| Research Goal: A study on the expressions of CD62 and CD63 in the peripheral blood T Lymphocytes and placentas of pregnant women with severe preeclampsia and its clinical significance.Materials and methods: sixty women are taken as the research objects who have received health examinations in the maternity department in the second clinical hospital attached to Jilin University during Feb.2009 to Feb.2010. According to the diagnostic standard of gestational hyperpiesia in the 7th edition of the Obstetric and Gynecology edited by Le Jie, these sixty women are divided into three groups, among which 30 women belong to the group of severe preeclampsia, and there are 20 women in the group of normal advanced period of pregnancy, and there are 10 women in the group of the normal unpregnancy.We get the vena abdominalis and clean catch midstream of women who belong to the normal advanced period of pregnancy and women who have the severe preeclampsia before and after the operation, as well as that of normal women who are not pregnant. We also get the fresh placenta tissue in the caesarean section of women who have severe preeclampsia as well as that of women who are in the advanced period of pregnancy as the control group. Before and after the delivery, CD62L and CD63 in the peripheral blood T lymphocytes in the severe preeclampsia patient and the advanced period of pregnant patient including in the unpregnant patient was detected by flow cytometry. CD62L and CD63 in placentas was detected by immunohistochemistry.XE-2100automatic blood cytoanalyze are adopted to examine the blood Rt, UF-100 automatic urin-sediment analysator and urin-chemical analysator are adopted to examine the urine Rt, and hepatic function and renal function are examined by Hitachi 7600 automatic biochemisty analysator. Using the software of Spss13.0 in Statistics, average +standard deviation is adopted in the measurement data, and data of each group is examined by t-test and rank-sum test. The analysis of dependability adopts Spearman interclass correlation.Results:1.The expression of CD62L in the pregnant patients'peripheral blood T Lymphocytes who have severe preeclampsiaBefore the delivery, the expression of the CD62L in the pregnant patient'peripheral blood T Lymphocytes in the group of advanced period of pregnancy and the group of severe preeclampsia are higher than that of the unpregnant group, and there is difference in statistics(P<0.05,P<0.05). the group of severe preeclampsia is different from the group of advanced period of pregnancy in statistics (P<0.05). After the delivery, there is the apparent difference in statistics between the group of normal advanced period of pregnancy, the group of severe preeclampsia and the unpregnant group(P<0.05, P<0.01), while there is no any difference in statistics between the other groups (P>0.05).2. The expression of CD63 in the pregnant patients'peripheral blood T Lymphocytes who have severe preeclampsiaBefore the delivery, the expression of the CD63 in the pregnant patients'peripheral blood T Lymphocytes in the group of advanced period of pregnancy and the group of severe preeclampsia are higher than that of the unpregnant group, and there is difference in statistics(P<0.05,P<0.05). It is higher in the group of severe preeclampsia than the group of advanced period of pregnancy, and there is difference in statistics (P<0.05). After the delivery, there is the apparent difference in statistics between the group of normal advanced period of pregnancy, the group of severe preeclampsia and the unpregnant group(P<0.05; P<0.01). In normal pregnancy group , it is higher after the delivery than before the delivery, and there is difference in statistics ,there is no any difference between the other groups(P>0.05).3. The expression of CD62L in the placenta tissue in the patients who have severe preeclampsia.There are positive locations of CD62L in every samples of placenta tissue, which are mainly expressed in the chorionic villi's endothelial cell, the interstitial cell of microvilli, the tubercular cell in the intervillous lacuna, endochylema and cell membrane of the microvilli vascular endothelial cell, and which is slightly expressed in the syneytiotrophoblasts. CD62L expressed excessively in the severe preeclampsia and normal advanced period of pregnancy patients'frozen placenta tissue, in which there is no pathological chang such as infarction, fiber calcification and so on. The positive proportion in the normal advanced period of pregnancy is 25%, while in the group of severe preeclampsia is 80%, and there is the apparent difference in statistics between them (P=0).4. The expression of CD63 in the frozen placenta tissue in the