早发型重度子痫前期中ADMA与DDAH2的表达水平及临床意义

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摘要目的探讨早发型重度子痫前期患者血清及胎盘组织中非对称二甲基精氨酸（ADMA）和二甲基精氨酸二甲胺水解酶（DDAH）的表达及其之间的相关性，揭示二者在疾病发生发展中的作用机制，从发病机制方面寻求疾病早期诊疗依据。方法选取2017年1月~2018年1月于广东省妇幼保健院（以下简称“我院”）住院的45例重度子痫前期孕妇作为实验组，其中早发型重度子痫前期组25例、晚发型重度子痫前期组20例。选择同期在我院待产的35名健康孕妇作为对照组。采用酶联免疫吸附实验（ELISA）检测血清中ADMA与DDAH2的表达水平及免疫组化SP法检测两组胎盘组织中ADMA与DDAH2的表达水平。采用Spearman线性相关分析进行相关性分析。结果外周血清中，ADMA在早发型重度子痫前期组中的表达水平显著高于晚发型组及对照组（P < 0.05）；晚发型重度子痫前期组显著高于对照组（P < 0.05）；早发型重度子痫前期组显著低于晚发型组及对照组（P < 0.05）；晚发型重度子痫前期组显著低于对照组（P < 0.05）。在胎盘组织中，早发型重度子痫前期患者ADMA阳性染色率显著高于晚发型组（P < 0.05），晚发型重度子痫前期组显著高于对照组（P < 0.05）；早发型重度子痫前期组显著低于晚发型组（P < 0.05），晚发型重度子痫前期组患者胎盘组织中DDAH2阳性表达率显著低于对照组（P < 0.05）。早发型重度子痫前期组患者DDAH2与ADMA在外周血清及胎盘中表达呈显著负相关（r = -0.77，P ＜ 0.05）。结论早发型重度子痫前期患者外周血清及胎盘组织中ADMA表达水平显著升高，DDAH2显著下降，且两者呈负相关性。提示ADMA和DDAH2与早发型重度子痫前期发病密切相关。两者可能通过作用血管内皮细胞损伤，影响滋养细胞浸润，参与早发型重度子痫前期疾病的发生和发展。

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	赵莉娜李嘉蔚刘国成

关键词 ：早发型重度子痫前期, 滋养细胞, ADMA, DDAH2

Abstract：Objective To discuss the expression of ADMA and DDAH2 in plasma and placental and the correlation between the two factors in early onset severe preeclampsia (EPSP). To approach the possible role of DDAH2 and ADMA in the pathogenesis and progression of EPSP. And to seek the basis of early diagnosis and treatment of disease based on pathogenesis. Methods From January 2017 to January 2018, 45 cases with severe preeclampsia in Guangdong Maternal and Child Health Hospital ("our hospital" for short) were selected as the experimental group, of which 25 cases in early onset severe preeclampsia group, 20 cases in late onset severe preeclampsia group, and 35 healthy pregnant women delivery in our hospital during the same period were selected as the control group. The expression levels of ADMA and DDAH2 in sera and placenta tissues of two groups were detected with Enzyme-linked immunosorbent assay (ELISA). Spearman linear correlation analysis was used for correlation analysis. Results The expression level of ADMA in serum of early-onset severe preeclampsia was significantly higher than that of later onset severe preeclampsia and control group (P < 0.05). The expression level of ADMA of later onset severe preeclampsia in serum was significantly higher than that of control group (P < 0.05). The expression level of DDAH2 of in serum of early onset severe preeclampsia group was significantly lower than that of later onset severe preeclampsia group and control group (P < 0.05). The expression level of DDAH2 in serum of later onset severe preeclampsia group was significantly lower than that of control group (P < 0.05). The positive staining rate of ADMA in the placenta tissues of early onset severe preeclampsia was significantly higher than that of late onset severe preeclampsia (P < 0.05). The positive staining rate of ADMA in the placenta tissue of late onset severe preeclampsia was significantly higher than that of control group (P < 0.05). The positive staining rate of DDAH2 in the placenta tissues of early onset severe preeclampsia was significantly lower than that of late onset severe preeclampsia (P < 0.05). The positive staining rate of DDAH2 in the placenta tissues of late onset severe preeclampsia was significantly lower than that of control group (P < 0.05). The expression levels of DDAH2 and ADMA in serum and in the placenta tissues of earlyonset severe preeclampsia appeared in a obvious negative correlation (r = -0.77, P < 0.05). Conclusion The significantly higher expression level of ADMA and the significantly lower expression level of DDAH2 in serum and in the placenta tissue of early onset severe preeclampsia, they are negatively correlated. ADMA and DDAH2 are closely related to early onset severe preeclampsia. They may interact with each other in the process of trophoblast infiltration and participate pathogenesis of the early onset severe preeclampsia.

Key words： Early onset severe preeclampsia Trophoblast cells ADMA DDAH2

基金资助:广东省科技计划项目（2017ZC0319）。

引用本文:

赵莉娜李嘉蔚刘国成. 早发型重度子痫前期中ADMA与DDAH2的表达水平及临床意义[J]. 中国医药导报, 2018, 15(36): 71-74,82.
ZHAO Li′na Li Jiawei LIU Guocheng. Expression level and clinical significance of ADMA and DDAH2 in earlyonset severe preeclampsia. 中国医药导报, 2018, 15(36): 71-74,82.

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