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目的探讨肝细胞生长因子(Hepatocyte growth factor,HGF)与胰岛素样生长因子-1(Insu lin like growth fac-tor-1,IGF-1)在正常晚孕妇女及妊娠期高血压疾病患者胎盘组织中的表达以及在妊娠期高血压疾病发病中的作用。方法采用免疫组织学方法检测62例妊娠期高血压疾病患者(妊娠期高血压疾病组,其中妊娠期高血压21例。轻度子痫前期19例,重度子痫前期22例)及20例正常晚孕妇女(对照组)的胎盘组织中HGF及IGF-1的表达强度,同时HE染色,选取5个高倍视野,计数绒毛血管数。结果(1)HGF主要表达于绒毛间质细胞胞浆,蜕膜细胞有少量表达。重度子痫前期患者胎盘绒毛间质细胞HGF的表达强度显著低于对照组(H=8.548,P=0.003),而妊娠期高血压及轻度子痫前期患者与对照组比较,差异无显著性(H=0.018,P=0.892;H=3.739,P=0.053);(2)IGF-1主要表达于胎盘合体滋养细胞、细胞滋养细胞及蜕膜细胞的胞膜及胞质中。胎盘组织中IGF-1的表达,轻、重度子痫前期患者明显低于对照组(H=4.948,P=0.026;H=15.245,P=0.001)而妊娠期高血压与对照组比较,差异无显著性(H=0.118,P=0.731);(3)不同程度妊娠期高血压疾病组胎盘绒毛血管密度均较对照组减少,重度子痫前期患者胎盘绒毛血管密度为(59.69±3.86)个/×400,与对照组(67.67±4.55)个/×400相比,差异有显著性(P<0.01);(4)相关性分析显示两组孕妇胎盘组织中HGF、IGF-1表达强度分别与绒毛血管密度、新生儿出生体重呈正相关(r=0.695,r=0.386;r=0.270,r=0.782);对照组及妊娠期高血压患者胎盘组织中HGF与IGF-1的表达强度呈强正相关性(r=0.950,P<0.01;r=0.864,P<0.01)。结论胎盘组织中HGF、IGF-1分泌减少与妊娠期高血压疾病发病及病情发展有关,IGF-1可能参与了HGF水平的调节。
Objective To investigate the effects of hepatocyte growth factor (HGF) and insulin-like growth factor-1 (IGF-1) on the plasma levels of placental tissue in normal pregnant women and patients with hypertensive disorder complicating pregnancy Expression and the role in the pathogenesis of hypertensive disorders during pregnancy. Methods Sixty-two patients with gestational hypertension (gestational hypertension group, 21 with gestational hypertension, 19 with mild preeclampsia and 22 with severe preeclampsia) and 20 normal controls The expression intensity of HGF and IGF-1 in placenta of pregnant women (control group) at the same time, HE staining at the same time, select five high power field, count the number of villus. Results (1) HGF was mainly expressed in the cytoplasm of villus stromal cells with a small amount of decidual cells. The expression of HGF in placental villi interstitial cells in patients with severe preeclampsia was significantly lower than that in the control group (H = 8.548, P = 0.003), but there was no significant difference between hypertensive pregnancy group and mild preeclampsia patients (H = 0.018, P = 0.892; H = 3.739, P = 0.053). (2) IGF-1 was mainly expressed in the membrane and cytoplasm of placental syncytiotrophoblast, cytotrophoblast and decidual cells. The expression of IGF-1 in placenta was significantly lower in patients with mild and severe preeclampsia than in controls (H = 4.948, P = 0.026; H = 15.245, P = 0.001) (3) The density of placental villi in patients with hypertensive disorder complicating pregnancy decreased compared with the control group, and the density of placental villi in severe preeclampsia was (59.69 ± 3.86) / (P <0.01). (4) The correlation analysis showed that the expression intensity of HGF and IGF-1 in the placenta of the two groups were significantly different from that of the control group (67.67 ± 4.55) / × 400 (R = 0.695, r = 0.386; r = 0.270, r = 0.782). The expression intensity of HGF and IGF-1 in control group and gestational hypertension placenta was positively correlated Correlation (r = 0.950, P <0.01; r = 0.864, P <0.01). Conclusions The decrease of HGF and IGF-1 secretion in placenta is related to the onset and progression of hypertensive disorders in pregnancy. IGF-1 may be involved in the regulation of HGF.