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目的:研究子痫前期(PE)患者血浆s TRAIL及胎盘滋养细胞上TRAIL/TRAIL-Rs的变化及其与PE发病的关系。方法:选取56例PE患者为研究对象,其中符合重度PE诊断标准者31例(研究组1),未及重度PE 25例(研究组2)。选取同期正常妊娠妇女为对照组,其中28~36周30例(对照组1)、36~(+1)~38周30例(对照组2),因胎膜早破、早产等于28~36周分娩者27例(对照组3),36~(+1)~38周分娩者30例(对照组4)。研究组孕妇留取静脉血及胎盘组织,对照组1、2留取静脉血,对照组3、4留取胎盘组织。ELISA法检测血浆中TRAIL含量,免疫组化法检测胎盘组织中TRAIL和TRAIL-Rs(DR4、DR5、DcR1、DcR2)含量。结果:研究组血浆中sTRAIL含量明显低于对照组(研究组1 vs对照组1,P<0.001;研究组2 vs对照组2,P<0.005);随着病情加重,s TRAIL含量明显下降(P<0.05)。研究组胎盘组织中TRAIL表达明显减少,随着病情加重而加重。研究组中死亡受体DR4、DR5的含量明显高于对照组,而诱骗受体DcR1、DcR2含量明显低于对照组。PE重度组中DR4、DR5含量高于轻度组(P<0.05),DcR1和DcR2含量则无显著差异。结论:PE患者血浆中sTRAIL及胎盘组织中TRAIL/TRAIL-Rs含量发生了明显变化,TRAIL/TRAIL-Rs的不平衡性参与了PE的病理过程。
Objective: To study the changes of plasma s TRAIL and TRAIL / TRAIL-Rs in placental trophoblast cells in patients with preeclampsia (PE) and its relationship with the pathogenesis of PE. Methods: Fifty-six patients with PE were enrolled. Among them, 31 patients (study group 1) who met the criteria of severe PE and 25 patients who did not receive severe PE (study group 2). The normal pregnant women in the same period were selected as the control group, among which 30 cases were 28 ~ 36 weeks (control group 1), 30 cases were 36 ~ (+1) ~ 38 weeks (control group 2) Week delivery 27 cases (control group 3), 36 ~ (+1) ~ 38 weeks delivery in 30 cases (control group 4). Venous blood and placental tissue were collected from pregnant women in study group. Venous blood was taken from control group 1 and 2 and placental tissue from control group 3 and 4. The content of TRAIL in plasma was detected by ELISA and the content of TRAIL and TRAIL-Rs (DR4, DR5, DcR1, DcR2) in placenta were detected by immunohistochemistry. Results: The content of sTRAIL in the study group was significantly lower than that in the control group (study group 1 vs control group 1, P <0.001; study group 2 vs control group 2, P <0.005); as the disease progressed, the content of s TRAIL decreased significantly P <0.05). Study group placental tissue TRAIL expression was significantly reduced, with aggravating aggravate. The DR4 and DR5 levels in the study group were significantly higher than those in the control group, while the levels of decoy receptors DcR1 and DcR2 in the study group were significantly lower than those in the control group. The levels of DR4 and DR5 in PE severe group were higher than those in mild group (P <0.05), while the contents of DcR1 and DcR2 were not significantly different. Conclusion: The levels of sTRAIL and placental TRAIL / TRAIL-Rs in PE patients have obvious changes. The imbalance of TRAIL / TRAIL-Rs is involved in the pathological process of PE.