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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 investigate the molecular mechanism of calcium ion in dysfunction of vascular smooth muscle cells in preeclampsia (PE). Methods: The blood pressure and serum calcium levels of 129 severe PE pregnant women (severe PE group) were detected and compared between preterm and late pregnant women during pregnancy and postnatal period. The correlations were also analyzed. Meanwhile, 120 normal pregnant women (normal control group ) During pregnancy and postpartum blood calcium levels in one month, comparing the difference of serum calcium between the severe PE group and the normal control group. The co-culture system of endothelial cells and smooth muscle cells was established in vitro. The experiment was divided into normal pregnant women serum treatment group (A group), PE serum treatment group (B group), co-cultured smooth muscle cells intracellular Ca2 + release channel blockage PE serum treatment group Group C). IP3R expression was silenced by IP3R-Ⅰ siRNA in group C, and RyRs pathway was blocked by Sri Lanka cinnamidine (10 μmol / L) Induced release of calcium ions. The changes of calcium concentration in smooth muscle cells were observed in three groups. Results: 1 The levels of serum calcium in premature and late PE patients were significantly lower than those in the normal pregnant women at the second trimester, the third trimester and the postnatal month (P <0.05) Compared with normal control group, the difference was not statistically significant (P> 0.05). The systolic blood pressure of premature severe PE was higher than that of severe PE (P <0.05). There was a negative correlation between serum calcium levels and systolic blood pressure (P <0.05), but no correlation with diastolic blood pressure (P> 0.05). The calcium concentration in group 3B and group C was significantly higher than that in group A (P <0.05). Conclusions: The level of serum calcium in severe PE is obviously lower than that in normal pregnancy, and it returns to normal quickly after delivery. The calcium ion is related to the pathological process of vasospasm contraction of PE, and influx of extracellular calcium in PE vascular smooth muscle may lead to hypocalcemia and smooth muscle cell spasm The important reason of sexual contraction plays an important role in the pathological process of PE.