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目的探讨妊娠期高血压疾病患者血清及胎盘组织中肝X受体α水平的变化及临床意义。方法 2008年11月至2009年7月北京军区总医院产科收治68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23例、轻度子痫前期22例、重度子痫前期23例)及20例正常妊娠妇女(对照组),采用酶联免疫吸附双抗体夹心法(ELISA)及免疫组化方法,检测其血清及胎盘组织中肝X受体α水平。结果妊娠期高血压疾病组血清肝X受体α水平[(217.65±89.43)μg/L]明显高于对照组[(152.38±76.52)μg/L],差异有统计学意义(P<0.01)。妊娠期高血压、轻度子痫前期、重度子痫前期患者血清中肝X受体α水平逐渐升高[分别为(158.33±67.19)μg/L,(225.36±79.22)μg/L,(298.48±81.24)μg/L],各组间差异有统计学意义(P均<0.01)。妊娠期高血压疾病组与对照组比较胎盘组织中肝X受体α表达明显升高(P<0.05)。轻、重度子痫前期患者胎盘组织中肝X受体α表达强度与对照组比较明显升高(P均<0.05)。两组血清肝X受体α水平与胎盘组织肝X受体α表达呈正相关(r=0.618,P<0.01;r=0.492,P<0.01)。结论肝X受体α水平升高可能与妊娠期高血压疾病的发病及病情发展有关。
Objective To investigate the changes of liver X receptor α in serum and placenta of patients with gestational hypertension and its clinical significance. Methods From November 2008 to July 2009, 68 cases of hypertensive disorder complicating pregnancy (gestational hypertension group, including 23 cases of gestational hypertension, 22 cases of mild preeclampsia, severe cases of severe preeclampsia 23 cases of preeclampsia and 20 normal pregnant women (control group). The levels of hepatic X receptor α in serum and placenta were detected by enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry. Results The serum level of X receptor α in gestational hypertension group was significantly higher than that in control group [(217.65 ± 89.43) μg / L [(152.38 ± 76.52) μg / L, P <0.01] . The levels of serum liver X receptor alpha in gestational hypertension, mild preeclampsia and severe preeclampsia patients were gradually increased [(158.33 ± 67.19) μg / L, (225.36 ± 79.22) μg / L, (298.48 ± 81.24) μg / L], with significant difference among the groups (all P <0.01). Compared with the control group, the expression of X receptor α in placental tissue of hypertensive disorder complicating pregnancy was significantly increased (P <0.05). The intensity of liver X receptor α expression in placenta of mild and severe preeclampsia patients was significantly higher than that of the control group (all P <0.05). There was a positive correlation between serum X receptor α level and liver X receptor α expression in the two groups (r = 0.618, P <0.01; r = 0.492, P <0.01). Conclusion The elevated level of liver X receptor α may be related to the pathogenesis and development of hypertensive disorder complicating pregnancy.