| Background and ObjectivePreeclampsia is an idiopathic disease of pregnancy, appearing after 20 weeks in pregnancy, hypertension, proteinuria, and edema as the main features of multiple organ damage diseas. The incidence of preeclampsia in China was 9.4%, it is a serious threat to maternal and child health, and it is the main reason of maternal and perinatal morbidity and mortality. So far, the cause and pathological mechanisms of preeclampsia are still unclear. At present, most studies suggest that the key of preeclampsia pathogenesis are too shallow trophoblast invasion, placental shallow implantation and placental hypoperfusion induced by placental vascular remodeling disorder. Endoglin, VEGF and Flt-1 were compared with trophoblast invasion-related cytokines, in this paper, Immunohistochemical staining SP was used to examine the relative expression of Endoglin, vascular endothelial growth factor (VEGF) and fms-like tyrosine kinase receptor 1 (Flt-1) in placenta of patients with preeclampsia, simultaneously detect 20 cases of normal pregnant women in late pregnancy as control, analyze the expression changes of Endoglin, VEGF and Flt-1 in placenta of patients with preeclampsia, and the relationship with the severity of preeclampsia, study the mechanism of Endoglin, VEGF and Flt-1 in preeclampsia preliminarily.Method 1 We selected a total of 45 cases of obstetric patients with preeclampsia at the First Affiliated Hospital of Zhengzhou University in October 2008～January 2009, of which there are 15 cases with mild preeclampsia,30 cases with severe preeclampsia, and at the same period, we selected 20 cases of pregnant women by cesarean section delivery of normal late pregnancy in this hospital as controls. The preeclampsia diagnostic and classification criteria refer to the seventh version "Obstetrics and Gynecology" by Jie Le.2 Immunohistochemistry SP was used to detected the expression level of Endoglin, VEGF and Flt-1 at placentas of pregnant women in each group, and image analysis system with Biosens to obtain the average gray value of Endoglin, VEGF and Flt-1 in placenta samples of each case, using the average gray value (OD) signify Endoglin, VEGF and Flt-1 expression level in the placenta tissue and analyzed the results statistically; using Hao s integrated scoring obtained the positive rate of Endoglin, VEGF and Flt-1 in placentas tissue.3 Statistical analysis All data were analyzed statistically using SPSS 13.0, measurement data with x±s, comparison of multi-sample mean with single factor analysis of variance, using X2 test to compare the positive rate, correlation analysis using Pearson correlation analysis, With a<0.05 level as significant test.Results1 The location and relative expression of Endoglin, VEGF and Flt-1 in in placenta tissue1.1 The location of Endoglin, VEGF and Flt-1 in in placenta tissueEndoglin was mainly expressed in syncytiotrophoblast cells membrane in normal term pregnant women's placenta, VEGF was mainly expressed in the syncytiotrophoblast cell cytoplasm and membrane, the cytoplasm of trophoblast cells and vascular endothelial cells. Flt-1 was mainly expressed in the syncytiotrophoblast and vascular endothelial cells membrane. In the preeclampsia placenta, Endoglin, VEGF and Flt-1 were expressed in the same position with the normal pregnant group.1.2 The relative expression of Endoglin, VEGF and Flt-1 in in placenta tissuePatients with preeclampsia and the control group relative expression of placental Endoglin was 111.48±11.51 and 86.88±6.80, there was significant difference between the two groups(t=6.221, P=0.000), of which Endoglin was 99.45±6.88 in mild preeclampsia,118.88±6.13 in severe preeclampsia, both significantly higher than the normal group (P<0.05, P<0.05), and there was significant differencebetween the mild and severe group (t=6.740, P=0.000); Patients with preeclampsia and the control group relative expression of placental VEGF was 107.79±8.43 and 133.70±6.08, there was significant difference between the two groups (t=8.804, P=0.000), of which VEGF was 99.45±6.88 in mild preeclampsia,118.88±6.13 in severe preeclampsia, both significantly higher than the normal group (P<0.05, P <0.05), and there was significant difference between the mild and severe group (t=5.189,P=0.000); Patients with preeclampsia and the control group relative expression of placental Flt-1 was 149.74±7.68 and 129.00±5.76, there was significant difference between the two groups (t=7.561, P=0.000), of which Flt-1was 125.14±6.68 in mild preeclampsia,136.58±4.21 in severe preeclampsia, both significantly higher than the normal group (P<0.05, P<0.05), and there was significant differences between the mild and severe group (t=5.408, P=0.000).2 The positive rate of Endoglin, VEGF and Flt-1 in placenta tissuePositive expression rates of Endoglin in Control group, patients with mild and severe preeclampsia placenta tissue were 36%,61.33% and 79.33%, there were significant statistical differences among these group; Positive expression rates of Endoglin in Control group, patients with mild and severe preeclampsia placenta tissue were 100%,86.67% and 68%, there were significant statistical differences among these group; Positive expression rates of Endoglin in Control group, patients with mild and severe preeclampsia placenta tissue were 48%,70.67% and 84%, there were significant statistical differences among these group. The positive expression rates of Endoglin, Flt-1 in placenta was significantly increased while VEGF was significantly decreased with the severity of PE.3 Correlation AnalysisIn PE group, there were no obvious relavence between Endoglin and VEGF(r=-0.054, P=0.815), similarly, Endoglin and Flt-1 have no obvious relavence (r=0.063, P=0.785). The relative expression of Flt-1 in the placenta of patients with preeclampsia was negatively correlated with VEGF expression (r=-0.653, P=0.001).Conclusions1 In the placenta of patients with preeclampsia, the expression levels of Endoglin and Flt-1 in placenta increased and VEGF decreased, suggested that these changes may involve in the occurrence of preeclampsia. 2 Patients with severe preeclampsia compared with patients with mild, the expre-ssion of placental the increase of Endoglin and Flt-1 and the decrease of VEGF are more obvious, suggested that these changes were related with the severity of disease.
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