【作者】 赵斌；

【导师】 宋薇薇；

【作者基本信息】 中国医科大学 ， 妇产科学， 2008， 硕士

【摘要】 目的异常出生体重的新生儿为高危儿,且异常出生体重儿易发生儿童、成年肥胖及某些成年疾病。导致异常出生体重的因素有很多,其中胎盘转运功能对于胎儿的生长发育起着十分重要的作用。葡萄糖是胎盘转运最多的营养物质,胎盘葡萄糖转运异常可影响胎儿生长发育。目前国内外对胎盘葡萄糖转运体(GLUTs)表达的研究报道较少。因此研究GLUT1、GLUTs在胎盘中的表达规律、调节机制具有重要意义。本文应用逆转录-聚合酶链反应(RT-PCR)及Western Blot方法检测孕晚期不同出生体重新生儿胎盘组织中GLUT1 mRNA及蛋白表达的差异性,探讨胎盘GLUT1在围产期对调控胎儿体重的影响。方法选择不同出生体重新生儿的新鲜胎盘组织标本120例。其中足月分娩80例,包括正常出生体重组、胎儿生长受限(FGR)组、高出生体重(LGA)组各20例(均无并发症及合并症),高出生体重且有糖尿病并发症(GDM/LGA)组20例;未足月(选择33周～35周)分娩40例:适于胎龄儿(AGA)组及小于胎龄儿(SGA)组各20例(均无其它并发症及合并症)。采用RT-PCR及Western Blot方法检测120例胎盘组织中GLUT1mRNA及蛋白的表达情况。统计学方法:应用SPSS13.0进行分析,计量资料实验数据结果采用均数±标准差((?)±s)表示,样本率的比较用卡方检验,以P＜0.05为差异有统计学意义。结果1、孕妇的一般状况比较(1)孕妇年龄、孕周的比较FGR组、LGA组与GDM/LGA组与正常组间比较及SGA组与AGA组比较,孕妇的年龄、孕周经统计学分析均差异(均P＞0.05)。(2)孕妇体重的比较FGR组孕妇体重(65.23±6.87 kg)与正常组孕妇体重(67.34±9.34 kg)比较,差异无显著性(P＞0.05);LGA组孕妇体重(81.02±8.45 kg)及GDM/LGA组(80.67±6.59kg)与正常组比较差异有显著性(均P＜0.05);LGA组及GDM/LGA组之间比较差异无显著性(P＞0.05)。2、胎盘重量的比较FGR组的胎盘重量(418.24±60.55g)、LGA组胎盘重量(820.44±65.24g)及GDM/LGA组胎盘重量(830.32±54.66g)与正常组胎盘重量(580.71±76.31g)比较有明显差异(均P＜0.05);GDM/LGA组与LGA组间比较无显著差异(P＞0.05);SGA组胎盘重量(352.56±79.38g)与AGA组胎盘重量(445.44±68.54g)比较有显著差异(P＜0.05)。3、胎盘GLUT1 mRNA相对含量的比较FGR组相对含量(0.593±0.142)、LGA组相对含量(0.815±0.155)及GDM/LGA组相对含量(0.859±0.201)与正常组相对含量(0.764±0.123)比较,有统计学意义(P＜0.05);SGA组相对含量(0.504±0.086)与AGA组相对含量(0.681±0.112)比较有统计学意义(P＜0.05);LGA组及GDM/LGA组比较无显著性差异,(P＞0.05)。FGR组、LGA组、GDM/LGA组与正常组mRNA的阳性表达率分别为85%、90%、90%、80%,差异无统计学意义;SGA组与AGA组mRNA阳性率为85%、80%,差异无统计学意义。4、胎盘GLUT1蛋白相对含量的比较FGR组相对含量(53.13±7.78)、LGA组相对含量(84.22±12.65)及GDM/LGA组相对含量(87.68±17.23)与正常组(65.27±9.32)比较,有统计学意义(P＜0.05);SGA组相对含量(48.36±6.71)与AGA组相对含量(61.45±7.63)比较,有统计学意义(P＜0.05);LGA组与GDM/LGA组比较无显著性差异(P＞0.05)。结论不同出生体重儿胎盘中GLUT1表达不同,FGR胎盘中的表达低于正常出生体重儿,而高出生体重儿表达更多,GLUT1可能是影响胎儿出生体重因素之一。更多还原

