【摘要】：目的:探討脂氧素A4(LXA4)、腫瘤壞死因子α(TNFα)及LXA4/TNFα比值與子癇前期(PE)發(fā)生發(fā)展的關系。方法:準備在天津醫(yī)科大學第二醫(yī)院產(chǎn)科分娩的健康孕婦200例,于妊娠10~12周、16~20周及32~36周采集孕婦血清檢測LXA4、TNFα水平及LXA4/TNFα比值,跟蹤產(chǎn)檢及妊娠結局。選取最終有完整產(chǎn)檢資料及妊娠結局患者195例,分為發(fā)生PE 23例(研究組),未發(fā)生PE 172例(對照組),進一步將兩組中在我院行剖宮產(chǎn)分娩的患者分為PE組17例及PE對照組20例,剖宮產(chǎn)后取胎盤組織,采用實時熒光定量聚合酶鏈反應法檢測各組胎盤中TNFαmRNA及LXA4受體(FPR2/ALX)mRNA的表達,ELISA方法測定孕婦剖宮產(chǎn)前及新生兒臍血LXA4、TNFα及LXA4/TNFα比值水平。對胎盤組織中TNFαmRNA及FPR2/ALX mRNA的表達與血清中TNFα及LXA4水平進行相關性分析。結果:研究組、對照組孕婦血清LXA4及TNFα水平均隨著妊娠進展呈上升趨勢(P0.05),研究組妊娠中、晚期LXA4及TNFα水平明顯高于對照組(P0.05);研究組妊娠中、晚期LXA4/TNFα比值明顯低于對照組,且隨著孕周的增加比值明顯下降(P0.05)。妊娠中期LXA4≥2.8 ng/ml、TNFα≥3.7 ng/ml,LXA4/TNFα≤0.7時預測PE的約登指數(shù)分別為0.76、0.72、0.81。PE組胎盤組織中TNFαmRNA、FPR2/ALXmRNA的表達及新生兒臍血TNFα水平明顯升高;孕婦外周血TNFα、LXA4水平與胎盤TNFαmRNA、FPR2/ALXmRNA表達水平均呈正相關。結論:PE患者體內(nèi)存在LXA4及其受體的相對缺乏,LXA4/TNFα比值降低可預測PE發(fā)生發(fā)展。推測適當激活胎盤中更多的LXA4受體或外源性補充LXA4可能是治療PE的新途徑。
[Abstract]:Objective: to investigate the relationship between the ratio of lipoxygenin A 4 (LXA4), tumor necrosis factor 偽 (TNF 偽) and LXA4/TNF 偽 and the occurrence and development of (PE) in preeclampsia. Methods: a total of 200 healthy pregnant women were enrolled in the second Hospital of Tianjin Medical University. The serum levels of LXA4,TNF 偽 and LXA4/TNF 偽 were measured at 10 ~ 12 weeks, 16 ~ 20 weeks and 32 ~ 36 weeks of pregnancy. One hundred and fifty-five patients with complete prenatal examination and pregnancy outcome were divided into two groups: 23 cases of PE (study group) and 172 cases of no PE (control group). The two groups were divided into PE group (n = 17) and PE control group (n = 20). The expression of TNF 偽 mRNA and LXA4 receptor (FPR2/ALX) mRNA in placenta was detected by real-time fluorescence quantitative polymerase chain reaction. The ratio of LXA4,TNF 偽 and LXA4/TNF 偽 in umbilical cord blood of pregnant women and newborns before cesarean section was measured by ELISA method. The correlation between the expression of TNF 偽 mRNA and FPR2/ALX mRNA in placenta and the levels of TNF 偽 and LXA4 in serum was analyzed. Results: in the study group, the serum LXA4 and TNF 偽 levels of pregnant women in the control group showed an upward trend with the progress of pregnancy (P0.05). The levels of LXA4 and TNF 偽 in the late pregnancy in the study group were significantly higher than those in the control group (P0.05). In the study group, the ratio of LXA4/TNF 偽 in late pregnancy was significantly lower than that in control group, and decreased with the increase of gestational week (P0.05). When LXA4 鈮，

本文編號：2378323