[1]吴翠杰,崔静雯,冯小丽,等.抗血管紧张素Ⅱ 1型受体自身抗体在子痫前期患者血清及新生儿脐血中的表达[J].新乡医学院学报,2017,34(4):303-306.[doi:10.7683/xxyxyxb.2017.04.015]
 WU Cui-jie,CUI Jing-wen,FENG Xiao-li,et al.Expression of angiotensinⅡtype 1 receptor agonistic autoantibody in serum of preeclampsia patients and the umbilical cord blood of neonatal[J].Journal of Xinxiang Medical University,2017,34(4):303-306.[doi:10.7683/xxyxyxb.2017.04.015]
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抗血管紧张素Ⅱ 1型受体自身抗体在子痫前期患者血清及新生儿脐血中的表达
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
34
期数:
2017年4
页码:
303-306
栏目:
临床研究
出版日期:
2017-04-05

文章信息/Info

Title:
Expression of angiotensinⅡtype 1 receptor agonistic autoantibody in serum of preeclampsia patients and the umbilical cord blood of neonatal
作者:
吴翠杰崔静雯冯小丽元 媛
(安阳市中医院妇产科,河南 安阳 455000)
Author(s):
WU Cui-jieCUI Jing-wenFENG Xiao-liYUAN Yuan
(Department of Obstetrics and Gynecology,Anyang Hospital of Traditional Chinese Medicine,Anyang 455000,Henan Province,China)
关键词:
子痫前期抗血管紧张素Ⅱ 1型受体自身抗体肾功能障碍
Keywords:
preeclamipsiaangiotensinⅡtype 1 receptor agonistic autoantibodyrenal dysfunction
分类号:
R714.244
DOI:
10.7683/xxyxyxb.2017.04.015
文献标志码:
A
摘要:
目的 观察抗血管紧张素Ⅱ 1型受体自身抗体(AT1-AA)在孕妇妊娠中期及分娩前后血清、新生儿脐血中的表达水平及其与子痫前期发病的关系。方法 选取2012年5月至2014年4月于安阳市中医院、安阳市妇幼保健院剖宫产终止妊娠孕妇80例,其中轻度子痫前期孕妇26例(轻度子痫前期组),重度子痫前期孕妇24例(重度子痫前期组),健康妊娠孕妇30例(对照组)。采用酶联免疫吸附试验检测各组孕妇在妊娠中期及剖宫产前1 d和产后1 d血清、新生儿脐血中AT1-AA表达水平,同时进行相关临床指标的检测并分析其与AT1-AA表达水平的相关性分析。结果 对照组、轻度子痫前期组、重度子痫前期组孕妇妊娠中期血清中AT1-AA表达水平分别为(46.932±6.868)、(58.426±7.146)、(67.120±8.922) ng·L-1,产前1 d血清中AT1-AA表达水平分别为(68.593±9.241)、(135.395±10.766)、(180.320±13.795)ng·L-1,产后1 d血清中AT1-AA表达水平分别为(45.681±4.277)、(47.274±5.120)、(48.899±5.065)ng·L-1。轻度子痫前期组、重度子痫前期组孕妇妊娠中期和产前1 d血清中AT1-AA表达水平均高于对照组,重度子痫前期组孕妇妊娠中期和产前1 d血清中AT1-AA表达水平高于轻度子痫前期组(P<0.01);产后1 d血清中AT1-AA表达水平重度子痫前期组高于对照组(P<0.05),其余各组两两比较差异均无统计学意义(P>0.05)。各组孕妇产前1 d血清中AT1-AA表达水平均高于产后 1 d(P<0.05)。对照组、轻度子痫前期组、重度子痫前期组新生儿脐静脉血中AT1-AA表达水平分别为(62.125±10.317)、(110.522±13.368)、(131.512±15.198)ng·L-1,各组间两两比较差异均有统计学意义(P<0.01)。子痫前期孕妇产前1 d血清中AT1-AA表达水平与新生儿出生体质量、胎盘质量呈明显负相关,与脐动脉收缩期最高血流速度与舒张期最低血流速度比值(S/D)、脐动脉血流阻力指数(RI)、收缩压、舒张压、24 h尿蛋白、血肌酐呈明显正相关(r=-0.853、-0.788、0.836、0.744、0.956、0.759、0.869、0.773,P<0.05)。多元线性回归分析显示,AT1-AA表达水平主要受收缩压、24 h尿蛋白、RI影响。妊娠中期血清AT1-AA表达水平预测子痫前期,曲线下面积为0.916,界限值为53.200 ng·L-1,敏感度和特异度分别为0.880、0.800。结论 AT1-AA在子痫前期患者血清、新生儿脐血中高表达,可以作为子痫前期的预测指标。
Abstract:
Objective To observe the expression level of angiotensinⅡtype 1 receptor agonistic autoantibody(AT1-AA) in serum during the second trimester of pregnancy and peripartum and in umbilical cord blood of neonatal and its relationship with preeclampsia.Methods Eighty pregnant women who underwent cesarean section operation in Anyang Hospital of Traditional Chinese Medicine and Anyang Maternal and Child Health Care Hospital from May 2012 to April 2014 was selected.Among them,26 cases were pregnant women with mild preeclampsia(mild preeclampsia group),24 cases were pregnant women with severe preeclampsia(severe preeclampsia group),30 cases were healthy pregnant women(control group).The level of AT1-AA in serum during the second trimester of pregnancy and 1 day before and after cesarean section operation and in umbilical cord blood of neonatal was detected by enzyme linked immunosorbent assay.At the same time,the clinical indexes was detected,and the correlation between them and AT1-AA level was analysed.Results The serum level of AT1-AA of the pregnant women during second trimester of pregnancy in control group,mild preeclampsia group,and severe preeclampsia group was(46.932±6.868),(58.426±7.146),(67.120±8..922)ng·L-1 respectively;the serum level of AT1-AA of the pregnant women at 1 day before cesarean section operation in the above three groups was(68.593±9.241),(135.395±10.766),(180.320±13.795)ng·L-1 respectively;the serum level of AT1-AA of the pregnant women at 1 day after cesarean section operation in the above three groups was(45.681±4.277),(47.274±5.120),(48.899±5.065)ng·L-1 respectively.The serum level of AT1-AA in mild preeclampsia group and severe preeclampsia group during second trimester of pregnancy and 1 day before cesarean section operation was significantly higher than that in the control group(P<0.01);and the AT1-AA level in severe preeclampsia group was significantly higher than that in mild preeclampsia group(P<0.01).The serum level of AT1-AA at 1 day after cesarean section operation in severe preeclampsia group was significantly higher than that in the control group(P<0.05);there was no statistic difference in serum level of AT1-AA among other groups(P>0.05).The serum level of AT1-AA at 1 day before cesarean section operation in each group was significantly higher than that at 1 day after cesarean section operation.The level of AT1-AA in the umbilical cord blood of neonatal in control group,mild preeclampsia group,and severe preeclampsia group was(62.125±10.317),(110.522±13.368),(131.512±15.198)ng·L-1 respectively;there was statistic difference in the AT1-AA level among the groups(P<0.01).The serum level of AT1-AA of the preeclampsia pregnant women at 1 day before cesarean section operation was negatively correlated with birth weight of neonate and the weight of placenta;and was positively correlated with the umbilical artery S/D ratio,resistance index(RI) of umbilical artery,systolic pressure,diastolic pressure,24 h urine protein and serum creatinine(r=-0.853,-0.788,0.836,0.744,0.956,0.759,0.869,0.773;P<0.05).The multiple linear regression results showed that the AT1-AA level was mainly impacted by systolic pressure,24 h urine protein and RI values.Using AT1-AA level in serum in the middle of the pregnancy to predict preeclampsia,the area under the curve(AUC) was 0.916,the boundary value was 53.200 ng·L-1,and the sensitivity and specificity was 0.880,0.800 respectively.Conclusion The high expression level of AT1-AA in patients′ serum and the umbilical cord blood.Therefore AT1-AA can be the predictive index of preeclampsia.And the AT1-AA in preeclampsia patients participate in patients′ renal dysfunction and fetus restricted growth in intrauterine happened.

