【作者】 刘娟；

【导师】 姚穗；

【作者基本信息】 湖南师范大学 ， 妇产科学（专业学位）， 2021， 硕士

【摘要】 目的:通过检测正常孕妇及早发型子痫前期(early-onset preeclampsia,EO-PE)孕妇孕晚期血清中颗粒状头样2(Grainyhead-like2,GRHL-2)与E-钙粘蛋白(E-cadherin,E-cad)的浓度及两者在胎盘组织的表达情况,探讨分析两因子与EO-PE的相关性。方法:选择2020年1月至2020年10月在湖南师范大学附属第一医院产科住院分娩的EO-PE孕妇16例作为研究组,同时随机选取16例正常孕妇作为对照组,通过酶联免疫吸附法(Enzyme-Linked Immuno Sorbent Assay,ELISA)测定所有研究对象血清中E-cad和GRHL-2的浓度,采用免疫组织化学技术(Immunohistochemistry,IHC)定位胎盘中E-cad和GRHL-2蛋白的表达部位,并用IPWIN32图像采集软件对免疫组化切片进行平均光密度值(mean Integrated Optical Density,mean IOD)测定它们在胎盘中的表达量,采用HE染色观察胎盘组织中绒毛的分布情况、绒毛间质纤维化和绒毛血管管径有无狭窄病变情况。使用SPSS 23.0统计软件进行分析数据。结果:1.研究组与对照组相比:孕妇年龄(31.50±2.68,29.06±3.02)岁、孕前BMI(22.70±3.51,22.06±2.26)kg/m~2,差异无统计学意义(P>0.05)。研究组与对照组相比:孕妇收缩压(157.56±8.25,118.31±12.31)mm Hg和舒张压(102.25±4.61,76.31±6.57)mm Hg;分娩孕周(36.02±2.51,38.30±0.74)周;采血孕周(33.21±1.86,35.76±0.53)周;24小时尿蛋白定量(2.93±3.20,0.23±0.10)g/24h;新生儿出生体重(2240.94±674.78,3103.13±246.24)g;差异均具有统计学意义(P<0.001)。2.ELISA检测结果:研究组血清E-cad、GRHL-2的浓度分别为(286.74±37.19)ng/ml、(167.25±30.06)pg/ml;对照组分别为(255.20±27.31)ng/ml、(150.15±12.77)pg/ml;研究组明显高于对照组,差异具有统计学意义(P<0.05)。3.IHC检测结果:GRHL-2主要表达定位于滋养细胞胞质和胞核中,半定量分析结果显示研究组GRHL-2 mean IOD值(18.52±5.11)较对照组(6.31±3.52)明显升高,差异具有统计学意义(P<0.001);E-cad主要表达定位于滋养细胞胞膜和胞浆中,半定量分析结果显示研究组E-cad mean IOD值(13.10±10.61)较对照组(7.43±2.97)明显升高,差异具有统计学意义(P<0.05)。4.相关性分析:研究组血清GRHL-2的浓度与收缩压及舒张压呈正相关关系(r分别为0.59、0.59,P<0.05);研究组血清E-cad、GRHL-2的浓度与24小时尿蛋白定量呈正相关关系(r分别为0.63、0.73,P<0.01);所有研究对象血清GRHL-2浓度与E-cad浓度呈正相关关系(r为0.54,P<0.01)。结论:1.在EO-PE患者孕晚期血清及胎盘组织中,E-cad、GRHL-2表达水平较对照组升高,两者与EO-PE有一定相关性。2.在EO-PE患者中,血清GRHL-2浓度与血压、尿蛋白定量呈正相关关系,血清E-cad浓度与尿蛋白定量呈正相关关系。3.在所有研究对象中,血清GRHL-2浓度与E-cad浓度呈正相关关系。更多还原

【Abstract】 Objective:The expression levels of grainyhead-like2(GRHL-2)and E-cad in serum and placental tissue of normal pregnant women and early onset preeclampsia(EO-PE)women were detected to investigate the correlation between the occurrence of EO-PE and the two factors.Methods:16 EO-PE pregnant women who delivered in the obstetrics department of the First Affiliated Hospital of Hunan Normal University from January 2020 to October 2020 were selected as the study group,and16 normal pregnant women were randomly selected as the control group,Enzyme-Linked Immuno Sorbent Assay(ELISA)was used to determine the serum levels of E-cad and GRHL-2 in all subjects,Immunohisto-chemistry(Immunohistochemistry,IHC)was used to determine the levels of E-cad and GRHL-2 at placentas in all subjects,And the expression sites of E-cad and GRHL-2 proteins in the placenta were located,Mean Integrated Optical Density(Mean IOD)was measured in the immunohistochemical sections by using IPWIN32 image acquisition software,The conditions of trophoblast cells,villous interstitial fibrosis and villous vascular lesions were observed by HE staining.SPSS 23.0statistical software was used to analyze the data.Results:1.Compared with the control group:there were no significant differences in pregnant women’s age(31.50±2.68,29.06±3.02)years,pre-pregnancy BMI(22.70±3.51,22.06±2.26)kg/m~2in study group(P>0.05).Compared with the control group:the systolic blood pressure(157.56±8.25,118.31±12.31)mm Hg and the diastolic blood pressure(102.25±4.61,76.31±6.57)mm Hg;delivery gestational age(36.02±2.51,38.30±0.74)weeks;gestational week of blood collectionthe(33.21±1.86,35.76±0.53)weeks;24-hour urinary protein(2.93±3.20,0.23±0.10)g/24h;and the newborn birth weight(2240.94±674.78,3103.13±246.24)g were significantly decreased;and the difference was statistically significant(P<0.001).2.ELISA test results:the serum levels of E-cad and GRHL-2 in the study group were(286.74±37.19)ng/ml and(167.25±30.06)pg/ml;respectively,and those in the control group were(255.20±27.31)ng/ml and(150.15±12.77)pg/ml;the study group was significantly higher than the control group,the difference was statistically significant(P<0.05).3.IHC results:GRHL-2 was mainly expressed in the cytoplasm and nucleus of trophoblast cells.Semi-quantitative analysis showed that the mean IOD value of GRHL-2 in the study group(18.52±5.11)was significantly higher than that in the control group(6.31±3.25),and the difference was statistically significant(P<0.001);E-cad was mainly expressed in the membrane and cytoplasm of trophoblast cells,Semi-quantitative analysis showed that the mean value of E-cad in the study group(13.10±10.61)was significantly higher than that in the control group(7.43±2.97),and the difference was statistically significant(P<0.05).4.Correlation analysis:study group serum GRHL-2 concentration was positively correlated with systolic and diastolic blood pressure(r=0.59,0.59,P<0.05);study group serum concentrations of E-cad and GRHL-2 were positively correlated with 24-hour urinary protein quantification(r=0.63,0.73,P<0.01);serum GRHL-2 concentration and E-cad concentration were positively correlated in all subjects(r=0.54,P<0.01).Conclusion:1.It was concluded that the expressions of E-cad and GRHL-2 in serum and placental tissues of EO-PE patients in the third trimester were significantly increased,both of them were of some correlation with EO-PE.2.In EO-PE patients,serum GRHL-2 concentration was positively correlated with blood pressure and urinary protein quantification,and serum E-cad concentrationwas positively correlated with urinary protein quantification.3.Serum GRHL-2 concentration and E-cad concentration were positively correlated in all subjects.更多还原