【摘要】：目的研究低氧誘導(dǎo)因子-1α (HIF-1α)和促紅細(xì)胞生成素(EPO)在妊娠期糖尿病(GDM)孕婦胎盤組織中的表達(dá)與孕婦血糖控制情況及胎兒體重參數(shù)的關(guān)系。 方法在2012年9月至2013年10月期間,選取在青島大學(xué)附屬醫(yī)院產(chǎn)科行擇期剖宮產(chǎn)的64例GDM孕婦作為GDM組,包括血糖控制不滿意者22例(A組),血糖控制滿意者42例(B組)；同期選擇糖耐量正常孕婦37例設(shè)為對(duì)照組(C組)。測(cè)量?jī)山M孕婦空腹血糖水平以及餐后血糖水平時(shí),利用葡萄糖氧化酶法。在胎盤組織中檢測(cè)HIF-I α及EPO蛋白的表達(dá)時(shí),利用SP免疫組化方法,；利用半定量逆轉(zhuǎn)錄聚合酶鏈技術(shù),即(RT-PCR)技術(shù),來(lái)檢測(cè)HIF-1α mRNA和EPOmRNA在胎盤中的表達(dá)。同時(shí)對(duì)GDM組孕婦胎盤組織中HIF-1α、EPO蛋白及mRNA表達(dá)和孕婦血糖控制水平的相關(guān)性進(jìn)行分析。 結(jié)果(1)HIF-1α和EPO在GDM胎盤組織中細(xì)胞滋養(yǎng)細(xì)胞,血管內(nèi)皮細(xì)胞及絨毛間質(zhì)細(xì)胞中呈現(xiàn)強(qiáng)表達(dá)(棕色染色),二者在對(duì)照組中表達(dá)位置相同但呈弱陽(yáng)性。 (2) GDM組胎盤HIF-1α及EPO蛋白陽(yáng)性表達(dá)率分別為85.9%(55/64)和89.1%(57/64),與對(duì)照組32.4%(12/37)和35.1%(13/37)比較差異具有統(tǒng)計(jì)學(xué)意義(P均0.05)。 (3) GDM組胎盤組織HIF-1α mRNA和EPOmRNA表達(dá)水平分別為(0.88±0.12)和(0.93±0.27),顯著高于對(duì)照組的(0.47±0.11)和(0.43±0.14),兩組比較,差異具有統(tǒng)計(jì)學(xué)意義(P均0.05)； (4)A、B、C組胎盤HIF-1α和EPO蛋白的陽(yáng)性表達(dá)率分別為90.9%、73.8%、32.4%和100%、88.1%、35.1%,組間比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)；A、B、C組胎盤HIF-1α mRNA和EPOmRNA表達(dá)水平分別為(0.9±0.13)、(0.7±0.12)、(0.47±0.11)和(0.96±0.23)、(0.75±0.27)、(0.43±0.14),組間比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 (5)GDM巨大兒組新生兒出生體重與HIF-1α及EPO表達(dá)均呈正相關(guān)性(r=0.662、0.475,P均0.05)。 結(jié)論GDM胎盤組織中存在HIF-1α和EPO基因的高表達(dá),其表達(dá)水平與孕婦血糖控制狀況和GDM巨大兒的發(fā)生相關(guān),HIF-1α的高表達(dá)可能是EPO表達(dá)上調(diào)的機(jī)制之一。積極控制母體血糖有助于改善母嬰結(jié)局。
[Abstract]:Objective to study the relationship between the expression of hypoxia inducible factor-1 偽 (HIF-1 偽) and erythropoietin (EPO) (EPO) in placenta of pregnant women with gestational diabetes mellitus (GDM) (GDM) and the control of maternal blood glucose and fetal weight parameters. Methods from September 2012 to October 2013, 64 pregnant women with GDM underwent elective cesarean section in Department of Obstetrics, Qingdao University Hospital as GDM group, including 22 patients with unsatisfactory blood glucose control (group A) and 42 patients with satisfactory blood glucose control (group B). At the same time, 37 pregnant women with normal glucose tolerance were selected as control group (group C). Fasting blood glucose level and postprandial blood glucose level were measured by glucose oxidase method. The expression of HIF-I 偽 and EPO protein in placenta was detected by SP immunohistochemical method, and the expression of HIF-1 偽 mRNA and EPOmRNA in placenta was detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). The correlation between the expression of HIF-1 偽, EPO protein and mRNA in placenta of pregnant women in GDM group and the control level of blood glucose in pregnant women was analyzed. Results (1) HIF-1 偽 and EPO were strongly expressed in trophoblast cells, vascular endothelial cells and villous stromal cells in placenta of GDM (brown staining). (2) the positive expression rates of HIF-1 偽 and EPO protein in placenta of GDM group were 85.9% (55 / 64) and 89.1% (57 / 64), respectively. The difference was statistically significant (P 0.05) compared with 32.4% (12 / 37) and 35.1% (13 / 37) of the control group. (3) the expression levels of HIF-1 偽 mRNA and EPOmRNA in placenta of GDM group were (0.88 鹵0.12) and (0.93 鹵0.27), significantly higher than those of control group (0.47 鹵0.11) and (0.43 鹵0.14), respectively. The difference was statistically significant (P 0.05). (4) the positive expression rates of HIF-1 偽 and EPO protein in placental placenta of group A and B C were 90.9% and 73.83.83.4%, respectively. The positive rate of HIF-1 偽 and EPO protein in group A were 32.4% and 88.01%, respectively. The difference between the two groups was statistically significant (P0.05). The expression levels of HIF-1 偽 mRNA and EPOmRNA were (0.9 鹵0.13), (鹵0.12), (0.47 鹵0.11) and (0.96 鹵0.23), (0.75 鹵0.27), (0.43 鹵0.14), respectively. The difference between groups was statistically significant (P0.05). (5) there was a positive correlation between birth weight and the expression of HIF-1 偽 and EPO in GDM macrosomia group. Conclusion there is high expression of HIF-1 偽 and EPO gene in placenta of GDM. The expression level of HIF-1 偽 is related to the blood glucose control status of pregnant women and the occurrence of GDM macrosomia. The high expression of HIF-1 偽 may be one of the mechanisms of up-regulation of EPO expression. Active control of maternal blood sugar helps improve maternal outcomes.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R714.256

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