李金艳;刘建;刘红;

• 1:重庆医科大学附属二院妇产科
• 2:重庆医科大学附属二院妇产科
• 3:重庆医科大学附属二院妇产科 重庆400010
• 4:重庆400010

摘要(Abstract)：

目的:探讨妊娠肝内胆汁淤积症(ICP)患者的血红素氧合酶/一氧化碳(HO/CO)体系变化意义及其与胎儿预后的关系。方法:采用双波长分光光度计法测定25例ICP患者及25例正常晚孕妇女母血、脐血血浆CO的含量;用免疫组化法测定两组孕妇胎盘组织中HO-2蛋白的相对表达量;用免疫组织化学SABC法确定血红素氧合酶(HO)在体外分离培养人胎盘滋养层细胞上的表达及定位。结果:(1)ICP组母血血浆CO的含量为33.0±10.9μmol/L,与对照组的含量为38.3±6.1μmol/L相比,差异有统计学意义(P<0.05);(2)ICP组脐血血浆CO的含量为26.7±7.0μmol/L,与对照组的含量31.1±7.7μmol/L相比,差异有统计学意义(P<0.05);(3)ICP组母血血浆CO的含量与TBA相关,(r=-0.32,P<0.005);(4)未发现ICP组CO水平与羊水粪染、胎儿出生体重、Apgar评分、脐动脉S/D值及孕周之间相关;(5)ICP组胎盘组织中HO-2蛋白定量结果为OD=0.88±0.41,与对照组的OD=1.24±0.47相比,差异有统计学意义(P<0.05);(6)HO在体外分离培养人胎盘滋养层细胞有表达,阳性物质分布于胞浆内,胞核为阴性反应。结论:(1)ICP患者母血血浆和脐血血浆CO的水平降低,胎盘组织中HO-2表达减少。HO/CO体系与ICP的发生发展及患者胎儿的不良结局有关;(2)HO在体外分离培养人胎盘滋养层细胞有表达,阳性物质分布于胞浆内,胞核为阴性反应。

关键词(KeyWords)： 妊娠;胆汁淤积,肝内;血红素氧化酶;一氧化碳;滋养层细胞;分离培养

Abstract:

Keywords:

基金项目(Foundation): 重庆市医学科研基金资助项目(03-2-049)

作者(Authors): 李金艳;刘建;刘红;

DOI: 10.13283/j.cnki.xdfckjz.2006.04.009

参考文献(References)：

• [1]Tschugguel,W alter T,Felix S,et al.Estrogen increasesendothelial carbon monoxide,hem e oxygenase 2,and car-bon monoxide-derived cGMP by a receptor-m ed iated sys-tem[J].C lin EndocrinolM etab,2001,86:3833-3839
• [2]Zenc lussen AC,L im E,Knoeller S,et al.Hem e oxygenas-es in pregnancy II:HO-2 is downregu lated in hum an path-ologic pregnanc ies[J].Am J Reprod Immunol,2003,50:66-76
• [3]Reyes H.The spectrum of liver and gastrointestinal d is-ease seen in cholestasis of pregnancy[J].GastroenterolC lin North Am,1992,21:905-921
• [4]曾锦生,叶启发.血浆一氧化碳测定的改良双波长分光光度法[J].中国现代医学杂志,2002,12:40-41
• [5]K lim an HJ,Nestler JE,Serm asi E,et al.Purification,char-acterization,and in vitro d ifferentiation of cytotrophob lastfrom hum an term p lacenta[J].Endocrinology,1986,118:1567-1582
• [6]程勇前,聂青和,周永兴,等.人胎盘滋养层细胞的分离培养及IgGFcγRⅢ在滋养层细胞的表达[J].医学研究生报,2002,15:105-108
• [7]ReyesH.Intrahepatic cholestasis of pregnancy.A puzzlingd isorder of pregnancy[J].J Gastroenteol Hepatol,1997,12:211-216
• [8]Sano T,Sh iom iM,W akabayash i Y,et al.Endogenous car-bon monoxide suppression stimu lates ac id-dependent b ili-ary transports in perfused rat live[J].Am J Physiol,1997,272:G1268-G1275
• [9]Sh inoda Y,Suem tsu M,W akabayash i Y,et al.Carbonmonoxide as a regu lator of canalicu lar contractility in cu l-tured rat hepatocytes[J].Hepatology,1998,28:286-295
• [10]Norim izu S,Kudo A,Kajimura M.Carbon monoxide stimu-lates mrp2-dependent excretion of bilirubin-IX alpha intobile in the perfused rat liver[J].Antioxid Redox Signal,2003,5:449-456
• [11]M cLaughlin BE,Hutch inson JM,G raham CH.Hem e oxy-genase activity in term hum an p lacenta[J].P lacenta,2000,21:870-873
• [12]App leton SD,M arks GS,Nakatsu K,et al.E ffects of hy-poxia on hem e oxygenase expression in hum an chrion icvilli exp lants and immortalized trophob last cells[J].AmJ Physiol Cric Pysiol,2003,284:H853-H858
• [13]Costoya AL,Leontic E,Rosenberg HG,et al.Morphoo-logical study of p lacenta term inal villi in intrahepaticcholestasis of pregnancy:h istochem istry,light and elec-tron m icroscopy[J].P lacenta,1980,1:361-368
• [14]刘朝阳,张逢香,岳亚飞.妊娠期肝内胆汁淤积症围生儿不良结局的研究[J].国外医学妇幼保健分册,2003,14:29-32