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目的研究过氧化物酶体增殖物激活型受体-γ(peroxisome proliferator activated receptor-γ,PPAR-γ)和环氧化酶-2(Cyclooxygenase-2,COX-2)在重度子痫前期及重度子痫前期合并胎儿生长受限(FGR)发病中的作用,以探讨重度子痫前期合并FGR的发病机制,为其早期诊断、早期治疗及病情预测提供新的理论和实验依据。方法收集重度子痫前期合并FGR患者30例(SPF组),单纯重度子痫前期患者30例(SP组),随机选取同期住院的正常晚期妊娠孕妇30例(NP组),采用酶联免疫吸附法(ELISA)方法检测这三组孕妇母血血浆和脐血血浆中COX-2的表达。采用免疫组化技术检测胎盘组织中PPAR-γ蛋白的表达。结果 SPF组、SP组、NP组脐血血清COX-2水平分别为(55.30±8.10),(39.25±7.90),(10.60±5.50)mg/mL,三组差异显著(P<0.05);SPF组、SP组、NP组孕妇血清COX-2水平分别为(35.25±6.58),(26.13±6.10),(7.20±5.36)mg/mL,三组亦有显著差异(P<0.05);SPF组孕妇血清与脐血血清中COX-2水平呈正相关(r=0.526,P<0.01);SPF组、SP组、NP组胎盘组织中PPAR-γ的阳性表达率分别为87.5%、53.1%、29.6%,三组差异显著(P<0.05)。结论 1.COX-2的升高在重度子痫前期和重度子痫前期合并FGR的预测中起着重要作用,COX-2明显升高可预测在重度子痫前期的发病基础上出现FGR;2.出现重度子痫前期合并FGR的胎盘组织PPAR-γ蛋白呈强阳性表达;3.通过测定孕母血清COX-2水平能预测胎儿血清COX-2水平。
Objective To investigate the expression of peroxisome proliferator activated receptor-γ (PPAR-γ) and cyclooxygenase-2 (COX-2) in severe preeclampsia and severe To study the role of FGR in the pathogenesis of preeclampsia combined with fetal growth restriction (FGR) to explore the pathogenesis of FGR complicated with severe preeclampsia and to provide new theoretical and experimental evidence for its early diagnosis, early treatment and prognosis. Methods Thirty patients (SPF group) with severe preeclampsia and 30 patients with severe preeclampsia (SP group) were enrolled in this study. Thirty normal pregnant women (n = 30) were enrolled in this study. Enzyme-linked immunosorbent assay Methods The levels of COX-2 in maternal plasma and cord blood were detected by ELISA. The expression of PPAR-γ protein in placenta was detected by immunohistochemistry. Results The levels of COX-2 in cord blood of SPF group, SP group and NP group were (55.30 ± 8.10), (39.25 ± 7.90) and (10.60 ± 5.50) mg / mL, The levels of COX-2 in pregnant women with SP group, SP group and NP group were (35.25 ± 6.58), (26.13 ± 6.10) and (7.20 ± 5.36) mg / mL respectively The positive rates of COX-2 in pregnant women serum and cord blood serum were positively correlated (r = 0.526, P <0.01). The positive rates of PPAR-γ in SPF, SP and NP groups were 87.5%, 53.1% and 29.6 %, The difference between the three groups was significant (P <0.05). Conclusions 1. The elevated COX-2 plays an important role in the prediction of severe preeclampsia and severe preeclampsia combined with FGR. The marked increase of COX-2 predicts FGR on the basis of severe preeclampsia.2 .The expression of PPAR-γprotein in placentas with severe preeclampsia combined with FGR was strongly positive.3.The level of COX-2 in fetal serum could be predicted by measuring the level of COX-2 in pregnant women.