胎盘法尼醇X受体的表达及其与妊娠期肝内胆汁淤积症关系的研究  

Placental Expression of Farnesoid X Receptor and Its Role in Intrahepatic Cholestasis of Pregnacy

作　　者：万红芳[1,2] 王利民[1,3] 邢爱耘[1] 

机构地区：[1]四川大学华西第二医院,四川成都610041 [2]四川省绵阳市人民医院 [3]四川省成都市妇幼保健院

出　　处：《实用妇产科杂志》2010年第2期136-139,共4页Journal of Practical Obstetrics and Gynecology

基　　金：国家自然科学基金(项目编号:30571964)

摘　　要：目的:探讨法尼醇X受体(FXR)在正常晚孕胎盘和妊娠期肝内胆汁淤积症(ICP)胎盘的表达,及其与母血、脐血总胆汁酸(TBA)水平的关系,分析胎盘FXR在ICP病理机制中的作用。方法:收集ICP患者(ICP组)及正常晚孕妇女(对照组)胎盘组织及母血、脐血各33例,并将ICP患者根据母血血清TBA是否≥40μmol/L将ICP组分为轻度ICP组和重度ICP组。并测定母血、脐血TBA水平和胎盘组织中FXRmRNA的相对表达量。结果:①羊水胎粪污染的发生率:ICP组羊水污染发生率高于对照组(χ2=7.543,P=0.013);重度ICP组高于轻度ICP组(χ2=7.637,P=0.013);②胎盘组织中FXRmRNA的表达情况:ICP组胎盘FXRmRNA表达量高于对照组(z=-2.391,P=0.017);重度ICP组胎盘FXRmRNA表达量高于轻度ICP组(z=-2.391,P=0.017);③ICP组胎盘FXRmRNA表达量与母血、脐血TBA呈正相关(rs=0.348,P=0.047;rs=0.284,P=0.027);对照组胎盘FXRmRNA表达量与母血、脐静脉血TBA无相关性(rs=-0.068,P=0.716;rs=0.010,P=0.959)。结论:ICP时增高的胆汁酸水平上调胎盘FXRmRNA的表达,胎盘FXR表达增加可能为ICP时胎盘的一种对抗胎儿胆汁淤积的保护性机制。Objective：To explore the placental expression of famesoid X receptor（FXR） ,as well as the total bile acid （TBA） levels in maternal and umbilical cord serum in intrahepatic cholestasis of pregnancy （ICP） and normal late pregnancy. To evaluate the roles of placental FXR in the pathological mechanism of ICP, Methods：Maternal and umbilical cord blood as well as placentas were collected in gravidas of 33 ICP （ICP group） and 33 normal late pregnancy （control group）. According to maternal serum TBA levels, ICP group was divided into mild and severe subgroup, the latter with TBA ≥40 μmol/L. TBA levels were measured by velocimetry and the placental FXR mRNA expression were examined by real time nested RT-PCR. Results：（1）,omparing the rate of meconium -stain of amniotic fluid： The rate in ICP group was significantly higher than that in control group（X^2 =7.543, P =0.013） ; The rate in serve ICP group was significantly higher than that in mild ICP group（X^2 =7.637, P = 0.013）. （2）The expression of FXR mRNA in placentas： placental FXR mRNA expression was significantly higher in ICP group than that in control group （ z = - 2.391, P = 0.017）. Placental FXR mRNA expression was higher in severe ICP group than that in mild ICP group （z = -2.391, P =0.017）. （3）In ICP group, a positive correlation was found between the placental FXR mRNA expression and the matemal serum TBA levels as well as umbilical serum TBA levels（ rs =0.348, P=0.047; rs = 0.284, P = 0.027）. There were no significant correlations between maternal serum as well as umbilical serum TBA levels and placental FXR mRNA expression in control group （rs = -0.068, P=0.716;rs = 0.010, P= 0.959）. Conclusions： Placental FXR mRNA expression is up regulated by increased bile acid levels in ICP,which may represent a compensatory （anti-cholestatic） mechanism of placenta in ICP.

关 键 词：妊娠并发症 胆汁淤积 胎盘 法尼醇X受体 胆汁酸 

分 类 号：R714.255[医药卫生—妇产科学]