【摘要】：目的:子癇前期(preeclampsia,PE)是妊娠期高血壓疾病中較為常見的一種,在初次妊娠中發(fā)病率大約2%-7%[1],在發(fā)展中國家發(fā)病率更高。其以蛋白尿和高血壓為主要臨床表現(xiàn),可同時(shí)伴有肝臟、腎臟等多臟器功能損害甚至衰竭,顯著影響孕產(chǎn)婦、圍產(chǎn)兒的病死率。目前關(guān)于子癇前期的發(fā)病機(jī)制尚未闡明,有學(xué)者認(rèn)為其發(fā)病可能源于胎盤:母胎界面免疫耐受異常,導(dǎo)致胎盤功能障礙,胎盤產(chǎn)生多種因子進(jìn)入母體血液循環(huán)進(jìn)而引發(fā)各種臨床癥狀。并且目前的研究發(fā)現(xiàn),Th1/Th2/Th17/Treg平衡學(xué)說已代替之前的Th1/Th2學(xué)說。本文通過研究子癇前期患者(輕度組、重度組)與正常妊娠孕婦胎盤組織中白介素-21(IL-21)、白介素-22(IL-22)的表達(dá)水平,進(jìn)而探討二者及Th17/Treg在子癇前期發(fā)病機(jī)制中的可能作用及相互關(guān)系。方法:選取2014年4月至2014年8月收住我科(山西醫(yī)科大學(xué)第一醫(yī)院產(chǎn)科)的子癇前期患者60例(輕度子癇前期組30例,重度子癇前期組30例),正常妊娠孕婦30例(對(duì)照組)。采用ELISA方法檢測(cè)子癇前期組及對(duì)照組胎盤組織中IL-21、IL-22含量。結(jié)果:1.在蛋白表達(dá)水平,IL-21、IL-22在各組中均有表達(dá),但是實(shí)驗(yàn)組(輕度子癇前期組、重度子癇前期組)胎盤組織中的表達(dá)明顯高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2.子癇前期患者胎盤組織中IL-21的表達(dá):子癇前期重度組IL-21表達(dá)雖然高于輕度組,但差異無統(tǒng)計(jì)學(xué)意義(P0.05);子癇前期患者胎盤組織中IL-22的表達(dá):子癇前期重度組IL-22表達(dá)高于輕度組,但差異無統(tǒng)計(jì)學(xué)意義(P0.05)。3.子癇前期組胎盤組織中IL-21和IL-22的相關(guān)性分析:子癇前期患者胎盤中的IL-21水平與IL-22水平呈正相關(guān),有統(tǒng)計(jì)學(xué)意義(r=0.803,p0.001)。結(jié)論:1.子癇前期組胎盤組織中IL-21、IL-22的含量與對(duì)照組相比均升高,推斷IL-21、IL-22可能與子癇前期的發(fā)病有關(guān),進(jìn)而提示Th17/Treg可能參與子癇前期的發(fā)生。2.子癇前期患者胎盤組織中IL-21水平與IL-22水平呈正相關(guān),提示IL-21、IL-22在子癇前期患者胎盤組織中可能存在相關(guān)性。
[Abstract]:Aim: preeclampsia (preeclampsia,PE) is one of the most common hypertensive disorder complicating pregnancy. The incidence of preeclampsia in the first pregnancy is about 2% / 7% [1], which is higher in developing countries. Albuminuria and hypertension are the main clinical manifestations, and can be accompanied by liver, kidney and other multiple organ function damage and even failure, which significantly affects the mortality of pregnant women and perinatal infants. At present, the pathogenesis of pre-eclampsia has not been clarified, some scholars believe that its pathogenesis may be due to placenta: maternal-fetal interface immune tolerance, resulting in placental dysfunction. Placenta produces a variety of factors into the maternal blood circulation, leading to a variety of clinical symptoms. And the current study found that the Th1/Th2/Th17/Treg equilibrium theory has replaced the previous Th1/Th2 theory. The expression of interleukin-21 (IL-21) and interleukin-22 (IL-22) in placenta of preeclampsia patients (mild group, severe group) and normal pregnant women were studied. Furthermore, the possible role of Th17/Treg and their roles in the pathogenesis of preeclampsia and their relationship were discussed. Methods: from April 2014 to August 2014, 60 cases of preeclampsia (30 cases in mild preeclampsia group, 30 cases in severe preeclampsia group) and 30 normal pregnant women (control group) were enrolled in our department (first Hospital of Shanxi Medical University). The content of IL-21,IL-22 in placenta of preeclampsia group and control group was detected by ELISA. Results: 1. At the level of protein expression, IL-21,IL-22 was expressed in all groups, but the expression in placenta of the experimental group (mild preeclampsia group, severe preeclampsia group) was significantly higher than that of the control group. The difference was statistically significant (P0.05). 2. The expression of IL-21 in placenta of preeclampsia patients: the expression of IL-21 in severe preeclampsia group was higher than that in mild preeclampsia group, but there was no significant difference (P0.05). The expression of IL-22 in placenta of preeclampsia patients: the expression of IL-22 in severe preeclampsia group was higher than that in mild preeclampsia group, but there was no significant difference (P0.05). Correlation analysis of IL-21 and IL-22 in placenta of preeclampsia group: the level of IL-21 in placenta of preeclampsia patients was positively correlated with the level of IL-22 (r = 0.803, p0.001). Conclusions: 1. The content of IL-21,IL-22 in placenta of preeclampsia group was higher than that of control group, which suggested that IL-21,IL-22 might be related to the pathogenesis of preeclampsia, and that Th17/Treg might be involved in the occurrence of preeclampsia. 2. There was a positive correlation between the levels of IL-21 and IL-22 in placenta of patients with preeclampsia, which suggested that IL-21,IL-22 might be correlated in placental tissues of patients 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】：2017
【分類號(hào)】：R714.244

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