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目的测定白血病抑制因子(LIF)在正常早孕、先兆流产及难免流产患者绒毛组织中表达的差异,探讨LIF在先兆流产及难免流产发病中的作用。方法采用放射免疫法检测正常早孕妇女(正常早孕组,30例)、先兆流产患者(先兆流产组,30例)及难免流产患者(难免流产组,30例)血清孕酮及人绒毛膜促性腺激素(hCG)水平;采用免疫组化技术———链霉菌抗生物素蛋白-过氧化酶连接(SP)法对LIF在3组妇女绒毛组织中的表达进行组织学定位和半定量分析;采用蛋白印迹法对3组妇女绒毛组织中LIF的相对表达量进行测定。结果(1)血清孕酮及hCG水平在正常早孕组、先兆流产组及难免流产组分别为(95±26)、(90±26)、(36±17)nmol/L及(75±14)、(68±13)、(13±3)kU/L。正常早孕组与先兆流产组血清孕酮及hCG水平分别比较,差异均无统计学意义(P>0·05);而难免流产组与其他两组妇女血清孕酮及hCG水平分别比较,差异均有统计学意义(P<0·01)。(2)3组妇女绒毛组织中LIF均呈现阳性表达,阳性染色主要位于滋养细胞胞质中,胞核无明显着色。(3)正常早孕组、先兆流产组及难免流产组LIF相对表达量分别为1·17±0·13、1·06±0·10、0·30±0·02,难免流产组与其他两组分别比较,差异均有统计学意义(P<0·01),而正常早孕组与先兆流产组比较,差异无统计学意义(P>0·05)。结论LIF对妊娠的正常维持有一定的保护作用,LIF在早孕绒毛组织中的低表达,可能与hCG及孕酮水平下降有关,是导致难免流产的原因之一。
Objective To determine the expression of leukemia inhibitory factor (LIF) in normal early pregnancy, threatened abortion and inevitable abortion, and to explore the role of LIF in the pathogenesis of threatened abortion and unavoidable abortion. Methods Serum progesterone and human chorionic gonadotropin (n = 30) were detected by radioimmunoassay in normal pregnant women (normal pregnancy group, 30 cases), threatened abortion (threatened abortion group, 30 cases) and unavoidable abortion group (30 inevitable abortion group) Hormone (hCG) were detected by immunohistochemistry and streptavidin-peroxidase (SP) method. Histological localization and semi-quantitative analysis of the expression of LIF in three groups of women’s villi were performed. The relative expression level of LIF in three groups of women’s villi was determined by Western blotting. Results (1) Serum progesterone and hCG levels were (95 ± 26), (90 ± 26), (36 ± 17) nmol / L and (75 ± 14) in the normal pregnancy group, threatened abortion group and inevitable abortion group , (68 ± 13), (13 ± 3) kU / L. The levels of serum progesterone and hCG in normal pregnancy group and threatened abortion group were not significantly different (P> 0.05), while the levels of serum progesterone and hCG in the women with unavoidable abortion group and the other two groups were respectively There was statistical significance (P <0.01). (2) The positive expression of LIF in the three groups of chorionic villi was positive. The positive staining was mainly located in the cytoplasm of trophoblasts, with no obvious staining of the nucleus. (3) The relative expression of LIF in normal pregnancy group, threatened abortion group and inevitable abortion group were respectively 1.17 ± 0.13, 1.06 ± 0.10 and 0.30 ± 0.02, (P <0.01). However, there was no significant difference between the normal pregnancy group and the threatened abortion group (P> 0.05). Conclusions LIF can protect normal pregnancy. Low expression of LIF in chorionic villi of early pregnancy may be related to the decrease of hCG and progesterone, which is one of the reasons leading to unavoidable abortion.