weeks of normal pregnant women group: age 20-36, pregnancy week 37-42 weeks (including 37 weeks, including 42 weeks). The six groups of pregnant and lying in and lying in the hospital within 24 hours after admission to the empty belly of elbow vein blood 3ml, morning urine 3ml, use ELISA method to detect pregnant and lying in the blood and urine of pregnant and lying in lying in lying in lying in lying in lying in women NGAL content.3 immunohistochemical assay was used to detect the expression of NGAL in placenta tissue in three groups: early onset preeclampsia group: age 20-35, 20-34 weeks of pregnancy (including 20 weeks, not 34 weeks). Late onset preeclampsia group: age 20-35, 34 weeks after pregnancy (including 34 weeks). Normal pregnant women: 20-36 years of age, and 37-42 weeks of pregnancy (including 37 weeks,) The placental tissue of the placental maternal umbilical cord root was taken within 2 minutes after delivery, and the size of the three groups was 2.0cm x 1.0cm x 1.0cm. with physiological saline for 3 times, and then put into the pathological bag containing the fixed liquid to mark the spare. All of these were performed by SPSS 13 software with.4 under aseptic conditions. Using the chi 2 test, there were statistical differences in P0.05. Results: 1 early onset preeclampsia group, late onset preeclampsia group and normal control group, the blood NGAL protein content in the A group was 1.635 + 0.1004g/L, and the amount of NGAL protein in the C group was 0.723 + 0.1124g/L, and the amount of NGAL protein in the two groups was significantly different (P0.01). The amount of NGAL protein in the blood of group B was 1.290 + 0.0845g/L, and the amount of NGAL protein in the blood of group E was 0.725 + 0.0539g/L, and the amount of NGAL protein in the blood of the two groups was significantly different (P0.01); the amount of NGAL protein in the C group was 1.269 + 0.1173g/L, and the amount of the protein in the blood of the F group was 0.705 +. The two groups had a significant difference in the amount of protein in the blood group. (P0.01): the amount of NGAL protein in blood of group A was significantly different from group B and NGAL protein in group C (P0.05), but there was no significant difference in the amount of NGAL protein in group B and C group (P0.05) in the early preeclampsia group of.2, and in the urine of the late onset preeclampsia group and the normal control group. The amount of NGAL protein in the urine of group D was 0.470 + 0.024g/L, and the amount of NGAL protein in the urine of the two groups was significantly different (P0.01), the amount of NGAL protein in the urine of the B group was 0.258 + 0.042g/L, and the NGAL protein in the urine of the E group was 0.102 + 0.006g/L. The two groups had a significant difference in the amount of protein in urine. The white amount was 0.249 + 0.041g/L, and the amount of NGAL protein in urine of group F was 0.116 + 0.020g/L, and there was a significant difference in the amount of NGAL protein in the urine of the two groups (P0.01). The amount of NGAL protein in the urine of the A group was significantly different from the B group and the NGAL protein in the urine of the C group (P0.05). The expression of NGAL protein in placental tissues of preeclampsia group, late onset preeclampsia group and normal control group. The positive expression of NGAL protein in the cytoplasm of villous chimeric trophoblast in placental tissue was found in brown yellow. Normal control group, N in early onset preeclampsia group and late onset preeclampsia group The light density values of GAL protein expression were 10.15 + 0.86g/L, 50.90 + 7.60g/L and 30.51 + 4.16g/L respectively. The density values of NGAL protein expression in placental tissues of early onset and late onset preeclampsia were all higher than those of normal controls (P0.01). The difference was statistically significant (P0.01). The light density value of the expression of NGAL protein in the disc tissue was higher than that in the placental tissue of the late preeclampsia group. The difference was statistically significant (P0.05). Conclusion: the levels of NGAL protein in the blood and urine of the 1 early onset and late preeclampsia group were higher than those in the normal control group, and the early onset NGAL protein was contained. The level of NGAL protein expression in the placental tissues of the early onset and late onset preeclampsia group increased significantly in.2 early onset and late onset preeclampsia, and the expression level of early onset NGAL protein increased significantly.
