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1、子痫前期患者可溶性血管内皮生长因子及其受体与子宫胎盘床螺旋动脉变化及意义作者:杨俊红,曹淑新,梁学军,刘志奇单位:河北省唐山市妇幼保健院妇产科(杨俊红、曹淑新);河北省滦县中医院妇产科(梁学军);河北省石家庄市中心医院麻醉科(刘志奇)【摘要】目的研究可溶性血管内皮生长因子受体1(sFlt1)和血管内皮生长因子(VEGF)在子痫前期患者血清中的浓度变化,以及子宫胎盘床螺旋动脉的相应变化,探讨sFlt1和VEGF在子痫前期中的作用。方法采用酶联免疫吸附试验(ELISA)分别测定轻度子痫前期、重度子痫前期患者及正
2、常妊娠妇女外周血清中sFlt1和VEGF的浓度。同时按照Robertson方法,获取胎盘床活检标本,在光学显微镜下观察子痫前期组与对照组胎盘床螺旋动脉的生理性变化。结果(1)子痫前期组各组外周血清中sFlt1水平明显高于对照组(P0.01),子痫前期重度组高于子痫前期轻度组(P0.05);(2)子痫前期组各组外周血血清中VEGF水平明显低于对照组(P0.05),子痫前期重度组低于子痫前期轻度组(P0.05)。正常妊娠组与子痫前期组胎盘床蜕膜螺旋动脉的生理性改变差异无统计学意义(P>0.05)。子痫前期组肌层
3、螺旋动脉的生理性改变明显少于正常妊娠组,2组差别有统计学意义(P<0.05)。结论外周血中升高的sFlt1和降低的VEGF以及相应的肌层螺旋动脉生理性改变可能与妊娠期高血压的发病有关,并参与了子痫前期病理生理过程。【关键词】子痫前期可溶性血管内皮生长因子受体1血管内皮生长因子胎盘床螺旋动脉 Alterationandpotentialroleofsolublefmsliketyrosinekinasereceptor1andthealterationoftheplacentalbedspiralarter
4、iesinpreeclampsia YANGJunhong,CAOShuxin,LIANGXuejun,etal. DepartmentofGynecologyandObstetrics,MaternalandChildHealthHospitalofTangshan,Hebei,Tangshan063000 【Abstract】ObjectiveToinvestigatethealterationofserumvascularendothelialgrowthfactorandsolublefmsl
5、iketyrosinekinasereceptor1(sFlt1)inpatientswithpreeclampsia.AndthecorrelationoftheplacentalbedspiralarteriesandtheroleroleofsFlt1andVEGFpreeclampisapathophysiology.MethodsSerumvascularendothelialgrowthfactorandsolublefmsliketyrosinekinasereceptor1inperiph
6、eralvenousbloodweredeterminedbyELISAinpatientswithpreeclampsia,severepreeclampsiaandhealthycontrols.AccordingtotheRobertson’smethods,theplacentalbedwasobtainedbybiopsies.Thephysiologicalchangesofspiralarterieswerecomparativelystudiedwithlightmicroscope
7、.ResultsPatientswithpreeclampsiahadhigherlevelofserumsFlt1andlowerserumlevelofVEGFthanthatincontrolgroup(P<0.01).Therewerenosignificantdifferencesbetweennormalpregnanceisandpreeclampsiapatientsinphysiologicalchangesofdeciduassegmentsofspiralarteries(P0.05).
8、Thephysiologicalchangesofmyometriumspiralarteriesinpreeclampsiaweremarkedlylessthanthatinnormalpregnanoy(P0.05).ConclusionThehappeningofpreeclampsiawasrelatedcloselytothedecreaseofphysiologicalc