| Objective: Hypertensive disorder complicating pregnancy(HDCP)is a systemic disease of gestational idiopathic, epidemiology survey found that the incidence of this disease in our country into 9.4%-10.4%, foreign reports 5%-12%. Hypertensive disorder complicating pregnancy risk is closely related to many risk factors such as pregnant woman is too old or too young, diabetes, obesity, family history of HDCP,low socioeconomic status. The placenta is fetal and maternal nutrient exchange sites,structure and function of placenta change would have a direct impact on the fetus.So explore the correlation of hypertensive disorders of pregnancy placenta pathological changes,pathophysiology and clinical tests(such as blood plasma ET,serum NO,PAPP-A,TXA2 etc.),PE incidence and degree of maternal and perinatal outcomes among has become a hot topic in the field of prevention and treatment of hypertensive disorders of pregnancy.The incidence of preeclampsia rate is 9.4%, is the main reason of higher morbidity and mortality of mother and infant. Effect of preeclampsia maternal mainly for placental abruption, fetal growth restricted, fetal distress,intrauterine fetal death,premature birth, potpartum hemorrhage and severe cases can cause death. But the etiology and pathogenesis of preeclampsia has not yet been elucidate, studies that may be related to gene, placental oxygen supply imbalance, domain hair trophoblastic erosionbad, maternal vascular damage, immune factors, the related treatment measures can improve the patient of acute and chronic phase of symptoms, but not fundamentally reverse the progression of the disease and ultimately prevent the incidence of preeclampsia, there may be other unknown factors involved in suggesting that occurred in the process of development of preeclampsia. Epidermal growth factor(EGF)by binding to receptors on target cells EGFR can stimulate a variety of cell division and proliferation, the study found that the study found that epidermal growth factor receptor(EGFR) has a strong expression in the placenta, suggesting that EGF may play an important role in placental stage of certain diseases, pregnancy in growth and development. h CG is a hormone secreted by placenta.And researchers found that h CG had the role of EGF in regulation of the organization,the phosphorylation of ERK1/2 mediated EGF can also be activated to promote the secretion of h CG guide.Results through the observation of hypertensive disorder complicating pregnancy pregnant women serum EGF and β-h CG serological examination of this study, and EGFR in placenta of patients with immune is to chemical analysis, and explore their correlation, to further explore their relationship with the pathogenesis of preeclampsia, and provide a theoretical basis for the study on the pathogenesis of hypertensive disorder complicating pregnancy.Method: 1 The object of study 1.1 Experimental group60 patients with preeclampsia childbirth patients hospitalized in 2014.5~2014.12 in the selection of the second hospital of Handan City, including 30 cases of severe preeclampsia patients, 30 cases of mild preeclampsia group. The experimental group of pregnant women aged 22-38 years, mean age 27.65±3.85 years; pregnancy 34-40 weeks, the mean gestational age was 36.80±2.30 weeks. 1.2 Control groupRandomly selected 20 cases of normal pregnant women as control group in the same period, the control group of women aged 22-36 years, mean age 26.35±3.75 years; pregnancy 36-40 weeks, the mean gestational age was 37.12±2.02 weeks.The control group and the experimental group of pregnant women are single pregnancy, have no chronic high blood pressure, heart disease, diabetes, chronic kidney disease, immunological disease history. 2 Specimen collectionAcquisition experiment object 5ml fasting venous blood, after centrifugation, minus 80 degrees save,measuring the β-h CG and EGF levels; Take vertically 1×1×1cm tissue block on the position of placental maternal surface center of pregnant women after delivery, 10% formalin fixed, HE stained 200 times, embedded in paraffinsectioning, 4μm to be pathological examination. 3 Chemiluminescence immunoassay(Chemiluminescence Analysis, CLIA method) for detemination of h CG level, Enzyme-linked immunosorbent assay(ELISA)method for determination of EGF level. For immunochemical analysis of EGFR in the placenta. 4 The SPSS17.0 system software for analysis, clinical data and the experimental results of patients with application of group test, linear correlation analysis and other statistical methods for statistical analysis,each group of data expressed in x ±s, P<0.05 had significant difference.Results:1 Maternal blood serum β-h CG levels of severe preeclampsia(SPE) and mild preeclampsia(MPE) groups were significantly higher than that of the control group,the difference was statistically significant(P<0.05,P<0.01);and there were significant differences between the two preeclampsia groups(P<0.05).2 Maternal blood serum EGF levels of SPE and MPE groups were significantly lower than that of the normal control group,the difference was statistically significant(P<0.05); and there were significant differences between the two preeclampsia groups(P<0.05).3 The positive expression rates of EGFR in normal pregnancy group was lower than that of the preeclampsia groups, the difference was statistically significant(P<0.05)Conclusions:1 β-h CG, EGF level in serum of patients with abnormal changes of preeclampsia, they act each other and influence proliferation, differentiation and other functions of trophoblast cells, participate in the pathoqenesis of preeclampsia.2 The abnormal expression of EGFR in placenta and trophoblast cells function abnormality and the growth of the placenta barrier is involved in the pathqenesis of preeclampsia.3 It is a negative correlation between serum β-h CG and EGF level in preeclampsia patients venous blood(r=-0.693 P<0.05)... |
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