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目的 探讨热休克蛋白70(HSP70)在妊娠期高血压疾病孕妇血清、脐血及胎盘组织中的表达及其在发病中的作用.方法 收集2011年8月至2012年12月在徐州市妇幼保健院产科住院分娩的妊娠期高血压疾病孕妇90例,其中妊娠期高血压组30例,轻度子痫前期组30例,重度子痫前期组30例.选择同期分娩的健康孕妇30例为对照组.采用ELISA法检测各组孕妇血清、脐血中HSP70水平;用免疫组化SP法检测胎盘组织中HSP70蛋白表达水平;用逆转录(RT)-PCR技术检测胎盘组织中HSP70 mRNA表达水平.结果 (1)轻度子痫前期组孕妇血清及脐血中HSP70水平分别为(2.61±0.98)及(0.78±0.27) μg/L,重度子痫前期组分别为(3.10±1.18)及(0.96±0.28)μg/L,两组孕妇血清及脐血中HSP70水平均分别高于对照组[分别为(1.88±0.79)及(0.61±0.15)μg/L]及妊娠期高血压组[分别为(2.13±0.71)及(0.64±0.18) μg/L],分别比较,差异均有统计学意义(P＜0.05);重度子痫前期组均分别高于轻度子痫前期组,差异也有统计学意义(P＜0.05);妊娠期高血压组虽高于对照组,但差异无统计学意义(P＞0.05).(2)妊娠期高血压组、轻度子痫前期组及重度子痫前期组胎盘组织中的HSP70蛋白表达总阳性率[分别为83％(25/30)、90％(27/30)及100％(30/30)]均高于对照组(43％,13/30),分别比较,差异均有统计学意义(P＜0.05);重度子痫前期组高于妊娠期高血压组及轻度子痫前期组,差异也均有统计学意义(P＜0.05).(3)妊娠期高血压组、轻度子痫前期组及重度子痫前期组胎盘组织中HSP70 mRNA表达水平(分别为0.82±0.27、0.92±0.26及1.36±0.29)明显高于对照组(0.45±0.18),分别比较,差异均有统计学意义(P＜0.05);重度子痫前期组高于妊娠期高血压组及轻度子痫前期组,分别比较,差异也均有统计学意义(P＜0.05).结论 妊娠期高血压疾病孕妇血清、脐血及胎盘组织中HSP70表达水平明显升高,且随疾病程度加重其表达水平明显升高.提示HSP70在妊娠期高血压疾病发病中可能起一定作用.

Objective To investigate the expression of heat shock protein 70 (HSP70) in maternal serum,umbilical cord blood and placenta of patients with hypertensive disorders complicating pregnancy (HDCP) and to discuss its role in the pathogenesis of HDCP.Methods Totally 90 patients with HDCP were recruited as HDCP group,and were devided into three subgroups,including gestational hypertension group (30 cases),mild preeclampsia group(30 cases) and severe preeclampsia group(30 cases).A totally of 30 cases of healthy pregnant women were defined as the control group.All of them were admitted to Xuzhou Maternity and Child Health Care Hospital from August 2011 to December 2012.ELISA was used to detect the expression of HSP70 in maternal serum and umbilical cord blood.Immunohistochemistry streptavidin peroxidase(SP) was used to detect the protein in placenta,and semi-quantitative reverse transcription (RT)-PCR was used to detect the expression of HSP70 mRNA.Results (1) The levels of HSP70 in maternal serum and cord blood of mild preeclampsia group were (2.61±0.98) and (0.78±0.27)μg/L,respectively; and were (3.10± 1.18) and (0.96±0.28)μg/L in severe preeclampsia group.The levels of HSP70 in mild and severe preeclampsia groups were significantly higher than those in the control group [(1.88±0.79) and (0.61±0.15) μg/L,respectively] and gestational hypertension group [(2.13 ± 0.71) and (0.64 ± 0.18) μg/L,respectively;P＜0.05].The level of HSP70 in severe preeclampsia group was significantly higher than that in mild preeclampsia group (P＜0.05).And the level of HSP70 in gestational hypertension group was higher than that in the control group,but there was no statistical difference (P＞0.05).(2)The positive rate of placental HSP70 in gestational hypertension group,mild and severe preeclampsia group [83％(25/30),90％ (27/30) and 100％(30/30)],respectively were significantly higher than those in the control group(43％,13/30;P＜0.05).The positive rate of placental HSP70 in severe preeclampsia group was significantly higher than that in gestational hypertension group and mild preeclampsia group(P＜0.05).(3)The expression of placental HSP70 mRNA in gestational hypertension group,mild and severe preeclampsia group (0.82±0.27,0.92± 0.26 and 1.36±0.29,respectively) were significantly higher than that in the control group (0.45±0.18),with statistically significant differences (P＜0.05).The expression of placental HSP70 mRNA in severe preeclampsia group was significantly higher than that in gestational hypertension group and mild preeclampsia group(P＜0.05).Conclusion The expression of HSP70 increased significantly in maternal serum,umbilical cord blood and placenta of patients with HDCP,and it had positive correlation with the severity of the disease,indicating that HSP70 may play a role in the pathogenesis of HDCP.