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目的探讨乙型肝炎病毒感染孕妇胎盘中细胞因子的笔表达以及与胎盘细胞凋亡的关系,阐明乙型肝炎病毒感染孕妇致异常妊娠的机理。方法选择30例HBV感染孕妇死胎胎盘作为研究组,正常分娩后的胎盘20例作为对照组,应用免疫组织化学法测定各组胎盘组织中TNF和IL-18的表达,应用TUNEL法检测胎盘细胞凋亡指数。结果在正常胎盘组织中有一定量的TNF和IL-18的表达,但在HBV感染孕妇死胎胎盘组织中TNF和IL-18的阳性细胞数显著高于对照组(P<0.01);研究组胎盘细胞凋亡指数显著高于对照组(P<0.01),合体滋养细胞的凋亡指数高于滋养细胞,在正常对照组两种细胞的凋亡指数差异有显著性(P<0.05),而在研究组两种细胞的凋亡指数差异无统计学意义(P>0.05)。经相关分析发现,胎盘细胞的凋亡指数与TNF、IL-18呈正相关,(A=6.38,B=0.82,r=0.54;A=9.66,B=0.52,r=0.61)。结论HBV感染孕妇死胎胎盘中TNF和IL-18的表达增加,使胎盘细胞凋亡加速,影响胎盘的正常功能,是导致胎儿异常的原因之一。
Objective To investigate the expression of cytokines in placenta and the relationship with placental apoptosis in hepatitis B virus infected pregnant women and to elucidate the mechanism of abnormal pregnancy induced by hepatitis B virus infection in pregnant women. Methods The placenta of 30 pregnant women with HBV infection were selected as the study group. Twenty normal placenta after delivery were taken as the control group. The expression of TNF and IL-18 in the placenta was detected by immunohistochemistry. The index of death. Results There was a certain amount of TNF and IL-18 expression in normal placenta, but the positive cells of TNF and IL-18 in placenta of deceased fetus with HBV infection were significantly higher than those in control group (P <0.01). The placental cells (P <0.01). The apoptotic index of syncytiotrophoblasts was higher than that of trophoblasts (P <0.01). There was a significant difference in apoptosis index between the two cells in the normal control group (P <0.05) There was no significant difference in apoptosis index between two groups (P> 0.05). The correlation analysis showed that the apoptosis index of placental cells was positively correlated with TNF and IL-18 (A = 6.38, B = 0.82, r = 0.54; A = 9.66, B = 0.52, r = 0.61). Conclusion The expression of TNF and IL-18 in the placenta of the fetus with HBV infection is increased, which may accelerate the apoptosis of the placenta and affect the normal function of the placenta, which is one of the causes of fetal abnormalities.