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目的探讨内皮细胞黏附分子(ECAM)在子前期患者外周血和脐血中的表达及意义。方法选择2001年12至2002年4月在苏州大学附属一院妇产科分娩的子前期患者与正常孕妇各30例,设为观察组和对照组。用双抗体ABC-ELISA法分别检测孕妇和胎儿静脉血中血管细胞黏附分子-1(VCAM-1)、细胞间黏附分子-1(ICAM-1)和E-选择素的水平。数据经方差分析和相关回归分析。结果VCAM-1,E-选择素在子前期患者外周血及脐血中均明显升高,差异有统计学意义(P<0.01),与舒张压呈正相关,与新生儿体重呈负相关。ICAM-1水平在子前期患者外周血比正常孕妇高,但其在脐血中水平较正常者低,差异均无统计学意义(P>0.05)。结论子前期患者和胎儿的内皮细胞黏附分子表达增强,具有选择性,能反映临床征象。黏附分子引起内皮活化和功能紊乱,可能是子前期发病的重要环节。VCAM-1和E-选择素可能作为孕期监测子前期的指标。
Objective To investigate the expression and significance of endothelial cell adhesion molecule (ECAM) in peripheral blood and umbilical cord blood of patients with preeclampsia. Methods From December 2001 to April 2002, 30 cases of preeclampsia and normal pregnant women delivered in obstetrics and gynecology department of the First Affiliated Hospital of Soochow University were selected as observation group and control group. The levels of VCAM-1, ICAM-1 and E-selectin in venous blood of pregnant women and fetuses were detected by double antibody ABC-ELISA. Data were analyzed by analysis of variance and related regression. Results The levels of VCAM-1 and E-selectin in peripheral blood and umbilical cord blood were significantly higher in preeclampsia patients (P <0.01), positively correlated with diastolic blood pressure and negatively correlated with neonatal body weight. The level of ICAM-1 in peripheral blood of preeclampsia was higher than that of normal pregnant women, but the level of ICAM-1 in umbilical cord blood was lower than that of normal people. There was no significant difference (P> 0.05). Conclusions The expression of endothelial cell adhesion molecules in preeclampsia and fetus is enhanced and selective, which can reflect the clinical signs. Adhesion molecules cause endothelial activation and dysfunction, may be an important part of the child preeclampsia. VCAM-1 and E-selectin may be used as indicators of pre-pregnancy monitoring.