新疆维吾尔族、汉族妊娠期肝内胆汁瘀积症患者FXR受体表达的相关研究  

Research of Intrahepatic Cholestasis of Pregnancy FXR Receptor Expression in Xinjiang Uygur and Han Nationality

作　　者：李芳[1] 武建利[1] 陈洁[1] 

机构地区：[1]新疆医科大学第一附属医院产科,乌鲁木齐830054

出　　处：《新疆医学》2016年第9期1093-1096,共4页Xinjiang Medical Journal

基　　金：新疆维吾尔自治区自然科学基金(2013211A088)

摘　　要：目的分析维吾尔族、汉族妊娠期肝内胆汁淤积症孕妇及正常妊娠孕妇胎盘中FXR受体的表达,及母血与胎儿脐血胆汁酸水平对妊娠结局的影响,探讨FXR在ICP发病机制中的作用。方法选择2013年1月-2014年1月我院分娩的60例汉族单胎ICP患者及60例维吾尔族ICP孕妇作为研究组,同时选取同期我院分娩的60例单胎正常妊娠孕妇(30例汉族、30例维吾尔族)作为对照组,检测所有孕妇外周血及胎儿脐血胆汁酸水平,观察比较四组孕妇的围生期结局。结果汉族、维族ICP孕妇母血及胎儿脐血胆汁酸水平较对照组均升高(P<0.05),汉族与维族ICP孕妇、对照组之间母血及脐血胆汁酸水平无差异(P>0.05);汉族、维族ICP孕妇Manning评分、早产、分娩时发生羊水污染及新生儿窒息率明显高于对照组(P<0.05),汉族与维族ICP孕妇间、对照组见均无差异,四组孕妇发生围产儿死亡、测定胎儿脐血流S/D值无差异(P>0.05)。汉族、维族ICP孕妇胎盘FXR m RNA的表达量明显高于对照组(P<0.05),汉族与维族ICP孕妇间、对照组间无差异(P>0.05);汉族、维族ICP孕妇胎盘FXR mRNA相对表达量与母血、脐血胆汁酸水平均成正相关,而对照组无相关性。结论检测孕妇外周血及胎儿脐血胆汁酸有助于判断ICP的严重程度,评估妊娠结局;ICP时胎盘FXR的表达异常可能是发病机制之一。Objective To analysis the expression of FXR receptor in placenta of the Uygur, Han intrahepatic cholestasis of pregnancy and normal pregnancy, and the effect on pregnancy outcome of bile acid levels in maternal and umbilical cord serum. To explore the role of FXR in the pathogenesis of ICP. Methods 60 cases of Han ICP pregnant women and 60 cases of Uygur ICP pregnant women were selected as the ICP group, 60 cases of normal pregnancy（30 cases of Han pregnant, 30 cases of Uygur pregnant） as the control group betwee March 2013 and June 2014 in our hospital, all pregnant women bile acid levels in maternal and umbilical cord serum and and the placental FXR m RNA expression were tested, three pregnant women group of perinatal outcomes were compared. Results Han and Uygur ICP pregnant in maternal blood and fetal cord blood bile acid levels were higher than that of the control group（P〈0.05）, but there was no difference（P〉0.05）. Han and Uighur ICP pregnant women with Manning score, premature delivery, amniotic fluid contamination and neonatal asphyxia rate were significantly higher than that of the control group（P〉0.05）, but there were no difference between Han and Uighur ICP pregnant women. There had no difference of perinatal death, fetal umbilical blood flow S/D values in three groups（P〉0.05）.FXR m RNA expression in the placenta of Han and Uygur ICP pregnant women were significantly higher than that of the control group（P〈0.05）, but there were no difference between Han and Uighur ICP pregnant women（P〉0.05）. FXR m RNA expression in placenta of Han and Uighur ICP pregnant women were positively correlated with maternal blood, umbilical cord blood bile acid levels, while the control group had no correlation. Conclusion Detection of bile acid levels in maternal and umbilical cord serum help determine the severity of the ICP and assess pregnancy outcomes; FXR expression of placental abnormalities may be one of the pathogenesis of ICP.

关 键 词：妊娠期肝内胆汁淤积症 胆汁酸 法尼醇X受体 胎盘 

分 类 号：R714.2[医药卫生—妇产科学]