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子痫前期是临床孕产妇妊娠期特有的一种疾病,到目前为止该病依然是导致围生期胎儿及孕产妇死亡的一个重要原因,其发病机制也一直是产科学者关注的焦点。子痫前期由2个阶段构成,包括胎盘血流灌注降低及产妇子痫前期综合征,而两者之间的关系如何始终是临床产科研究的热点[1]。文献[2]报道,子痫前期产妇氧化应激反应明显,与此同时子痫前期与炎性反应间的关系也受到越来越多医生的关注。近年来提出的一元化学说、炎性学说、氧化应激学说和内皮细胞损伤学说来阐述子痫前期的发病机制,而氧化应激被认为是目前联系子痫前期胎盘血流灌注不足与子痫前期综合征的重要因素[3]。正常妊娠自身也有炎性反应,而子痫前期是孕产妇对妊娠的过度炎性反应[4]。本研究通过比较子痫前期与健康产妇超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)与氧化低密度脂蛋白(ox-LDL)、丙二醛(malondialdehyde,MDA)及8-异构前列腺素(8-isoprostane)水平,以及子痫前期病人中上述炎性与氧化应激因子在该病中的相关性。现作报道。
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重度组产妇血清hs-CRP、TNF-α、IL-6等高于轻度组,轻度组高于对照组(P < 0.01)(见表 1)。血清ox-LDL、MDA、8-isoprostane等氧化应激因子水平,重度组产妇高于轻度组,轻度组高于对照组(P < 0.01)(见表 2)。
分组 n hs-CRP/(mg/L) TNF-α/(ng/L) IL-6/(ng/L) 对照组 30 1.41±0.09 8.93±0.98 14.36±1.81 轻度组 18 1.93±0.11** 13.84±1.74** 17.74±1.35** 重度组 12 2.48±0.09**△△ 17.17±1.54**△△ 23.78±1.56**△△ F — 763.93 211.99 213.16 P — < 0.01 < 0.01 < 0.01 MS组内 — 0.009 1.849 2.680 q检验:与对照组比较**P < 0.01;与轻度组比较△△P < 0.01 表 1 3组血清炎症因子水平比较(x±s)
分组 n ox-LDL/(μg/L) MDA/(μmol/L) 8-isoprostane/(pg/L) 对照组 30 429.71±7.96 4.44±0.10 84.16±9.38 轻度组 18 594.49±13.45** 4.68±0.21** 104.43±7.99** 重度组 12 768.05±9.49**△△ 5.26±0.09**△△ 155.99±12.76**△△ F — 6 439.90 242.76 299.32 P — < 0.01 < 0.01 < 0.01 MS组内 — 103.570 0.020 95.225 q检验:与对照组比较**P < 0.01;与轻度组比较△△P < 0.01 表 2 3组血清氧化应激因子水平比较(x±s)
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子痫前期产妇血清ox-LDL、MDA、8-isoprostane等氧化应激因子与hs-CRP、TNF-α、IL-6等炎症因子水平具有正相关关系(P < 0.01)(见表 3、图 1~3)。
因子 ox-LDL MDA 8-isoprostane r P r P r P hs-CRP 0.927 < 0.01 0.83 < 0.01 0.839 < 0.01 TNF-α 0.713 < 0.01 0.538 < 0.01 0.704 < 0.01 IL-6 0.881 < 0.01 0.736 < 0.01 0.826 < 0.01 表 3 子痫前期产妇血清炎症因子与氧化应激因子相关性分析
血清炎症因子在子痫前期病人发病中的作用机制及与氧化应激因子的相关性
Action mechanism of serum inflammatory factors in the pathogenesis of preeclampsia and its correlation with oxidative stress factors
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摘要:
目的探讨血清炎症因子和氧化应激因子在子痫前期病人发病中的作用及相关性。 方法选取30例子痫前期孕产妇作为观察组,其中18例轻度子痫前期(轻度组),12例重度子痫前期(重度组),同时选取同期分娩的30例正常孕产妇作为对照组。比较不同组超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)与氧化低密度脂蛋白(ox-LDL)、丙二醛(MDA)及8-异构前列腺素(8-isoprostane)水平,分析子痫前期产妇hs-CRP、TNF-α、IL-6与ox-LDL、MDA及8-isoprostane的相关性。 结果血清hs-CRP、TNF-α、IL-6炎症因子水平,血清ox-LDL、MDA、8-isoprostane氧化应激因子水平,子痫前期重度组产妇高于轻度组,轻度组高于对照组,差异均有统计学意义(P < 0.01);子痫前期产妇血清ox-LDL、MDA、8-isoprostane等氧化应激因子与hs-CRP、TNF-α、IL-6等炎症因子水平具有正相关关系(P < 0.01)。 