目的:研究血管细胞黏附分子-1( VCAM-1)和妊娠相关血浆蛋白-A (PAPP-A)在妊娠期高血压疾病患者血清中的变化及在胎盘组织中的表达情况,探讨与妊娠期高血压疾病发病机制的关系.方法:收集2009年3月至2011年6月我院确诊为妊娠期高血压疾病的120例孕妇为实验组,正常孕妇40例为对照组.采用酶联免疫吸附法( ELISA)测定两组孕妇血清中VCAM-1和PAPP-A水平变化并进行比较.采用免疫组织化学染色方法检测VCAM-1和PAPP-A在两组胎盘组织中的表达.结果:①实验组VCAM-1和PAPP-A血清水平明显高于对照组,差异有统计学意义(P＜0.05).②VCAM-1在实验组胎盘组织中阳性表达较对照组减弱,差异有统计学意义(P＜0.05).PAPP-A在实验组胎盘组织中阳性表达较对照组明显增强,差异有统计学意义(P＜0.05).③实验组中血清VCAM-1、PAPP-A表达呈明显正相关(r=0.713,P＜0.05),实验组胎盘免疫组化VCAM-1、PAPP-A表达呈负相关(r=-0.513,P＜0.05).结论:VCAM-1和PAPP-A在孕期母血清及胎盘组织中的改变与妊娠期高血压疾病的发病有明确关系.%Objective: To investigate the level of vascular-cellular adhesion molecule-1 (VCAM-1) and pregnancy-associated plasma protein A (PAPP-A ) in serum and the expression in placenta of pregnant women with hypertensive disorders, as well as the relationship between these two factors and mechanism of hypertensive disorders in pregnancy. Methods: 120 pregnant women with hypertensive disorders and40 normal pregnant women were recruited in Chengdu Women and Children's Central Hospital from March 2009 to June 2011. The serum levels of VCAM-1 and PAPP-A were detected by enzyme-linked immunosorbent assay (ELISA), and the expression of VCAM-1 and PAPP-A in placental tissue was examined by immunohis-tochemistry. Results: ①The serum levels of VCAM-1 and PAPP-A in pregnany with hypertensive disorders were significantly higher than that in normal pregnancy( P<0.05). ②The positive staining of VCAM-1 in placental tissue of study group decreased significantly compared with that in control group, whereas the positive staining of PAPP-A in placental tissue of study group increased remarkably compared with that in control groupf P<0.05). ②The expression of the two factors in serum was positively correlated(r = 0.713,P< 0. 05), the expressions of VCAM-1 and PAPP-A in placenta tissue of study group were negatively correlated (r= -0.513,P<0. 05). Conclusions:The change of VCAM-1 and PAPP-A in maternal serum and placenta are correlated with the incidence of hypertensive disorders in pregnancy.
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