目的探讨高温需求因子A1(HtrA1)在子痫前期合并胎儿生长受限(PE-FGR)患者胎盘组织及血清中的表达及意义。方法利用免疫组化SABC法检测正常妊娠者100例为对照组,子痫前期(PE)组83例及PE—FGR组17例胎盘组织中HtrA1蛋白表达,同时利用E1isa法分别检测晚孕期28^+1-32周、32^+1-36周、I〉36^+13个时间段内血清HtrA1浓度。结果PE—FGR组预后较差,多为早发型子痫前期。HtrA1在对照组、PE组、PE—FGR组胎盘中的表达逐渐升高(平均灰度表达分别为152.69±4.11、156.03±5.07,165.82q-3.20),任意2组间差异均有统计学意义(t=2.974~5.688,均P〈0.05)。仅28^+1-32周间PE组及PE.FGR组血清中HtrA1水平(分别为42.66±2.24,47.32-I-3.22)显著高于对照组(28.18±2.40)(t分别为8.38、9.37,均P〈0.05),PE组与PE-FGR组间无显著差异(t=2.562,P〉0.05)。结论HtrA1可能参与PE—FGR的发生,孕28“~32周血清中HtrA1高表达可能预示着PE及PE—FGR的发生。
Objective To study the expression and significance of high temperature requirement A1 (HtrA1) in placenta and serum of pregnant woman with preeclampsia and fetal growth restriction (PE-FGR). Methods One hundred riormal pregnant women (control group), 83 women with PE(PE group) and 17 women with PE-FGR (PE-FGR group)were selected in the research. The expression of HtrA1 in placenta of each group was detected by immunohistochemistry SABC method. Meanwhile, concentration of serum HtrA1 was detected by Elisa at three periods in third trimester of pregnancy, 28^+1-32 weeks, 32^+1-36 weeks and ≥ 36^+1 weeks. Results The prognosis of PE-FGR group was relatively poor, and most of them developed early onset PE. The expression of HtrA1 in placenta of control group, PE group and PE-FGR group increased gradually ( average grey expression was 152.69 ± 4.11, 156.03 ± 5.07 and 165.82 ± 3.20, respectively ), and there was statistical difference between any two groups ( t = 2. 974-5. 688, all P 〈 0.05 ). Only during the period of 28 ^+1 to 32 weeks, concentration of serum HtrA1 in PE group and PE-FGR group (42.66 ± 2.24 and 47.32 ± 3.22, respectively ) was significantly higher than that in control group (28.18 ± 2.40)( t value was 8.38 and 9.37, respectively, both P 〈 0.05 ). But there was no significant difference between PE group and PE-FGR group ( t = 2. 562, P 〉 0. 05 ). Conclusion HtrAl may participate in etiology of PE-FGR. Elevation of serum HtrA1 during 28 +1to 32 weeks may indicate the happening of PE and PE-FGR.