稽留流产患者血清和绒毛中HIF-1alpha和VEGF表达水平及其相关性分析

目的：探讨缺氧诱导因子-1alpha（HIF-1alpha）和血管内皮生长因子（VEGF）在稽留流产患者血清和绒毛中的表达水平及其相关性 分析。方法：选择2014 年8 月至2015 年8 月我院妇产科76 例稽留流产患者为观察组及行人工流产的60 例正常早产孕妇为对 照组；根据患者稽留流产时间将稽留流产患者分为稽留时间<2 周组（12 例），2~4周组（33 例），>4周组（31 例）；采用酶联免疫吸 附（ELISA）和免疫组化SP 法检测并分析患者血清与绒毛中HIF-1琢与VEGF的表达水平。结果：观察组血清中HIF-1alpha与VEGF 表达水平均显著低于对照组，差异有统计学意义（P<0.05）；观察组和对照组绒毛VEGF 和HIF-1-alpha均表达，其中VEGF 主要表达 于滋养层细胞细胞质和细胞间质，HIF-1琢主要表达于滋养层细胞的细胞核与细胞质，且观察组患者绒毛HIF-1-alpha与VEGF 表达水 平均显著低于对照组，差异有统计学意义（P<0.05）；不同稽留时间患者绒毛HIF--alpha与VEGF表达水平间比较，差异均无统计学意 义（P>0.05）观察组患者血清HIF-1alpha与VEGF的表达水平呈现正相关关系（r=0.601；P<0.05）；且绒毛HIF-1琢与VEGF的表达水平 也呈现正相关关系（r=0.401；P<0.05）。结论：HIF-1琢和VEGF在血清和绒毛中的低表达可能是稽留流产的发生的重要原因，临床 上可以通过检测患者血清和绒毛组织中HIF-1琢和VEGF的水平，有针对性的对患者进行监护和治疗，预防稽留流产的发生。

Expression Levels of HIF-1-alpha and VEGF in Serumand Villus in Patients with Missed Abortion

Objective:To explore the expression levels of hypoxia-inducible factor-1alpha(HIF-1alpha) and vascular endothelial growth factor (VEGF) in patients with missed abortion and its correlation analysis.Methods:A total of 76 patients with missed abortion, who were admitted to Wuhan General Hospita of Guangzhou Military Region from August 2014 to August 2015, were chosen as observation group; and 60 cases of normal preterm pregnant woman with abortion, as control group. The patients with missed abortion were divided into <2 weeks group (n=12), 2~4 weeks group (n=33), and >4 weeks group (n=31) according to the time of missed abortion. The expression levels of HIF-1-alpha and VEGF in the serumand villus of patients were detected and analyzed by enzyme-linked immuno sorbent assay (ELISA) and immunohistochemical SP method.Results:The expression levels of HIF-1-alpha and VEGF in the serum of observation group were significantly lower than those in the control group, the differences were statistically significant(P<0.05). HIF-1-alpha and VEGF in the villus were expressed both in observation group and control group, and VEGF was mainly expressed in the trophoblast cell of cytoplasm and intercellular substance, HIF-1-alpha, in trophoblast cells of the nucleus and cytoplasm; the expression levels of HIF-1-alpha and VEGF in the villus of observation group were significantly lower than those in he villus of control group, the differences were statistically significant (P<0.05). There were no statistical significance in the comparison between the expression levels of HIF-1-alpha and VEGF in the serum and villus at different missed time (P>0.05). The expression level of HIF-1-alpha in the serum was positively correlated with the expression level of VEGF in the observation group (r=0.601, P<0.05); and the expression level of HIF-1-alpha in the villus was positively correlated with the expression level of VEGF (r=0.401, P<0.05).Conclusion:The low expression of HIF-1-alpha and VEGF in the serum and villus may be an important reason of the occurrence of missed abortion; so detecting the levels of of HIF-1a and VEGF in the serum and villus of paitients in clinic and pertinently monitoring and treating patients can prevent the occurrence of missed abortion.