妊娠期肝内胆汁淤积症孕妇血清PDCD4,GLUT1表达水平及其与妊娠结局的相关性研究  

Study on the Expression Level of Serum PDCD4 and GLUT1 in Pregnant Women with Intrahepatic Cholestasis During Pregnancy and Its Correlation with Pregnancy Outcome

作　　者：罗亚丽[1] 黄志刚[2] 罗思通 徐洲 LUO Ya-li;HUANG Zhi-gang;LUO Si-tong;XU Zhou(Department of Obstetrics and Gynecology,Bazhong City Bazhou District Maternal and Child Health Hospital,Sichuan Bazhong 636000,China;Department of Experimental Medicine,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Obstetrics and Gynecology,Sichuan Jinxin Women’s and Children’s Hospital,Chengdu 610066,China)

机构地区：[1]巴中市巴州区妇幼保健院妇产科,四川巴中636000 [2]四川大学华西医院实验医学科,成都610041 [3]四川锦欣妇女儿童医院妇产科,成都610066

出　　处：《现代检验医学杂志》2023年第3期143-148,共6页Journal of Modern Laboratory Medicine

基　　金：四川省医学会青年创新科研课题计划(S21092):经方“麻黄连翘赤小豆-茵陈篙汤”治疗妊娠期肝内胆汁淤积症的临床研究。

摘　　要：目的检测妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)孕妇血清程序性细胞死亡因子4(programmed cell death factor 4,PDCD4)和葡萄糖转运蛋白1(glucose transporter 1,GLUT1)的表达水平,分析二者与孕妇妊娠结局的相关性。方法收集巴中市巴州区妇幼保健院产科2018年7月~2020年7月收治的ICP孕妇126例作为研究组,其中轻度ICP组46例,重度ICP组80例,选择同期该院120例健康产检孕妇作为对照组。采用实时荧光定量PCR(qRT-PCR)法测定ICP孕妇血清PDCD4和GLUT1水平,多因素Logistic回归分析影响ICP孕妇妊娠结局的因素,Pearson相关性分析ICP孕妇血清PDCD4和GLUT1水平的相关性。结果与对照组比较,研究组PDCD4(1.36±0.23 vs 1.02±0.21),GLUT1(1.40±0.22 vs 0.99±0.18)水平升高,差异具有统计学意义(t=15.935,12.090,均P=0.000)。重度ICP组PDCD4(1.41±0.25),GLUT1(1.45±0.22)水平显著高于轻度ICP组(1.27±0.20,1.31±0.21),差异具有统计学意义(t=3.246,3.496,均P<0.05)。研究组羊水胎粪污染(20.63%)、自发性早产(7.14%)、产后出血(8.73%)、宫内窘迫(11.90%)等不良妊娠结局的发生率均高于对照组(0.00%,0.83%,0.83%,1.67%),差异均具有统计学意义(χ^(2)=1.049~29.159,均P<0.05);妊娠结局良好组和妊娠结局不良组患者的发病程度(OR=1.109,95%CI=1.035~1.188)、PDCD4(OR=1.428,95%CI=1.013~2.012)以及GLUT1(OR=1.453,95%CI=1.066~1.980)水平差异具有统计学意义(均P<0.05);多因素Logistic回归分析显示,发病程度、PDCD4,GLUT1为ICP孕妇妊娠结局不良的影响因素(Waldχ^(2)==8.738,1.428,1.453;P=0.003,0.041,0.018);Pearson相关性分析显示,ICP孕妇血清PDCD4与GLUT1水平呈正相关(r=0.460,P<0.05)。结论PDCD4,GLUT1在ICP孕妇血清中表达均上调,二者呈正相关,是ICP孕妇妊娠结局不良的影响因素。Objective To measure the expression levels of serum programmed cell death 4(PDCD4)and glucose transporter 1(GLUT1)in pregnant women with intrahepatic cholestasis of pregnancy(ICP),and analyze the correlation between the two and the pregnancy outcome of pregnant women.Methods From July 2018 to July 2020,126 pregnant women with ICP who were admitted to Department of Obstetrics and Gynecology,Bazhong City Bazhou District Maternal and Child Health Hospital were gathered as the study group,including 46 cases in mild ICP group and 80 cases in severe ICP group.A total of 120 healthy pregnant women in the hospital were regarded as the control group.Quantitative real-time PCR(qRT-PCR)was used to measure the serum PDCD4 and GLUT1 levels in pregnant women with ICP,multivariate logistic regression was performed to analyze the factors affecting pregnancy outcomes in pregnant women with ICP,and Pearson correlation was performed to analyze the correlation of serum PDCD4 and GLUT1 levels in pregnant women with ICP.Results The levels of PDCD4(1.36±0.23 vs 1.02±0.21)and GLUT1(1.40±0.22 vs 0.99±0.18)in the study group were obviously higher than those in the control group(t=15.935,12.090,all P=0.000).The levels of PDCD4(1.41±0.25)and GLUT1(1.45±0.22)in the severe ICP group were obviously higher than those in the mild ICP group(1.27±0.20,1.31±0.21),the differences were statistically significant(t=3.246,3.496,all P<0.05).The incidences of adverse pregnancy outcomes such as amniotic fluid meconium pollution(20.63%),spontaneous premature birth(7.14%),postpartum hemorrhage(8.73%),and intrauterine distress(11.90%)in the study group were higher than those in the control group(0.00%,0.83%,0.83%,1.67%),and the differences were statistically significant(χ^(2)=1.049~29.159,all P<0.05),and there were significant differences in the incidence(OR=1.109,95%CI=1.035~1.188),PDCD4(OR=1.428,95%CI=1.013~0.012)and GLUT1(OR=1.453,95%CI=1.066~1.980)levels between the two groups(all P<0.05).Multivariate Logistic regression analysis showed that the

关 键 词：妊娠期肝内胆汁淤积症 程序性细胞死亡因子4 葡萄糖转运蛋白1 

分 类 号：R714.255[医药卫生—妇产科学] R446.11[医药卫生—临床医学]