妊娠期肝内胆汁淤积症诱发胎儿生长受限发病机制的探究  

Study on the pathogenesis of fetal growth restriction caused by intrahepatic cholestasis of pregnancy

作　　者：李莉[1] 李晓兰 杨媛媛[1] 韦雯雯[1] 丛林[1] Li Li;Li Xiaolan;Yang Yuanyuan(Department of Obstetrics and Gynecology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022)

机构地区：[1]安徽医科大学第一附属医院妇产科,合肥230022

出　　处：《现代妇产科进展》2020年第9期676-679,共4页Progress in Obstetrics and Gynecology

基　　金：国家自然科学青年基金(No:81801477)。

摘　　要：目的:探讨ICP诱发FGR发生的可能发病机制。方法:免疫组化和ELISA法检测对照组、ICP(轻、重度)组胎盘组织中Nrf2、3-NT、Ki67、PCNA、CD34的表达分布和血清TNF-α、IL-8、IL-10的水平。结果:CD34在对照组和轻、重度ICP组胎盘中表达无差异;PCNA、Ki67、Nrf2阳性细胞在对照组胎盘中表达较多,在轻度ICP组表达较少,在重度ICP组几无表达;3-NT阳性细胞在重度ICP组胎盘中表达较多,在轻度ICP组表达较重度组少,在对照组中几无表达。轻、重度ICP组孕妇血清TNF-α水平均显著高于对照组(P<0.05),但轻、重度ICP组之间无明显差异(P>0.05);轻、重度ICP组孕妇血清IL-8水平均显著高于对照组(P<0.05),且重度ICP组血清IL-8水平显著高于轻度ICP组(P<0.05);轻、重度ICP组孕妇血清IL-10水平均显著低于对照组(P<0.05),但轻、重度ICP之间无明显差异(P>0.05)。结论:ICP可能通过引起胎盘氧化应激、母体炎症导致胎盘发育受损和功能障碍,从而诱发FGR的发生。Objective:To explore the possible pathogenesis of FGR caused by ICP.Methods:The expressions and distributions of Nrf2,3-NT,Ki67,PCNA and CD34 in placenta and the levels of TNF-α,IL-8 and IL-10 in serum of control group and mild、severe ICP group were detected by immunohistochemistry and ELISA respectively.Results:There was no difference in the expression of placenta CD34 between the control group、the light and heavy ICP groups.The expressions of PCNA,Ki67,Nrf2 positive cells were more in the control group,less in the light ICP group,and little in the heavy ICP group.The expression of 3-NT positive cells was more in the heavy ICP placenta group,less in the light ICP group,and little in the control group.The serum TNF-αlevels of the light and heavy ICP groups were significantly higher than that of the control group(P<0.05),but there was no significant difference between the light and heavy ICP groups(P>0.05).The serum IL-8 levels of the light and heavy ICP groups were significantly higher than that of the control group(P<0.05),and the serum IL-8 level of the heavy ICP group was significantly higher than that of the light ICP group(P<0.05).The serum IL-10 levels of the light and heavy ICP groups were significantly lower than that of the control group(P<0.05),but there was no significant difference between the light and heavy ICP(P>0.05).Conclusion:ICP may lead to the occurrence of FGR by causing oxidative stress of placenta and inflammation of mother,resulting in the impairment and dysfunction of placenta development.

关 键 词：妊娠期肝内胆汁淤积 胎儿生长受限 氧化应激 炎症 

分 类 号：R714[医药卫生—妇产科学]