| 潘亚文,朱锦明,张倩,等.子痫前期孕妇外周血及胎盘组织中 Krüppel样因子 5、低氧诱导因子 -1α的表达及临床意义[J].安徽医药,2026,30(9):1821-1826. |
| 子痫前期孕妇外周血及胎盘组织中 Krüppel样因子 5、低氧诱导因子 -1α的表达及临床意义 |
| Expression and clinical significance of KLF5 and HIF-1α in peripheral blood and placenta of preeclampsia patients |
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| DOI：10.3969/j.issn.1009-6469.2026.09.023 |
| 中文关键词: 子痫前期 外周血 胎盘组织 Krüppel样因子 5 低氧诱导因子 -1α |
| 英文关键词: Preeclampsia Peripheral blood Placental tissue Krüppel-like factor 5 Hypoxia-inducible factor-1α |
| 基金项目:江苏省省级临床重点专科(苏卫办医政〔2018〕3号) |
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| 中文摘要: |
| 目的探讨子痫前期(PE)孕妇外周血及胎盘组织中 Krüppel样因子 5(KLF5)、低氧诱导因子 -1α(HIF-1α)的表达及临床意义。方法前瞻性研究。选取徐州市妇幼保健院中 2024年 2—8月经剖宫产分娩的孕妇 88例，其中 PE孕妇 58例，早发型 PE孕妇 30例(早发组)，晚发型 PE孕妇 28例(晚发组)正常足月分娩孕妇 30例(对照组)。选取孕妇入院治疗前的空腹外周静脉血及分娩时新鲜胎盘组织为标本，采用酶联免疫吸附分，析( ELISA)检测孕妇血清中 KLF5、HIF-1α的水平。通过实时荧光定量逆转录聚合酶链反应( qRT-PCR)技术检测三组胎盘组织中 KLF5和 HIF-1α mRNA的相对表达量，并采用免疫组织化学染色检测胎盘组织中 KLF5表达水平及定位。另外根据 PE严重程度，分别比较早发组和晚发组内重度与非重度孕妇的血清 KLF5水平，胎盘组织 KLF5 mRNA相对表达量及 KLF5阳性表达率，采用受试者操作特征曲线( ROC曲线)评估血清 KLF5和 HIF-1α水平对 PE的诊断效能。结果早发组、晚发组和对照组血清 KLF5水平分别为(3 523.84±825.33)μg/L、(3 045.21±536.23)μg/L和( 2 593.87±728.13)μg/L，HIF-1α水平分别为( 338.60±82.29)μg/L、(282.43±83.49)μg/L和( 239.67±72.77)μg/L；早发组、晚发组和对照组胎盘组织 KLF5 mRNA相对表达量分别为 5.50±2.78、2.99±1.51和 1.34±1.05，HIF-1α mRNA相对表达量分别为 4.86±1.09、3.58±0.33和 1.52±1.15。KLF5、HIF-1α在三组的血清和胎盘中的水平均差异有统计学意义( P<0.05)；与对照组相比，早发组、晚发组的血清中 KLF5、HIF-1α水平和胎盘中 KLF5 mRNA、HIF-1α mRNA的相对表达量均显著升高，且早发组均高于晚发组( P<0.05)。 KLF5与 HIF-1α水平在孕妇血清中呈正相关( r=0.59，P<0.001)。免疫组织化学染色结果显示， KLF5主要表达于胎盘滋养细胞与胎盘血管内皮细胞的细胞核及细胞质中，其阳性表达率在三组间两两比较均差异有统计学意义( P<0.001)。早发组和晚发组内重度与非重度孕妇的血清 KLF5水平，胎盘组织 KLF5 mRNA相对表达量及 KLF5阳性表达率比较均差异无统计学意义( P>0.05)。血清 KLF5、HIF-1α水平在诊断 PE中具有中等诊断效能［曲线下面积( AUC)在 0.7~0.8］。结论 KLF5高表达可能与 PE的发生密切相关， KLF5、HIF-1α在 PE组孕妇血清及胎盘组织中的水平均显著上调，二者血清水平呈正相关，可能共同参与了 PE的发生发展。 |
| 英文摘要: |
| Objective To investigate the expression levels and clinical significance of Krüppel-like factor 5 (KLF5) and hypoxia-in. ducible factor-1α (HIF-1α) in the peripheral blood and placental tissues of pregnant women with preeclampsia (PE).Methods A pro.spective study was conducted. A total of 88 pregnant women who underwent cesarean delivery at Xuzhou Maternal and Child HealthCare Hospital from February to August 2024 were selected, including 58 pregnant women with PE, of whom 30 had early-onset PE (ear. ly-onset group) and 28 had late-onset PE (late-onset group); 30 pregnant women with normal term delivery were selected as the controlgroup. Fasting peripheral venous blood collected before hospital treatment and fresh placental tissues obtained at delivery were used asspecimens. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of KLF5 and HIF-1α in the serum of pregnant women. Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect the relative expression levels of KLF5 and HIF-1α mRNA in placental tissues of the three groups, and immunohistochemistry was used to detect the expres. sion level and localization of KLF5 in placental tissues. In addition, according to the severity of PE, the serum KLF5 level, relative ex.pression level of KLF5 mRNA in placental tissues, and KLF5-positive expression rate were compared between pregnant women with se. vere and non-severe PE within the early-onset group and the late-onset group, respectively. Receiver operating characteristic curves(ROC curves) were used to evaluate the diagnostic efficacy of serum KLF5 and HIF-1α levels for PE.Results Serum KLF5 levels in the early-onset, late-onset, and control groups were (3 523.84±825.33) mg/L, (3 045.21±536.23) mg/L, and (2 593.87±728.13) mg/L, re.spectively, and serum HIF-1α levels were (338.60±82.29) mg/L, (282.43±83.49) mg/L, and (239.67±72.77) mg/L, respectively. The rel.ative expression levels of KLF5 mRNA in placental tissues of the early-onset, late-onset, and control groups were 5.50±2.78, 2.99± 1.51, and 1.34±1.05, respectively, and the relative expression levels of HIF-1α mRNA were 4.86±1.09, 3.58±0.33, and 1.52±1.15, re. spectively. The serum and placental levels of KLF5 and HIF-1α showed statistically significant differences among the three groups (P< 0.05). Compared with the control group, serum KLF5 and HIF-1α levels and the relative expression levels of KLF5 mRNA and HIF-1α mRNA in placental tissues were significantly increased in both the early-onset and late-onset groups, and all these levels were higher in the early-onset group than in the late-onset group (P<0.05). Serum KLF5 and HIF-1α levels were positively correlated in pregnant wom. en (r=0.59, P<0.001). Immunohistochemical results showed that KLF5 was mainly expressed in the nuclei and cytoplasm of placentaltrophoblast cells and placental vascular endothelial cells, and pairwise comparisons of the KLF5-positive expression rates among the three groups showed statistically significant differences (P<0.001). There were no statistically significant differences in serum KLF5levels, relative KLF5 mRNA expression levels in placental tissues, or KLF5-positive expression rates between pregnant women with se. vere and non-severe PE within either the early-onset or late-onset group (P>0.05). Serum KLF5 and HIF-1α levels showed moderate di. agnostic performance for PE [area under the curve (AUC), 0.7-0.8].Conclusions Elevated KLF5 expression may be closely associated with the occurrence of PE. KLF5 and HIF-1α were significantly upregulated in both the serum and placental tissues of women with PE,and their serum levels were positively correlated. These findings suggest that KLF5 and HIF-1α may jointly contribute to the pathogene. sis and progression of PE. |
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