Expession Of Maternal And Umbilical Plasma Vcam-1,Icam-1and Tnf-α In Severe Preeclamptic Pregnancies With Fetal Growth Restriction

Object:This study was to examine VCAM-1,ICAM-land TNF-α in severe pre-eclampsia and severe pre-eclampsia complicated by FGR, and to explore the pathogenesis of severe preeclampsia with FGR,so as to provide a new experim-ental and theoretical basis for early diagnosis, early treatment and disease forecast of severe preeclampsia with FGR.Method:The study was carried out on18patients with severe preeclampsia complicated by FGR(SPF group),25severe preeclamptic patients with normal intrauterine fetal growth(SP group) and25healthy normotensive patient with singleton uncomplicated pregnancies (NP group).Maternal and umbilical plasma VCAM-1,ICAM-1and TNF-a concentrations were estimated using enzyme-linked immunosorbent assay (ELISA).Result:(1) Maternal and umbilical plasma of three groups had expressed VCAM-1,ICAM-1and TNF-α;(2)The levels of maternal plasma VCAM-1, ICAM-1and TNF-α in SPF group and SP group were significantly higher than in NP group(p<0.01,p<0.01;p<0.01,p<0.05;p<0.01, p<0.01, respectively),and SPF group was significantly higher than the SP group(p<0.01,p<0.05,p<0.05, respectively);(3)The levels of umbilical plasma TNF-a in SPF group and SP group were significantly higher than in NP group(p<0.05,p<0.05),but there were no statistically significant differences betwteen SPF group and SP group(p>0.05),VCAM-1and ICAM-1expression in umbilical plasma of three groups showed no significant difference (p>0.05);(4)VCAM-1and ICAM-1expression in maternal and umbilical plasma of NP group showed a significant difference (p <0.01, p<0.01), The maternal plasma TNF-α levels in the three groups were significantly higher in comparison with the umbilical levels(p<0.05, p<0.05, p <0.05).(5) There showed a significant linear positive correlation between the maternal plasma VCAM-1and TNF-a levels in both SPF group and SP group(r=0.88,p<0.01; r=0.75,p<0.05),there showed a significant linear positive correlation between the maternal plasma ICAM-1and TNF-α levels in both SPF group and SP group(r=0.79, p<0.01;r=0.55, p<0.05).Conclusions:Elevated VCAM-1, ICAM-1and TNF-α play an important role in the pathogenesis of severe preeclampsia and severe preeclampsia complicated by FGR, and the apparent increase in the three can predict the incidence of FGR on the basis of severe preeclampsia; TNF-α may be involved in the pathological process of vascular endothelial injury in the fetal circulation, and VCAM-1and ICAM-1may not be involved.