【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】：2015
【分類號(hào)】：R714.244
本文編號(hào)：2159567
[Abstract]:Objective: hypertensive disorders complicating pregnancy (HDP) is a group of diseases associated with elevated blood pressure during pregnancy, including pregnancy induced hypertension, preeclampsia, eclampsia, and chronic hypertension combined with preeclampsia and chronic hypertension. The pathogenesis is so far uncertain and is generally recognized. The pathogenesis of pregnancy induced hypertension is caused by a variety of factors and ways, and the activation and / or damage of the mother body diffuse vascular endothelial cells are important reasons. However, the mechanism of the activation and injury of endothelial cells is not clear. The occurrence and development of hypertensive disorders in pregnancy are crucial to the prevention and treatment of hypertensive disorders in pregnancy. The neutrophil gelatinase related lipid carrier protein (neutrophilgelatinase-associated lipoealin, NGAL) is one of the members of the lipoprotein (lipoealin) family. It is the proliferation, growth and differentiation of many cells. NGAL is an important marker for the severity of endothelial damage caused by inflammation or tumor formation. Many studies also suggest that NGAL is an early detection of renal failure. An important index of exhaustion and acute inflammation has a high sensitivity and specificity; in addition, studies have shown that the content of NGAL in hypertensive patients is significantly higher than that in normal human body. But how is the expression of NGAL protein in the blood, urine and placenta of patients with premature and late onset preeclampsia in pregnancy. In this study, the content of NGAL in the blood and urine of patients with early onset hypertension and late onset preeclampsia, and the expression of NGAL in the placental tissue were detected and compared with the levels of NGAL expression in the blood, urine and placenta tissue of the normal control group, and NGAL was explored in preeclampsia. The role of development and development provides a basis for further research on the pathogenesis of preeclampsia. Methods: 1 specimens were collected to select early onset preeclampsia, preeclampsia, late onset preeclampsia and normal pregnancy in the second hospital, Handan, December 2013, -2014, December 2013. There were 20 pregnant women. Pregnant women were single pregnancy, no bad pregnancy history, no assisted reproductive technology, except for gestational diabetes, pregnancy combined with other complications such as diabetes, hypertension, heart disease and other.2 ELISA tests of pregnant and lying in the blood and urine of NGAL in six groups: group A: early onset preeclampsia group: age 2 0-35 years of age (including 20 weeks, excluding 34 weeks) group.B: late onset preeclampsia group: age 20-35, 34-37 weeks of pregnancy (including 34 weeks, not including 37 weeks) group.C: late onset preeclampsia group: age 20-35, and 37 weeks of pregnancy (including 37 weeks).D: 34 Zhou Zhengchang group: age 20-29, week of pregnancy (including weeks, not included) Group.E: 34-37 Zhou Zhengchang pregnant women group: age 21-30, 34-37 weeks of pregnancy (including 34 weeks, not including 37 weeks) group.F: 37 weeks of normal pregnant women group: age 20-36, pregnancy week 37-42 weeks (including 37 weeks, including 42 weeks). The six groups of pregnant and lying in and lying in the hospital within 24 hours after admission to the empty belly of elbow vein blood 3ml, morning urine 3ml, use ELISA method to detect pregnant and lying in the blood and urine of pregnant and lying in lying in lying in lying in lying in lying in women NGAL content.3 immunohistochemical assay was used to detect the expression of NGAL in placenta tissue in three groups: early onset preeclampsia group: age 20-35, 20-34 weeks of pregnancy (including 20 weeks, not 34 weeks). Late onset preeclampsia group: age 20-35, 34 weeks after pregnancy (including 34 weeks). Normal pregnant women: 20-36 years of age, and 37-42 weeks of pregnancy (including 37 weeks,) The placental tissue of the placental maternal umbilical cord root was taken within 2 minutes after delivery, and the size of the three groups was 2.0cm x 1.0cm x 1.0cm. with physiological saline for 3 times, and then put into the pathological bag containing the fixed liquid to mark the spare. All of these were performed by SPSS 13 software with.4 under aseptic conditions. Using the chi 2 test, there were statistical differences in P0.05. Results: 1 early onset preeclampsia group, late onset preeclampsia group and normal control group, the blood NGAL protein content in the A group was 1.635 + 0.1004g/L, and the amount of NGAL protein in the C group was 0.723 + 0.1124g/L, and the amount of NGAL protein in the two groups was significantly different (P0.01). The amount of NGAL protein in the blood of group B was 1.290 + 0.0845g/L, and the amount of NGAL protein in the blood of group E was 0.725 + 0.0539g/L, and the amount of NGAL protein in the blood of the two groups was significantly different (P0.01); the amount of NGAL protein in the C group was 1.269 + 0.1173g/L, and the amount of the protein in the blood of the F group was 0.705 +. The two groups had a significant difference in the amount of protein in the blood group. (P0.01): the amount of NGAL protein in blood of group A was significantly different from group B and NGAL protein in group C (P0.05), but there was no significant difference in the amount of NGAL protein in group B and C group (P0.05) in the early preeclampsia group of.2, and in the urine of the late onset preeclampsia group and the normal control group. The amount of NGAL protein in the urine of group D was 0.470 + 0.024g/L, and the amount of NGAL protein in the urine of the two groups was significantly different (P0.01), the amount of NGAL protein in the urine of the B group was 0.258 + 0.042g/L, and the NGAL protein in the urine of the E group was 0.102 + 0.006g/L. The two groups had a significant difference in the amount of protein in urine. The white amount was 0.249 + 0.041g/L, and the amount of NGAL protein in urine of group F was 0.116 + 0.020g/L, and there was a significant difference in the amount of NGAL protein in the urine of the two groups (P0.01). The amount of NGAL protein in the urine of the A group was significantly different from the B group and the NGAL protein in the urine of the C group (P0.05). The expression of NGAL protein in placental tissues of preeclampsia group, late onset preeclampsia group and normal control group. The positive expression of NGAL protein in the cytoplasm of villous chimeric trophoblast in placental tissue was found in brown yellow. Normal control group, N in early onset preeclampsia group and late onset preeclampsia group The light density values of GAL protein expression were 10.15 + 0.86g/L, 50.90 + 7.60g/L and 30.51 + 4.16g/L respectively. The density values of NGAL protein expression in placental tissues of early onset and late onset preeclampsia were all higher than those of normal controls (P0.01). The difference was statistically significant (P0.01). The light density value of the expression of NGAL protein in the disc tissue was higher than that in the placental tissue of the late preeclampsia group. The difference was statistically significant (P0.05). Conclusion: the levels of NGAL protein in the blood and urine of the 1 early onset and late preeclampsia group were higher than those in the normal control group, and the early onset NGAL protein was contained. The level of NGAL protein expression in the placental tissues of the early onset and late onset preeclampsia group increased significantly in.2 early onset and late onset preeclampsia, and the expression level of early onset NGAL protein increased significantly.
【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】：2015
【分類號(hào)】：R714.244
【引證文獻(xiàn)】
相關(guān)碩士學(xué)位論文 前1條
1 戚潔;中性粒細(xì)胞明膠酶相關(guān)載脂蛋白（NGAL）與子癇前期的關(guān)系[D];吉林大學(xué);2016年
，本文編號(hào)：2159567
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