胎盘中FXRBSEP表达及其与ICP关系研究.docVIP

胎盘中FXRBSEP表达及其与ICP关系研究 　　【摘要】 目的 探讨ICP胎盘中FXR、BSEP的表达，以及母、脐血清中CG(甘胆酸)水平的变化，进而从胎盘角度探讨ICP发病机制。方法 以35例ICP患者为ICP组，对照组为40例正常妊娠者。测定两组母、脐血清CG水平、母血清肝功能指标、两组胎盘组织中FXR、BSEP的表达。结果 ICP组胎盘组织中FXR的表达与母血清、脐血清CG水平呈正相关性。BSEP的表达量与母血清、脐血清CG水平呈负相关性。结论 ICP组母、脐血清CG水平明显高于对照组。ICP时，患者胎盘上FXR表达虽明显增强，但BSEP的表达并未因此而上调，反而表达减低，引起胎盘排泌胎儿胆汁酸下降，胎儿体内胆汁酸瘀积，可能是ICP发病机制之一。? 　　【关键词】 胆汁瘀积;胎盘;甘胆酸 FXR BSEP 　　?? 　　 　　Study on the relationship between the expression of placental FXR,BSEP and intrahepatic cholestasis of pregnacy 　　 　　MENG Li, XU Jian-ying. Department of Gynecology and Obstetrics of The First People’s Hospital Which Afflitated to Suzhou University,Suzhou 215006,China 　　? 　　【Abstract】 Objective 　　To explore the expression of placental FXR,BSEP,as well as maternal and umbilical cord serum glycocholic acic(CG) levels.To evaluate the pathogenesis of intrahepatic cholestasis of pregnancy(ICP).Methods CG levels in 35 cases of ICP and 40 cases of normal pregnancy as compared group were detected in maternal and umbilical cord serum.The express of FXR and BSEP in placenta were detected in both guoups.Results There was a positive correlation in expression of FXR and CG level of maternal and umbilical cord serum in ICP group.However,between the expression of BSEP and the CG level of maternal and umbilical cord serum,there was a negative correlation in ICP group.Conclusion The CG level in maternal and umbilical cord serum in ICP group is significantly higher than that of control group. The expression of FXR is more in ICP group than control group. Then, the expression of BSEP on placenta falls in patients with ICP. The dysfunction of placenta transport bile acid resulted in fetal cholestasis,this may be one of the mechanisms of ICP.? 　　【Key words】 Cholestasis; Placenta; CG; FXR; BSEP 　　 　　妊娠期肝内胆汁瘀积症(intrahepatic cholestasis of pregnancy，ICP)是一种妊娠中、晚期出现的以皮肤瘙痒、胆汁瘀积和黄疸为特征的并发症。该病可引起胎儿窘迫、早产、死产，增加围生儿发病率和死亡率，同时增加剖宫产率。现很少有从母胎之间的重要代谢器官一胎盘，对胆酸代谢的影响进行探索。? 　　研究发现，人胎盘中存在FXR及MRPs、OATP、MDR3、FIC1、BSEP等多种肝脏中类似的胆汁酸