| Pregnancy-induced-Hypertension (PIH) is an important cause of fetal and maternal mortality. The incidence of it is 9.4%.Its etiology and pathogenesis are undefined now, and it is still one of the most important subjects in perinatology. PIH is a pregnancy-dependent syndrome that would disappear when the pregnancy is end and the placenta is delivered. So the placenta is regarded as a factor which is closely related with PIH.In recent years, more and more researchers have noticed the role of dysfunction of trophoblast and of endothelial cell damage in the pathogenesis of PIH. The researches on the parasecretion of trophoblast and the marker of endothelial cell damage are developing step by step. Neuropeptide Y (NPY) is one of factors cytotrophoblast cell synthesized secreted whose mainly function isto constrict vessel and increase the blood pressure, damage endothelial cell, and cause dysfunction of endothelial cell parasecretion and further increase blood pressure. The aim of this study is to elucidate the role of NPY and endothelial cell damage in pathophysiologic, and provide theoretical foundation of prevention ,and treatment to PIH.Material and Method: 1. All subjects were divided into three group: (l)the early pregnant group (n=22), woman with normal early pregnancy; (2)the normal late pregnant group (n=22), woman with normal late pregnant; (3)the PIH group (n=61), according to the diagnostic standard (Obstetrics and Genecology, the Fifth Edit), it is further subdivided into mild (n=20), middle (n=20) and severe (n=21) group. All patients were of without other complications of pregnancy and primary hypertension, renal disorders. 2. The biopsies were immediately collected after delivery of placenta or villous. Tissue was fixed in 10% formalin and embedded in paraffin wax for subsequent examination. 3. The expression of NPY and cFN were determined using immunohistochemistry. 4. Blood were drown into tubes containing sodium ethylenediamine tetra acetic acid and aprotinin on admission and 6 days after delivery for the measurement of NPY. Sample were centrifuged at 4,3000r/min for 10 minutes, divided into aliquots under sterile conditions, and stored at-80. And plasma NPY concentration was measuredwith a radioimmunoassay.Result: There are no significant difference between PIH group and the normal late pregnant group in maternal ages, labouring gestastional age and the basic diastolic blood pressure (P>0.05). The mean systolic and diastolic blood pressure of three group of PIH in late pregnancy were significantly higher than normal late pregnancy group (P<0.01) as well as basic systolic blood pressure in middle and severe PIH group (P<0.05). The mean birth weight was significantly reduced in severe PIH group(P<0.01). 2. The immunostaining of NPY was observed in syncytiotrophoblast,and nearly staining was absented in the other tissues of the placenta. The intensity of NPY immunostaining of syncytiotrophoblast was significantly increased in PIH group compared with the normal late pregnancy group, especially in middle and severe PIH group (P<0.05). There was positive correlation between the intensity of NPY inmunostaining of syncytiotraphoblast and the state of PIH (r=0.285,P<0.04). 3. The strong immunostaining of cFN was observed in endothelium of villous and stromal cells. Weaker staining was also observed in decidual cells. But it was absent in syncytiotrophoblast. There was no significant difference in the intensity of immunostaining in decidual cells. However, the intensity of cFN immunostaining of endothelium of villous and stromal cells was significantly increased in PIH group comparedwith the normal late pregnancy group (P<0.05), especially in middle and severe PIH group. There was positive correlation between the intensity of cFN immunostaining of villous endothelium and stromal cells and the state of PIH (r=0.367,P<0.04). 4. There was positive correlation between the expression of NPY and cFN in placenta(P<0.05). 5. The strong immunostaining of NPY was observed in syncytiotrophoblast...
|
PDF Full Text Request