摘要
目的:探讨钙离子在子痫前期(PE)血管平滑肌细胞功能异常中作用的分子机制。方法:检测并比较129例重度PE孕妇(重度PE组)中早发、晚发型孕期及产后的血压及血钙水平,并分析两者的相关性;同时检测120例正常妊娠孕妇(正常对照组)孕期及产后1月血钙水平,比较重度PE组与正常对照组血钙水平的差异。体外建立内皮细胞与平滑肌细胞共培养体系,试验分为正常孕妇血清处理组(A组)、PE血清处理组(B组)、共培养平滑肌细胞内钙离子释放通道阻断后PE血清处理组(C组),C组为三磷酸肌醇受体-Ⅰ小干扰RNA(IP3R-ⅠsiRNA)沉默平滑肌细胞IP3R表达,斯里兰卡肉桂碱(终浓度10μmol/L)阻断兰诺定受体(RyRs)通路诱发的钙离子释放。观察3组共培养平滑肌细胞内钙离子浓度变化。结果:1早发、晚发重度PE产前血钙水平明显低于正常对照组孕中期、孕晚期及产后1月水平(P<0.05),早发、晚发重度PE产后1月血钙水平与正常对照组产后1月比较,差异无统计学意义(P>0.05);早发重度PE收缩压高于晚发重度PE(P<0.05)。2晚发重度PE和重度PE患者血钙水平与收缩压呈负相关(P<0.05),与舒张压无相关性(P>0.05)。3B组与C组钙离子浓度明显高于A组(P<0.05)。结论:重度PE血钙水平明显低于正常妊娠,产后迅速恢复正常;钙离子与PE血管痉挛性收缩的病理过程有关,PE血管平滑肌细胞外钙离子内流可能是导致低血钙及平滑肌细胞痉挛性收缩的重要原因,在PE的病理过程中起重要作用。
Objective：To explore the molecular mechanism of Ca^2＋ in smooth muscle cells dysfunction of preeclampsia patients. Methods：The blood pressure and concentration of serum Ca^2＋ in 129 severe preeclampsia （sPE） patients in early and late onset preeclampsia and in postpartum were tested and compared, and the correlation between the blood pressure and concentration of serum Ca^2＋ was analyzed. Meanwhile the concentration of serum Ca^2＋ in 120 normal pregnancy women（normal control）in pregnancyand one month after delivery were detected. Serum Ca^2＋ level were compared between sPE patients group and normal women group. Three groups were divided including Group A： normal pregnancy serum group; Group B： sPE serum group; and Group C： HUVEC（ human umbilical vein endothelial cells）and H UASMC （human umbilical artery smooth muscle cells）were co-cultured in transwells with preeclamptic serum. HUASMC was transferred by inositol 1,4,5 trisphosphate receptor-Ⅰ siRNA（ IP3R- Ⅰ siRNA）and pre-deal with by ryanodine （10 μmol/L） before incubated with preeclamptic serum. The changes of serum Ca2 ＋ in the co-culture smooth muscle cells of the three groups were observed. Resuits ：①Serum Ca^2＋ of early and late onset sPE patients were significantly lower than those of normal pregnancy （the second and the third trimester）before delivery（ P 〈0.05）, and there was no significant difference between the postpartum serum Ca^2＋ of patients in early and late onset preeclampsia and the normal control one month after delivery（P〉0.05）. The systolic pressure of early onset preeclampsia was higher than that in late onset preeclampsia（ P 〈0. 05）. ②The serum Ca^2＋ in late onset sPE was negatively correlated with the systolic pressure （P 〈0.05） ,while it was not related with the diastolic pressure（ P 〉0. 05）. ③The concentration of serum Ca^2＋ in group B and C were significant higher than that in group A（ P 〈0.05）. Conclusions：The level of serum Ca^2＋ in sPE patient is significantly lower than that in healthy pregnancy woman ,and returns to normal rapidly after delivery. The concentration of serum Ca^2＋ is related to the pathological processes of spasmodic contraction in PE blood vessels. Preeclamptic serum stimulating the influx of extracellular calcium of smooth muscle cells（ SMC） is one of the reasons which decrease the concentration of serum Ca^2＋ and spasmodic contraction of SMC in preeclampsia,which may play a key role in the pathogenesis of placental blood vessel in preeclampsia.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2014年第12期902-906,共5页
Journal of Practical Obstetrics and Gynecology
基金
国家自然基金青年基金(编号:31101065)