【Abstract】 ObjectiveAbnormal birth weight newborn baby is that the very dangerous baby, and the abnormal birth weight baby are easy to suffer children, adult adiposity and some adult diseases. There are many factors that can lead to abnormal birth weight, among which placenta’s transport function plays very important role to embryo’s growth. Glucose is the most nutrient substance that the placenta transports, therefore the abnormal placenta glucose transports will affect the embryo growth. At present, the research report about the placenta glucose transporting (GLUTs) at home and abroad is less. Therefore, study on the GLUT1, GLUTs’ expression law and adjusting mechanism in placenta has important significance. The reverse transcription polymerase chain reaction (RT-PCR) and Western Blot method were used in this paper to detect the GLUT1 mRNA and protein expression in the different birth weight newborn placenta of the third term. Discussed the placenta GLUT1’s influence on the newborn baby’s birth weight in the perinatal period.MethodsThe collection of fresh placental tissue 120 cases of different birth weight .Term delivery cases have 80 cases including without complications 20 cases, FGR 20 cases, high birth weight infants without complications and high birth weight infants who were caused by gestational diabetes mellitus 20 cases. Premature delivery cases include normal birth weight infants 20 cases and FGR 20 cases. Reveres transcription polymerase chain reaction (RT-PCR) and Western Blot method were used to assess the expression of GLUT1 mRNA and quantitative analysis of proteins in placental tissues of abnormal and normal birth weight. Statistic analysis: the results were analyzed on by SPSS software (version 13.0), there is significance difference, P > 0.05.Result1. The pregnant women’s general situation.(1) Pregnant women’s age, pregnancy weeks’ comparisonComparing with normal group, FGR, LGA and GDM/LGA groups have no significant difference (P>0.05). There are no significant difference between SGA and LGA group (P>0.05).(2) Groups of pregnant women’s body weight comparisonComparing with normal group (67.34±9.34 kg), LGA (81.02±8.45 kg) and GDM/LGA (80.67±6.59 kg) groups have a significant difference except FGR group (65.23±6.87 kg) (P< 0.05). But there is no significant difference between LGA and GDM/LGA group (P > 0.05).2. Placenta weight comparisonComparing with normal group (580.71±76.31g), FGR (418.24±60.55g), LGA (820.44±65.24g) and GDM/LGA (830.32±54.66g) groups have significant difference (P<0.05). But there is no significant difference between LGA and GDM/LGA group (P> 0.05). There is a significant difference between SGA (352.56±79.38g) and AGA (445.44±68.54g) group (P< 0.05).3. The positive expression and relative content of GLUT1 mRNA in placentaComparing with normal group (0.764±0.123), relative content of Glut1 mRNA was of FGR(0.593±0.142)、LGA(0.815±0.155) and GDM/LGA(0.859±0.201) , each group has a significant difference(P<0.05); SGA group (0.504±0.086) comparing with AGA group (0.681±0.112) has a significant difference (P<0.05); LGA and GDM/LGA group have no significant difference (P >0.05). The positive expression of Glut1 in FGR group、LGA group、GDM/LGA group and normal group was 85%, 90%, 90% and 80% respectively, having no significant difference; The positive expression of GLUT1 in SGA group and AGA group was 85%, 80% respectively, without significant difference.4. The relative content of GLUT1 in placentaWestern blot analysis showed that the relative content of GLUT1 in different group was different. Comparing with normal group (65.27±9.32), the relative content of FGR group (53.13±7.78), LGA group (84.22±12.65) and GDM/LGA group (87.68±17.23) has a significant difference (P<0.05); SGA group (48.36±6.71) comparing with AGA group (61.45±7.63) has a significant difference (P<0.05); LGA group and GDM/LGA group have no significant difference (P > 0.05).ConclusionsThe placenta GLUT1 expressions of different birth weight are different. The expression of FGR group infra normal birth weigh group. The expression of high birth weight group is higher. The GLUT1 may be one of the causes that affect the fatal birth weight.更多还原