patients who have severe preeclampsiaThere are positive locations of CD63 in almost all placenta tissue in every group, which are mainly expressed in syneytiotrophoblasts, the endochylema and cell membrane of the microvilli vascular endothelial cell, the interstitial cell of microvilli , the tubercular cell in the intervillous lacuna, and slightly expressed in endochylema and cell membrane of the microvilli vascular endothelial cell. CD63 expressed excessively in the severe preeclampsia and normal advanced period of pregnancy patients'frozen placenta tissue, in which there is no pathological chang such as infarction, fiber calcification, and so on. The positive proportion in the normal advanced period of pregnancy is 65%, while in the group of severe preeclampsia is 83%, and there is the apparent difference in statistics between them(P<0.05).5. All patients'Clinical data(1)the mean arterial blood pressure in all groupBefore the delivery, the mean arterial blood pressure in the group of severe preeclampsia is higher than that of the advanced period of pregnancy and the unpregnant group, and there is the apparent difference in statistics(P<0.05;P<0.01),and there also is difference in statistics to compare the advanced period of pregnancy to the unpregnant group(P<0.05). After the delivery, there is difference in statistics between the group of severe preeclampsia and the unpregnant group, the group of normal advanced period of pregnancy(P<0.05;P<0.01).while there is no any difference in statistics between the other groups(P>0.05).(2)the blood routine in all groupBefore the delivery, there is difference in statistics between the group of severe preeclampsia and the unpregnant group among WBC count, neutrophile granulocyte count, the percentage of neutrophile granulocyte, the percentage of leukomonocyte(P<0.01;P<0.05;P<0.05;P<0.05), and there is the apparent difference in statistics between the group of the advanced period of pregnancy and the unpregnant group(P<0.01;P<0.05;P<0.01; P<0.01), and there is difference in statistics between the group of severe preeclampsia and the group of the advanced period of pregnancy(P<0.05). After the delivery, there is the apparent difference in statistics between the group of severe preeclampsia and the unpregnant group among WBC count, neutrophile granulocyte count, the percentage of neutrophile granulocyte, the percentage of leukomonocyte(P<0.01; P<0.01;P<0.01;P<0.01), and there is difference in statistics between the group of severe preeclampsia and the group of the advanced period of pregnancy among WBC count, neutrophile granulocyte count, the percentage of neutrophile granulocyte, the percentage of leukomonocyte and platelet count(P<0.01; P<0.05;P<0.05;P<0.01;P<0.05). There is the apparent difference in statistics between the unpregnant group and the group of the advanced period of pregnancy on the percentage of leukomonocyte(P<0.01). There is difference in statistics in the group of severe preeclampsia between antepartum and postpartum among WBC count, neutrophile granulocyte count, the percentage of neutrophile granulocyte, the percentage of leukomonocyt(eP<0.05;P<0.05;P<0.05;P<0.05). The platelet count is difference in the group of the advanced period of pregnancy between antepartum and postpartum(P<0.05).While there is no any difference in statistics between the other groups(P>0.05).(3)Urine protein in all groupBefore the delivery, there is no urine protein in the group of the advanced period of pregnancy and the unpregnant group, while there is urine protein in the group of severe preeclampsia,in which the percentage of urine protein +++ is 85.71% and the percentage of urine protein ++ is 14.29%, and there is the apparent difference in statistics between the group of severe preeclampsia and the group of the advanced period of pregnancy, the unpregnant group(t=12.649,P<0.01,t=11.53,P<0.01). After the delivery, there is also no urine protein in the group of the advanced period of pregnancy and the unpregnant group, and there is also urine protein in the group of severe preeclampsia, but it decreased conspicuously, in which the percentage of urine protein +++ is14.29%, the percentage of urine protein ++ is 42.86% and the percentage of urine protein + is 42.85%. There is the apparent difference in the group of severe preeclampsia between antepartum and postpartum(t=4.382,P<0.01), and there is the apparent difference in statistics between the group of severe preeclampsia and the group of the advanced period of pregnancy, the unpregnant group(t=3.795,P<0.01,t=4.225,P<0.01).