结论血清炎症因子及氧化应激因子可能在子痫前期病人发病中具有重要作用,通过干预炎症和氧化应激反应有助于预防子痫前期疾病的发生和发展。 Abstract:ObjectiveTo explore action mechanism of serum inflammatory factors and oxidative stress factors in the pathogenesis of preeclampsia and its correlation. MethodsThirty preeclampsia pregnant women were set as the observation group, which included 18 cases of mild preeclampsia(mild group) and 12 cases of severe preeclampsia(severe group).Meanwhile, 30 normal pregnant women with delivering at the same time were set as the control group.The serum levels of hs-CRP, TNF-α, IL-6 and ox-LDL, MDA and 8-isoprostane were compared among three groups, and the correlations of hs-CRP, TNF-α, IL-6 and ox-LDL and MDA with 8-isoprostane in preeclampsia pregnant women were analyzed. ResultsThe serum levels of inflammatory factors hs-CRP, TNF-α and IL-6, and serum levels of oxidative stress factors ox-LDL, MDA and 8-isoprostane in severe group were higher than those in mild group and control group, respectively(P < 0.01).The serum levels of ox-LDL, MDA and 8-isoprostane were positively correlated with the levels of hs-CRP, TNF-α and IL-6(P < 0.01). ConclusionsThe serum inflammatory and oxidative stress factors may play an important role in the pathogenesis of preeclampsia.Intervening the inflammation and oxidative stress response can help prevent the occurrence and development of preeclampsia. -
Key words:
- preeclampsia /
- oxidative stress factor /
- inflammatory factor /
- pregnant women
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表 1 3组血清炎症因子水平比较(x±s)
分组 n hs-CRP/(mg/L) TNF-α/(ng/L) IL-6/(ng/L) 对照组 30 1.41±0.09 8.93±0.98 14.36±1.81 轻度组 18 1.93±0.11** 13.84±1.74** 17.74±1.35** 重度组 12 2.48±0.09**△△ 17.17±1.54**△△ 23.78±1.56**△△ F — 763.93 211.99 213.16 P — < 0.01 < 0.01 < 0.01 MS组内 — 0.009 1.849 2.680 q检验:与对照组比较**P < 0.01;与轻度组比较△△P < 0.01 表 2 3组血清氧化应激因子水平比较(x±s)
分组 n ox-LDL/(μg/L) MDA/(μmol/L) 8-isoprostane/(pg/L) 对照组 30 429.71±7.96 4.44±0.10 84.16±9.38 轻度组 18 594.49±13.45** 4.68±0.21** 104.43±7.99** 重度组 12 768.05±9.49**△△ 5.26±0.09**△△ 155.99±12.76**△△ F — 6 439.90 242.76 299.32 P — < 0.01 < 0.01 < 0.01 MS组内 — 103.570 0.020 95.225 q检验:与对照组比较**P < 0.01;与轻度组比较△△P < 0.01 表 3 子痫前期产妇血清炎症因子与氧化应激因子相关性分析
因子 ox-LDL MDA 8-isoprostane r P r P r P hs-CRP 0.927 < 0.01 0.83 < 0.01 0.839 < 0.01 TNF-α 0.713 < 0.01 0.538 < 0.01 0.704 < 0.01 IL-6 0.881 < 0.01 0.736 < 0.01 0.826 < 0.01 -
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