- 學位論文
母體與胎兒臍帶血血清中Hedgehog蛋白濃度和懷孕不同週期生理變化之相關性分析
Correlation of maternal and umbilical cord serum Hedgehog protein contents with physiological changes at different semesters of pregnancy
摘要
孕婦死亡總數之四分之一是由子癇前症所引起的相關併發症所導致之最後結果，也是全世界與懷孕相關之婦女死亡原因之第二位；因此，發展子癇前症早期診斷及治療策略一直是產科研究的重要項目。子癇前症之病因目前尚不清楚，一般的討論認為與胎盤功能缺失有關。Hedgehog蛋白在脊椎及非脊椎動物的身體器官發育過程中扮演很重要的角色，經被證實參與促進血管生成作用及血球生成之活化，且在早期胎盤形成中扮演重要角色；因此，Hedgehog蛋白和子癇前症相關性的研究是個自然發展出的研究課題。本研究目標在於評估母體及胎兒臍帶血血清中的Hedgehog蛋白是否可以作為早期診斷子癇前症的標誌分子。本研究收集至光田醫院產檢的懷孕婦女共60位的檢體進行分析，探討懷孕族群血清中Hedgehog的蛋白濃度在懷孕不同週期的變化與胎次、懷孕年齡、有無流產經驗、孕程血壓、孕程中紅血球及血紅素量、胎兒體重、胎盤重量等因子之間是否有相關性。結果顯示懷孕族群血清中Hedgehog蛋白與懷孕婦女懷孕年齡、有無流產經驗、孕程血壓、孕程中紅血球及血紅素量似乎有相關性，分析後也發現在第二週期血清中Hedgehog蛋白也顯示出有意義的下降。有無流產經驗與子宮內膜穩定度有相關，貧血與否也與血球生成有相關，胎盤重量也與血管生成有相關；胎盤功能會受到血管生成、血球生成及子宮內膜穩定度所影響，所以進一步推測血清中Hedgehog蛋白極有作為早期診斷子癇前症標誌分子之潛能。
並列摘要
Preeclampsia causes one-fourth of pregnant-related mortality that is directly or indirectly resulted from its complications.Globally,preeclampsia represents the second leading cause of death related to pregnancy.Therefore, development of early diagnosis and therapy strategy has always been an important subject of obstetrical research. The etiology of preeclampsia has not been known, but it is generally regarded as related to placental malfunction. Hedgehog protein plays pivotal roles during body and organ development, both in invertebrates and vertebrates. It is also known to regulate vasculogenesis and angiogenesis as well as early placenta formation. Previous studies also showed Hedgehog involvement in, hematopoetic differentiation. Therefore, it is well-justified to study the correlation between serum Hedgehog protein contents in different cycle and preeclampsia factors, in order to assess whether Hedgehog may be used as an early serum diagnostic marker. A total of 60 pregnant women were recruited as volunteers for this study. Maternal serum Hedgehog concentrations were measured by ELISA assay and correlated with factors including maternal age, order of pregnancy, previous abortion, stages of pregnancy (early and 3 trimesters), blood pressure, hemoglobin and red blood cell contents, placental weight, and fetal birth weight. The results showed that serum Hedgehog protein contents at different pregnancy stages appeared to correlate with the order of pregnancy, maternal age, previous abortion experience, maternal blood pressure, red blood cell counts, and hemoglobin, with Hedgehog contents significantly dropped down during the second trimester. Previous abortion experience is related to the stability of endometrium, while anemia is related to the ability of erythropoiesis, and so is placental weight related to angiogenesis. All of the elements of this scenario are pivotal to placental functions and are implicated with hedgehog involvement. Threfore, results of the present study support Hedgehog protein as a highly potential marker for early diagnosis for preeclampsia.