【作者】 周勇；

【导师】 冯玲；

【作者基本信息】 华中科技大学 ， 妇产科学， 2013， 硕士

【摘要】 【目的】研究妊娠期糖尿病胎盘中的巨噬细胞与妊娠期糖尿病发病机制的相关性。【方法】选取在华中科技大学同济医院进行产检和手术分娩的孕妇作为研究对象，其中病例组GDM患者15人，对照组正常孕妇10人。GDM按照2011年ADA的标准进行诊断。术后留取上述研究对象的胎盘组织，分别用免疫组化检测巨噬细胞特异性标志分子（CD68/CD14）以检测细胞数量；用荧光定量PCR检测两组胎盘组织中巨噬细胞所分泌炎症因子（IL-6、TNF-α）及巨噬细胞标记（CD68）mRNA的表达水平以评估细胞功能及数量。【结果】1、与正常对照组相比，糖尿病组胎盘中的巨噬细胞的检出率更高，CD68或CD14阳性的巨噬细胞数目和滋养细胞核染色面积的比值如下：3.61±1.08vs4.59±1.22cell/10000μm2,p<0.05；4.32±0.75vs3.341±0.08cell/10000μm2,p<0.05。两组差异间有统计学意义。2、与正常组比较，病例组分子标记和炎症因子的mRNA的表达水平升高：CD68(3.41±2.9vs1.38±1.2p<0.05)、IL-6（2.2±1.1vs1.3±1.0,p<0.05）、TNF-α(2.11±1.21vs1.2±0.6,p<0.05)。两组差异间有统计学意义。【结论】在妊娠期糖尿病孕妇胎盘中的巨噬细胞聚集倾向显著增高，而且这些巨噬细胞的促炎症因子分泌功能显著性增强，说明胎盘中巨噬细胞在妊娠期糖尿病的发病中起到一定的作用。更多还原

【Abstract】 ObjectiveTo assess the relationship between the placental macrophage and the pathogenesis gestational diabetes mellitusMethodsPregnant women with gestational diabetes mellitus (GDM) as well as normal pregnancies was recuited form the clients who attented Tongjing. Placenta samples were collected from15GDM patients and10women with normal pregnancies after cesarean delivery (CD). The expression of macrophage markers (CD68/CD14) and inflammatory cytokines (IL-6/TNF-a) in placenta were detected by immunohistochemistry and PCR.Result1. A significantly higher rate of macrophages was found in the GDM group compared with control group. The ratio of the number of CD68+or CD14+macrophages and the total area of cytotrophoblast’s nuclear are shown as follows:CD68+macrophages vs cytotrophoblast:4.59+1.22vs3.61±1.08cell/10000μm2, p<0.05; CD14+macrophages vs cytotrophoblast:4.32±0.75vs3.341±0.08cell/10000μm2, p<0.05.2. The mRNA expression of macrophage makers and inflammatory cytokines between the two groups are shown as follows:CD68(3.41±2.9vs1.38±1.2, p<0.05); IL-6(2.2±1.1vs1.3±1.0, p<0.05) and TNF-α (2.11±1.21vs1.2±0.6, p<0.05).ConclusionIn conclusion, a higher rate of macrophages accumulation in placenta is noted in gestational diabetes mellitus pregnancies and there are more pro-inflammation factors secreted by the macrophages in the placenta. It indicate the the macrophage play a role in the pathogenesis of gestational dibetes mellitus.更多还原