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目的检测VEGF、sFlt-1及NO在早发型子痫前期和晚发型子痫前期患者血清和胎盘中的表达。方法随机选取2013年5月至2014年6月规律产检并分娩的子痫前期孕妇75例,其中早发型子痫前期31例,晚发型子痫前期44例。选取同期健康晚期妊娠孕妇30例作为健康对照组,采用免疫组织化学SP法检测VEGF、sFlt-1的表达,用硝酸还原法测定胎盘中NO的表达,并进行相关性分析。结果早发型子痫前期患者胎盘组织中VEGF阳性表达率32.2%,晚发型组为61.4%,正常对照组为86.7%,3组差异有统计学意义(P<0.05);早发型子痫前期患者胎盘组织中sFlt-1阳性表达率82.1%,晚发型组74.8%,正常对照组12.9%,3组差异有统计学意义(P<0.05);NO的光密度结果在早发型子痫前期患者胎盘组织中是59.3±2.21,晚发型组为31.6±1.90,正常对照组89.9±2.17,3组差异有统计学意义(P<0.05)。结论 sFlt-1在早发型子痫患者的胎盘组织中表达最高,抑制了其靶组织VEGF表达,影响了胎盘微血管形成;NO在早发型子痫患者的胎盘组织中表达最低,抑制了微血管的舒张。SFlt-1和NO与早发型子痫前期的发病密切相关。
Objective To detect the expression of VEGF, sFlt-1 and NO in serum and placenta of patients with preeclampsia and late-onset preeclampsia. Methods A total of 75 pregnant women with preeclampsia were randomly selected from May 2013 to June 2014 with preeclampsia in 31 cases and late-onset preeclampsia in 44 cases. Thirty healthy pregnant women at the same period of healthy pregnancy were selected as the healthy control group. The expression of VEGF and sFlt-1 was detected by immunohistochemical SP method. The NO expression in the placenta was determined by nitric acid reduction method and the correlation was analyzed. Results The positive expression rate of VEGF in placenta of preeclampsia patients was 32.2%, in the late-onset group was 61.4%, in the normal control group was 86.7%, there was significant difference between the 3 groups (P <0.05); in the patients with early-onset preeclampsia The positive expression rates of sFlt-1 in placenta were 82.1%, 74.8% in late-onset group and 12.9% in normal control group, and the difference was statistically significant (P <0.05). The optical density of NO was significantly higher in placenta of early-onset preeclampsia 59.3 ± 2.21 in the tissue, 31.6 ± 1.90 in the late-onset group and 89.9 ± 2.17 in the normal control group, with significant difference (P <0.05). Conclusion The expression of sFlt-1 in the placenta of patients with early-onset eclampsia is the highest, which inhibits the expression of VEGF in target tissues and affects the formation of placental microvessels. The expression of sFlt-1 is the lowest in the placenta of early-onset eclampsia and inhibits the relaxation of microvessels . SFlt-1 and NO are closely related to the onset of preeclampsia.