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目的:探讨血管活性肽Apelin及其唯一降解酶血管紧张素转换酶2(ACE2)在妊娠期高血压疾病患者及正常妊娠妇女胎盘组织中的表达。方法:分别取26例妊娠期高血压疾病妇女(妊娠期高血压10例,轻度子痫前期6例,重度子痫前期10例)(HDCP组)和28例正常妊娠妇女的胎盘组织(对照组),采用实时荧光定量逆转录聚合酶链式反应法(FO-RT-PCR)检测两组孕妇胎盘Apelin-36和ACE2 mRNA的表达情况,并用高清晰度彩色图文报告系统进行定量分析。结果:HDCP组胎盘组织Apelin-36 mRNA的表达量显著高于对照组(P<0.01);HDCP组胎盘组织ACE2 mRNA的表达量低于对照组(P<0.05),这种异常表达主要体现在重度子痫前期胎盘组织中(P<0.01)。结论:①Apelin-36在妊娠期高血压疾病患者胎盘组织中有表达,且Apelin-36 mRNA表达水平增加与病情程度相关。②ACE2在妊娠期高血压疾病患者胎盘组织中有表达,且ACE2mRNA的表达低下,这种下降主要体现在子痫前期重度患者的胎盘组织中。提示ACE2可能仅在重度子痫前期的发病中起到重要作用。③Apelin-36与ACE2 mRNA的表达水平呈负相关关系,提示ACE2降低,Apelin-36的降解亦随之降低,推动了妊娠期高血压疾病的发生。
AIM: To investigate the expression of angiotensin converting enzyme 2 (ACE2), a vasoactive peptide, in the placenta of patients with gestational hypertension and normal pregnant women. Methods: The placental tissues of 26 women with gestational hypertension (10 with gestational hypertension, 6 with mild preeclampsia and 10 with severe preeclampsia) (HDCP group) and 28 normal pregnant women (control group Group). The expression of Apelin-36 and ACE2 mRNA in placenta of two groups were detected by real-time fluorescence quantitative reverse transcription polymerase chain reaction (RT-PCR) and quantified by high definition color image report system. Results: The expression of Apelin-36 mRNA in placental tissue of HDCP group was significantly higher than that of control group (P <0.01). The expression of ACE2 mRNA in placental tissue of HDCP group was lower than that of control group (P <0.05) Severe preeclampsia placental tissue (P <0.01). Conclusion: ①Apelin-36 is expressed in placenta of patients with hypertensive disorders of pregnancy, and the increase of Apelin-36 mRNA expression is related to the severity of the disease. ② ACE2 expression in placental tissue of patients with hypertensive disorders of pregnancy, and low expression of ACE2 mRNA, this decline is mainly reflected in the placenta of severe preeclampsia. Suggesting that ACE2 may only play an important role in the pathogenesis of severe preeclampsia. (3) The negative correlation between the expression of Apelin-36 and ACE2 mRNA suggests that ACE2 is decreased and the degradation of Apelin-36 is also reduced, which promotes the occurrence of hypertensive disorders during pregnancy.