【摘要】 目的 探讨母胎外周循环系统和母胎界面组织中Tribbles同源蛋白3 (TRB-3)的表达水平与妊娠期糖尿病（GDM）的相关性，为阐明GDM发病的分子机制及其临床诊断提供新的依据。方法 选取2022年1—12月于深圳市龙华区人民医院产科行择期剖宫产术的32例GDM产妇及同期32例行剖宫产术的健康孕产妇，采集其分娩前48 h外周血、分娩时脐静脉血、胎盘组织和脐带组织，用于制作石蜡切片并进行TRB-3免疫组织化学检测；采用酶联免疫吸附试验（ELISA）测定母体外周血及脐静脉血中的TRB-3水平。结果 TRB-3主要表达在母胎界面的滋养层细胞及脐静脉内皮细胞；GDM组的胎盘及脐带组织中TRB-3的表达水平高于健康对照组；GDM组外周血浆及其胎儿的脐静脉血中TRB-3的水平高于健康对照组；母体外周血TRB-3水平与孕妇年龄、1 h餐后血糖（PBG）水平、2 h PBG呈正相关关系，与糖化血红蛋白水平、新生儿体重呈负相关关系；孕妇分娩孕周和PBG与脐静脉组织TRB-3的表达呈正相关关系，新生儿体重与脐静脉组织TRB-3表达呈负相关关系。结结论 母胎外周血的TRB-3及胎盘组织、脐静脉组织中TRB-3在临床诊断GDM中具有一定的参考意义和应用价值。更多还原

【Abstract】 Objective To explore the correlation between the expression level of tribbles homologous protein 3(TRB-3) in maternal fetal peripheral circulation system and maternal fetal interface tissue and the occurrence of gestational diabetes mellitus(GDM), to provide new insights for the molecular mechanism study and clinical diagnosis of GDM. Methods 32 GDM pregnant women who underwent elective cesarean section at the Obstetrics and Gynecology Department of People’s Hospital of Longhua, Shenzhen from January to December 2021, as well as 32 healthy pregnancies who underwent cesarean section during the same period, were randomly selected. Peripheral blood, umbilical cord venous blood, placental tissue and umbilical cord tissue were collected 48 hours before delivery; paraffin sections were organized for TRB-3 immunohistochemical testing; ELISA was used to determine the levels of TRB-3 in maternal peripheral plasma and umbilical vein plasma. Results TRB-3 is usually mainly expressed in the trophoblast cells and umbilical vein endothelial cells at the maternal fetal interface. The expression level of TRB-3 in placental and umbilical cord tissues of the GDM group was significantly higher than that of the healthy control group; the levels of TRB-3 in the peripheral plasma of GDM pregnant women and the umbilical vein plasma of their fetuses were significantly higher than those in the healthy control group; maternal peripheral plasma TRB-3 levels were significantly positively correlated with maternal age, postprandial 1-hour blood glucose levels and PBG, but significantly negatively correlated with glycated hemoglobin levels and neonatal weight; pregnant women’s gestational weeks and 2-hour postprandial blood glucose levels were positively correlated with the expression intensity of TRB-3 in umbilical vein tissue, while newborn weight was negatively correlated with the expression intensity of TRB-3 in umbilical vein tissue. Conclusion TRB-3 in maternal fetal peripheral plasma and placental and umbilical vein tissues have good specificity and sensitivity in clinical diagnosis of GDM.更多还原