(4)liver function and renal function in all groupBefore the delivery, the clinical data of GPT, GOT, UN, Cr, UA in the group of severe preeclampsia is higher than the unpregnant group, and there is the apparent difference in statistics between them(P<0.01;P<0.01;P<0.01;P<0.05;P<0.01). And the clinical data of TSP, SAB and A/G in the group of severe preeclampsia is lower than the unpregnant group, and there is the apparent difference in statistics(P<0.05; P<0.01). The clinical data of GPT, GOT, UN, Cr in the group of severe preeclampsia is higher than the unpregnant group, and there is the apparent difference in statistics between them (P<0.01;P<0.05;P<0.01;P<0.05). The clinical data of UN in the group of the advanced period of pregnancy is higher than the unpregnant group, and there is the apparent difference in statistics between them(P<0.01). After the delivery, the clinical data of TSP, SAB, A/G in the group of severe preeclampsia is lower than the unpregnant group, and there is the apparent difference in statistics between them(P<0.05;P<0.01;P<0.05;P<0.01). The clinical data of UN in the group of severe preeclampsia is higher than the unpregnant group, and there is the apparent difference in statistics between them(P<0.01). The clinical data of UN, Cr in the group of severe preeclampsia is higher than the group of the advanced period of pregnancy, and there is difference in statistics between them(P<0.01,P<0.05),while the clinical data of SAB is lower than the group of the advanced period of pregnancy, and there is difference in statistics between them(P<0.05).In the group of severe preeclampsia, the clinical data of UN decreased after the delivery, and there is difference in statistics(P<0.05). There is no any difference in statistics between the other groups(P>0.05).6. The correlation of CD62L,CD63 and the clinical data of BRT in the peripheral blood T Lymphocytes of pregnant women with severe preeclampsia.There were apparent positive correlations of the expressions of CD62L and CD63 in the peripheral blood T Lymphocytes of pregnant women with severe preeclampsia between antepartum and postpartum. After the delivery, the expressions of CD62L in the peripheral blood T Lymphocytes of pregnant women with severe preeclampsia correlated positively with the percentage of neutrophile granulocyte and the percentage of leukomonocyte. Whether befor the delivery or after the delivery, the expressions of CD63 in the peripheral blood T Lymphocytes of pregnant women with severe preeclampsia correlated positively with the percentage of neutrophile granulocyte and the percentage of leukomonocyte.Conclusion:1. Whether befor the delivery or after the delivery, the positive percentage of the expressions of CD62L in the peripheral blood T Lymphocytes and placentas of pregnant women with severe preeclampsia was higher conspicuously than that of the group of advanced period of pregnancy and the unpregnant group, and after the delivery, it ascensused conspicuously than antepartums'. It was correlated positively with the percentage of neutrophile granulocyte and the percentage of leukomonocyte in the peripheral blood. In the pregnant women with severe preeclampsia, all of these suggest that T lymphocytes in the peripheral blood was activated, immune tolerance was destroyed, Lymphocytes and neutrophile granulocyte mediated by CD62L participated in injuring the vascular endothelial cell and placentas, and it participated in oxidative stress mechanism before the delivery.2.Whether befor the delivery or after the delivery, the positive percentage of the expressions of CD63 in the peripheral blood T Lymphocytes and placentas of pregnant women with severe preeclampsia was higher conspicuously than that of the group of advanced period of pregnancy and the unpregnant group, and It was correlated positively with the percentage of neutrophile granulocyte, the percentage of leukomonocyte in the peripheral blood and the positive percentage of CD62L of peripheral blood T Lymphocytes. It suggest that CD63 was in coordination with CD62L in the activation of T lymphocyte in the peripheral blood , injuring the vascular endothelial cell and oxidative stress.The hyper-expression of CD62L and CD63 of T lymphocyte in the peripheral blood suggest that it was concerned with the vascular endothelial cell's injuring and oxidative stress, which lead to functional defect of all organ, such as edema, high blood pressure, proteinuria, hepatic inadequacy, renal inadequacy, and so on .4. The positive percentage of the expressions of CD62L, CD63 in the peripheral blood T Lymphocytes could be a index in monitoring the activation of T leucocyte in the peripheral blood, the condition of immune tolerance, the injury of the vascular endothelial cell and oxidative stress.
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