参考文献/References:

[1] 董金菊,周宇涵.子痫前期并发急性肾损伤孕妇尿液中肾损伤分子-1和β2-微球蛋白水平的变化[J].新乡医学院学报,2015,32(9):833-835,838.
[2] 马桂伶,李艳芳,张麟.血管紧张素Ⅱ1型受体自身抗体与子痫前期[J].临床医学进展,2013,3(1):1-4.
[3] HERSE F,LAMARCA B.Angiotensin Ⅱ type 1 receptor autoantibody(AT1-AA)-mediated pregnancy hypertensio[J].Am J Reprod Immunol,2013,69(4):413-418.
[4] BAI K H,WANG K,LI X Y,et al.Autoantibody against angiotensin AT1 receptor from preeclamptic patients enhances collagen-induced human platelet aggregation[J].Acta Biochim Biophys Sin,2013,45(9):749-755.
[5] YANG X L,WANG F,LAU W B,et al.Autoantibodies isolated from preeclamptic patients induce endothelial dysfunction via interaction with the angiotensin Ⅱ AT1 receptor[J].Cardiovasc Toxicol,2014,14(1):21-29.
[6] 刘翔,任红旗.先兆子痫肾损害发病机制的研究进展[J].中华临床医师杂志:电子版,2015,9(13):2577-2582.DOI:10.3877/cma.j.issn.1674-0785.2015.13.027.
[7] 熊京,杨慧敏,朱峰,等.血管紧张素Ⅱ1型受体自身抗体在原发性肾小球疾病患者血清中的表达及意义[J].中国病理生理杂志,2013,29(8):1487-1491.
[8] PARRISH M R,RYAN M J,GLOVER P,et al.Angiotensin Ⅱ type 1 autoantibody induced hypertension during pregnancy is associated with renal endothelial dysfunction [J].Gen Med,2011,8(3):184-188.
[9] IRANI R A,ZHANG Y,BLACKWELL S C,et al.The detrimental role of angiotensin receptor agonistic antibodies in intrauterine growth restriction seen in preeclampsia[J].J Exp Med,2009,206(12):2809-2822.
[10] 赵先兰,刘传,刘彩.孕妇外周血、脐血和胎盘组织中AT1-AA及内皮素1的表达及其与子痫前期发病的关系[J].中华妇产科杂志,2012,47(10):721-725.
[11] ZHANG D,WANG L,QIAO C,et al.The role of the reduction of spiral artery remodeling and heme oxygenase 1 in mediating AT1-AA-induced hypertension and intrauterine growth restriction in pregnant rats[J].Am J Perinatol,2014,31(10):883-890.
[12] 梁莹,王妍春.抗AT1受体自身抗体的研究进展[J].中国中西医结合肾病杂志,2012,13(7):651-653.

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更新日期/Last Update: 2017-04-05