妊娠期肝内胆汁淤积症患者胎盘细胞凋亡的研究  

The relationship between intrahepatic cholestasis and placenta cells apoptosis in pregnancy

作　　者：陈敏[1] 孙丽洲[1] 丁虹娟[2] 武卫平[2] 

机构地区：[1]南京医科大学,江苏南京210029 [2]南京医科大学附属南京市妇幼保健院,江苏南京210004

出　　处：《现代医学》2007年第6期428-431,共4页Modern Medical Journal

摘　　要：目的研究妊娠期肝内胆汁淤积症(ICP)患者胎盘细胞凋亡与胆酸水平的关系,初步探讨ICP患者胎儿预后不良的原因。方法采用原位末端标记法(TUNEL)检测ICP组和正常妊娠组胎盘细胞凋亡指数,免疫组织化学方法检测两组凋亡基因bax、bcl-2和caspase-3的表达水平,通过对细胞凋亡指数和凋亡相关基因的检测,了解胎盘细胞的凋亡情况,探讨ICP患者发生胎儿预后不良是否与胎盘细胞凋亡有关。结果ICP组胎盘细胞凋亡率明显高于正常妊娠组(P<0.05),且促进细胞凋亡基因bax、caspase-3表达增加,抑制细胞凋亡基因bcl-2表达降低;随着胆酸水平的升高,bax/bcl-2比例升高,细胞凋亡增加。结论ICP患者存在胎盘细胞过度凋亡现象,并与血清胆酸水平有相关性;胎盘细胞过度凋亡使胎盘功能减退,导致胎儿预后不良。Objective Though investigating the apoptosis condition and the gene exptression level of bax,bcl-2 and caspase-3 in placenta cells,to research and explore the relationship between serum cholylglycine and placenta apoptosis,as well as the possible mechanism of placental dysfunction in patients with intrahepatic cholestasis of pregnancy(ICP).Methods TDT-mediated dUTP nick end labeling(TUNEL)was used to detect apoptosis index and immuno-histochemistry methods was preformed to study the expression of bax,bcl-2 and caspase-3 in 30 ICP placental samples and 15 normal placental samples.The relationship between the placenta cells apoptosis and intrahepatic cholestasis was eveluated by the detection of apoptosis index and apoptosis related gene.Results The apoptosis index in placental tissues of ICP group was significantly higher than that in normal group.The expression of bax and caspase-3 in ICP group was higher than that in normal group.However,the expression of bcl-2 in ICP group was lower than that in normal group.The ratio of bax/bcl-2 became higher following with the changes of serum cholylglycine.Conclusion The apoptosis in placental cells may be related to the serum cholylglycine in ICP patients.The changes of apoptosis in placenta tissues may have a role on the placenta dysfunction.

关 键 词：妊娠期 肝内胆汁淤积症 细胞凋亡 基因BAX 基因BCL-2 基因caspase-3 胎儿预后 

分 类 号：R714.25[医药卫生—妇产科学]