妊娠期肝内胆汁淤积症围生儿缺氧机理的研究

目的探讨妊娠期肝内胆汁淤积症(ICP)围生儿缺氧的可能机理.方法分别用放免法、生化法及原子吸收法测定ICP组及对照组母儿血甘胆酸(CG)、红细胞膜三磷酸腺苷酶(ATPase)活性及细胞内离子浓度,统计各组围生儿缺氧率.结果 ICP组母儿CG水平显著高于对照组(P＜0.01),母血CG值显著高于新生儿血;红细胞膜ATPase活性明显低于对照组(P＜0.01),并与CG水平呈负相关 (Na -K -ATPase:rs=-0.498,P＜0.01;Ca2 -ATPase:rs=-0.443,P＜0.05);红细胞内Na 、Ca2 浓度明显高于对照组(P＜0.01);围生儿缺氧的发生率明显高于对照组(P＜0.05).结论 ICP围生儿血清内高浓度的胆汁酸影响其红细胞的结构与功能,可能是ICP围生儿缺氧的机理之一.

A Study on perinatal hypoxia in intrahepatic cholestasis of pregnancy

Objective: To explore the possible mechanism of perinatal hypoxia in ICP. Methods:Twenty-nine newborns of pregnant women with ICP and twenty-nine newborns of health pregnant women were as (ICP)and controls. The levels of cholyglycine (CG), the activities of ATPase of erythrocyte membrane, the intracellular concentration of ions in umbilical blood were determined by radioimmunossay, biochemical and atomic absorption spectrometry respectively. Results: The level of CG in ICP group was higher significantly than in the controls (P<0.01). The activities of ATPase of erythrocyte were significantly lower in ICP group. There was a negative correlation between ATPase activities and CG levels (P<0.05). Na~+ and Ca~(2+) concentrations in erythrocyte were significantly higher in ICP group (P<0.01). The incidence of Perinatal hypoxia was higher in ICP(P<0.05). Conclusion: The high concentrations of bile acids in fetus could change the structure and function of their erythrocytes. It may be one of the mechanisms of perinatal hypoxia in ICP.