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子痫前期孕妇胎盘组织中SIRT1和SIRT3的表达及其与孕妇预后的相关性
作者:杨琼1  袁毅翀2  唐晓华3 
单位:1. 湖北省妇幼保健院 产科, 湖北 武汉 430070;
2. 湖北省妇幼保健院 妇科, 湖北 武汉 430070;
3. 广州医科大学附属第三医院 检验科, 广东 广州 510150
关键词:子痫前期 沉默信息调节因子1 沉默信息调节因子3 预后 相关性 
分类号:R714.24
出版年·卷·期(页码):2020·48·第九期(1124-1129)
摘要:

目的:探讨子痫前期孕妇胎盘组织中沉默信息调节因子1(SIRT1)和沉默信息调节因子3(SIRT3)表达及其与孕妇预后的相关性。方法:收集2018年3月至2019年3月湖北省妇幼保健院收治的未临产并择期剖宫产的孕妇122例,分为病例组和对照组。其中病例组62例,按照临床严重程度分为轻度病例组(30例)和重度病例组(32例),按胎龄分为病例组A[(早产未临产子痫前期(PE),36例]和病例组B(足月未临产PE,26例)。对照组60例,按胎龄分为对照组A(早产未临产,30例)与对照组B(足月未临产,30例)。通过免疫组化定量检测产妇胎盘SIRT1、SIRT3表达水平,分析其与孕妇预后的相关性。结果:病例组孕妇的收缩压、舒张压明显高于对照组(均P<0.05),而孕龄和慢性高血压差异无统计学意义(P>0.05)。病例组A妊娠频次、胎次、新生儿体重、小于胎龄儿比例与对照组A比较差异无统计学意义(P>0.05);而病例组B的妊娠频次、胎次、新生儿体重均显著低于对照组B(P<0.05),小于胎龄儿比例显著高于对照组B(P<0.05)。病例组SIRT1、SIRT3蛋白表达评分和SIRT1、SIRT3阳性率均显著低于对照组(P<0.05)。重度病例组的SIRT1、SIRT3的蛋白表达评分及阳性率均显著小于轻度病例组(均P<0.05)。子痫前期严重程度与SIRT1、SIRT3蛋白负相关关系明显(P<0.05)。SIRT1、SIRT3高表达组产后出血发生率、胎盘早剥发生率、DIC发生率、心衰发生率、总不良事件发生率分别低于SIRT1、SIRT3低表达组(均P<0.05)。结论:子痫前期孕妇胎盘组织中SIRT1、SIRT3的表达均降低,且SIRT1或SIRT3低表达的子痫前期孕妇不良预后更多,二者可能是判断子痫前期孕妇严重程度及预后的生物标志物。

Objective: To investigate the expression levels of silence information regulator 1(SIRT1) and silence information regulator 3(SIRT3) in placental tissues of pre-eclampsia(PE) women and their correlation with maternal prognosis. Methods: One hundred and twenty-two cases of pregnant women treated in Hubei maternal and child health hospital from March 2018 to March 2019 were selected. Of them, there were 62 cases in case group, which was subdivided into mild case group(30 cases) and severe case group(32 cases) according to clinical severity, and into case group A(preterm preeclampsia without labor(PE), 36 cases), and case group B(full-term non-labor PE, 26 cases) according to gestational age. There were 60 cases in the control group, which was divided into control group A(preterm labor without labor, 30 cases) and control group B(full-term labor without labor, 30 cases) according to gestational age. The expression levels of SIRT1 and SIRT3 in placenta of pregnant women were quantitatively detected by immunohistochemistry, and the correlation between expression levels of SIRT1, SIRT3 and prognosis of pregnant women was analyzed.Results: The systolic and diastolic blood pressures of pregnant women in case group were significantly higher than those in the control group(P<0.05), but there was no significant difference between gestational age and chronic hypertension(P>0.05). Pregnancy frequency, parity, neonatal weight and the proportion of newborns less than the time of gestational age in case group A were not significantly different from those in the control group A(P>0.05), while the pregnancy frequency, parity and neonatal weight in case group B were significantly lower than those in the control group B(P<0.05), and the proportion of infants less than the time of gestational age was significantly higher than that in control group B(P<0.05). The protein expression score and positive rate of SIRT1, SIRT3 in case group were significantly lower than those in the control group(P<0.05). The protein expression score and positive rate of SIRT1 and SIRT3 in severe case group were significantly lower than those in mild case group(P<0.05). The severity of pre-eclampsia was negatively correlated with expression levels of SIRT1 and SIRT3 proteins(P<0.05). The incidence of postpartum hemorrhage, placental abruption, DIC, heart failure and total adverse events in SIRT1 and SIRT3 high expression groups were lower than those in SIRT1 and SIRT3 low expression groups(P<0.05).Conclusion: The expression of SIRT1 and SIRT3 in placenta of pre-eclampsia pregnant women are decreased, and there is more poor prognosis in pre-eclampsia pregnant women with low expression of SIRT1 or SIRT3, which can be used as biomarkers to judge the severity and prognosis of pre-eclampsia pregnant women.

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