【摘要】：目的： 通過檢測正常葡萄糖耐量妊娠孕婦、葡萄糖耐量受損孕婦及妊娠期糖尿病孕婦胎盤母體面與胎兒面中炎性因子（腫瘤壞死因子-α和白細(xì)胞介素-6）和脂肪因子（瘦素和脂聯(lián)素）蛋白陽性表達(dá)強(qiáng)度及蛋白含量水平的變化，探討炎性因子和脂肪因子在妊娠期糖尿病的發(fā)病中所起的重要作用及其臨床意義。 方法： 收集我院2013年6月至2014年8月生產(chǎn)的孕婦100例，分為正常葡萄糖耐量妊娠組（A組）24例、GDM飲食可控制組（B組）31例及GDM胰島素控制組（C組）45例。三組孕婦均于分娩后立即采集胎盤的胎兒面和母體面，一部分凍存，一部分固定于4%多聚甲醛液中。采用免疫組織化學(xué)方法檢測三組胎盤胎兒面和母體面中腫瘤壞死因子-α（TNF-α）、白細(xì)胞介素-6(IL-6)、瘦素和脂聯(lián)素的蛋白陽性表達(dá)強(qiáng)度。采用酶聯(lián)免疫法（ELISA法）檢測三組胎盤胎兒面和母體面中腫瘤壞死因子-α（TNF-α）、白細(xì)胞介素-6(IL-6)、瘦素和脂聯(lián)素蛋白含量的水平。 結(jié)果： 1.各組胎盤炎性因子（TNF-α和IL-6）蛋白陽性強(qiáng)度表達(dá)的比較 與A組比較，，B組、C組胎兒面和母體面胎盤中TNF-α、IL-6蛋白陽性強(qiáng)度表達(dá)均升高且GDM組高于IGT組，差異有顯著性（P0.01）；兩組的母體面TNF-α、IL-6表達(dá)均顯著高于胎兒面有統(tǒng)計學(xué)意義（P0.01）。 2.各組胎盤脂肪因子（瘦素和脂聯(lián)素）蛋白陽性強(qiáng)度表達(dá)的比較與A組比較，B組、C組胎兒面和母體面胎盤中瘦素蛋白陽性強(qiáng)度表達(dá)均升高且C組高于B組，脂聯(lián)素蛋白陽性表達(dá)水平均降低且C組低于B組，差異顯著有統(tǒng)計學(xué)意義（P0.01）；兩組的母體面瘦素的表達(dá)均顯著高于胎兒面（P0.01），母體面脂聯(lián)素的表達(dá)低于胎兒面有統(tǒng)計學(xué)意義（P0.05）。 3.各組胎盤炎性因子（TNF-α和IL-6）蛋白含量的結(jié)果 與A組比較，B組、C組胎兒面和母體面胎盤中TNF-α、IL-6蛋白含量均升高且C組高于B組，差異顯著有統(tǒng)計學(xué)意義（P0.01）；兩組的母體面TNF-α、IL-6的表達(dá)均顯著高于胎兒面有統(tǒng)計學(xué)意義（P0.01）。 4.各組胎盤脂肪因子（瘦素和脂聯(lián)素）蛋白含量的結(jié)果 與A組比較，B組、C組胎兒面和母體面胎盤中瘦素蛋白含量均升高且C組高于B組，脂聯(lián)素蛋白含量均降低且C組低于B組，差異顯著有統(tǒng)計學(xué)意義（P0.01）；兩組的母體面瘦素的表達(dá)均顯著高于胎兒面（P0.01），母體面脂聯(lián)素的表達(dá)低于胎兒面有統(tǒng)計學(xué)意義（P0.05）。 結(jié)論： 1.妊娠期糖尿病可上調(diào)胎盤組織中TNF-α、IL-6、瘦素的表達(dá)及下調(diào)脂聯(lián)素的表達(dá)，且兩組的母體面TNF-α、IL-6、瘦素的表達(dá)均顯著高于胎兒面，脂聯(lián)素的表達(dá)低于胎兒面。 2. TNF-α、IL-6、瘦素的上調(diào)及脂聯(lián)素的下調(diào)表達(dá)，可能參與了GDM的發(fā)生、發(fā)展過程，在GDM的發(fā)病中起重要作用。
[Abstract]:Objective: to detect normal glucose tolerant pregnant women. The positive expression of placental maternal decent and fetal inflammatory factors (tumor necrosis factor-偽 and IL-6) and adiponectin (leptin and adiponectin) in pregnant women with impaired glucose tolerance and gestational diabetes mellitus Changes in degree and protein content, To investigate the important role and clinical significance of inflammatory factors and fat factors in the pathogenesis of gestational diabetes mellitus (GDM). Methods: from June 2013 to August 2014, 100 pregnant women were divided into normal glucose tolerance pregnancy group (group A, n = 24), GDM diet controllable group (group B, n = 31) and GDM insulin control group (group C, n = 45). The fetal and maternal faces of placenta were collected immediately after delivery, some of which were frozen and some were fixed in 4% polyformaldehyde solution. The positive expression of tumor necrosis factor-偽 (TNF- 偽), IL-6 (IL-6), leptin and adiponectin in fetal and maternal surfaces of placenta was detected by immunohistochemistry. The levels of TNF- 偽, IL-6, leptin and adiponectin in fetal and maternal surfaces of placenta were measured by enzyme-linked immunosorbent assay (ELISA). Result: 1. The positive expression of placental inflammatory factor (TNF- 偽 and IL-6) protein in each group was compared with that in group A, group B, group C and group C, TNF- 偽 in fetal face and maternal placenta. The positive expression of IL-6 protein in GDM group was significantly higher than that in IGT group (P 0.01). The expression of maternal decent TNF- 偽 and IL-6 in both groups was significantly higher than that in fetal surface (P 0.01). two銆

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