人工羊水置换对改善肝内胆汁淤积胎鼠宫内缺氧的作用  

Artificial amniotic fluid replacement using amniocentesis improves intrauterine hypoxia of fetal rats during the treatment of intrahepatic cholestasis of pregnancy

作　　者：赵颖[1] 刘建[1] 

机构地区：[1]重庆医科大学附属第二医院妇产科,重庆市400010

出　　处：《中国组织工程研究与临床康复》2009年第31期6071-6074,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：重庆市自然科学基金资助项目(CSTC;2005BB5256)~~

摘　　要：背景:通过母体给药治疗虽可部分改善妊娠期肝内胆汁淤积症孕妇的临床症状、延长孕周,但不能明确改善胎儿缺氧及羊水粪染的情况。目的:采用药物配置人工羊水来置换妊娠期肝内胆汁淤积症孕鼠模型的高胆汁酸羊水,观察孕鼠子宫内环境的变化。设计、时间及地点:随机对照动物实验,于2008-03/09在重庆医科大学动物实验中心实验室(一级实验室)完成。材料:孕15dSD雌鼠40只,随机数字表法分为4组:S-腺苷基-L-蛋氨酸(S-Adenosyl-L-methionine,SAMe)羊膜腔内注射组、生理盐水羊膜腔内注射组、SAMe静脉注射组、空白对照组,每组10只。方法:4组于孕15d起每天用苯甲酸雌二醇诱导妊娠期肝内胆汁淤积症模型。孕17dSAMe羊膜腔内注射组和生理盐水羊膜腔内注射组分别予各胎囊内注射SAMe1mg和9g/L氯化钠液0.3mL,SAMe静脉注射组尾静脉注射SAMe30mg,空白对照组不予特殊处理。主要观察指标:各组于妊娠第20天计算羊水粪染率、死胎率,测定羊水中总胆汁酸水平,采用免疫组织化学染色技术分析胎盘中缺氧诱导因子1α表达的变化,并用RT-PCR方法检测胎盘中缺氧诱导因子1αmRNA的表达。结果:各实验处理组羊水粪染率较空白对照组低(P<0.05);羊膜腔内给药组羊水粪染率较尾静脉注射组低(P<0.05);生理盐水羊膜腔内注射组与SAMe羊膜腔内注射组羊水粪染率差异无显著性意义。羊膜腔内注射组死胎率较SAMe静脉注射组、空白对照组低(P<0.05);SAMe静脉注射组与空白对照组、生理盐水羊膜腔内注射组与SAMe羊膜腔内注射组死胎率差异无显著性意义。各实验组羊水胆汁酸浓度较空白对照组显著降低(P<0.01);羊膜腔内注射组羊水胆汁酸浓度较SAMe静脉注射组低(P<0.01);SAMe羊膜腔内注射组羊水胆汁酸浓度显著低于生理盐水羊膜腔内注射组(P<0.01)。SAMe羊膜腔内注射组和生理盐水羊膜腔内注射组胎盘上缺氧诱导因�BACKGROUND： Drug therapy can improve the clinical symptoms and extend the gestational age through the maternal way to treat intrahepatic cholestasis of pregnancy （ICP）, however, fetal hypoxia and meconium-stained amniotic fluid can not clearly improved. OBJECTIVE： To explore the effect of replacement of amniotic fluid that contains high concentrations of bile acids by artificial amniotic fluid through amniocentesis in the rat model of ICP. DESIGN, TIME AND SETTING： Random control animal experiments were completed in the Laboratory （first-degree laboratory） of Animal Experimental Center in Chongqing Medical University from March to September 2008. MATERIALS： Forty SD pregnant rats with 15 days of pregnancy were randomly divided into intracavitary injection of S-Adenosyl-L-methionine （SAMe） （IUS）, intracavitary injection of sodium chloride （IUN）, intravenous injection of SAMe （IVS） and blank control （IC） groups, with 10 rats in each group. METHODS： On day 15 of pregnancy, ICP rat models were induced by daily injection of estradiol benzoate. On day 17 of pregnancy, 1 mg SAMe and 0.3 mL sodium chloride were injected into amniotic cavity of in the IUS and IUN groups through amniocentasis. Meanwhile, 30 mg SAMe were injected though tail veins in IVS group. No treatment was performed in the IC group. MAIN OUTCOME MEASURES： The meconium-stained amniotic fluid rate and the still birth rate were calculated. Total bile acid （TBA） level in amniotic fluid was measured. In addition, the expression of hypoxia-inducible factor 1 a（HIF-la） mRNA in the placenta of rats were examined by immunohistochemistry and reverse transcription PCR at the days 20 of pregnancy. RESULTS： The meconium-stained amniotic fluid rate in the experimental group was lower than that of the IC group （P〈 0.05） which was lower in the IUS group than IVS group （P 〈 0.05）. The difference of the meconium-stained amniotic fluid rate and was not significant between IUN and IUS groups. The still birth ra

关 键 词：妊娠 胆汁淤积 肝内 胆汁酸 羊膜腔 

分 类 号：R318[医药卫生—生物医学工程]