血红素氧合酶/一氧化碳体系在妊娠期肝内胆汁淤积症的表达及意义

目的:探讨妊娠肝内胆汁淤积症(ICP)患者的血红素氧合酶/一氧化碳(HO/CO)体系变化意义及其与胎儿预后的关系。方法:采用双波长分光光度计法测定25例ICP患者及25例正常晚孕妇女母血、脐血血浆CO的含量;用免疫组化法测定两组孕妇胎盘组织中HO-2蛋白的相对表达量;用免疫组织化学SABC法确定血红素氧合酶(HO)在体外分离培养人胎盘滋养层细胞上的表达及定位。结果:(1)ICP组母血血浆CO的含量为33.0±10.9μmol/L,与对照组的含量为38.3±6.1μmol/L相比,差异有统计学意义(P<0.05);(2)ICP组脐血血浆CO的含量为26.7±7.0μmol/L,与对照组的含量31.1±7.7μmol/L相比,差异有统计学意义(P<0.05);(3)ICP组母血血浆CO的含量与TBA相关,(r=-0.32,P<0.005);(4)未发现ICP组CO水平与羊水粪染、胎儿出生体重、Apgar评分、脐动脉S/D值及孕周之间相关;(5)ICP组胎盘组织中HO-2蛋白定量结果为OD=0.88±0.41,与对照组的OD=1.24±0.47相比,差异有统计学意义(P<0.05);(6)HO在体外分离培养人胎盘滋养层细胞有表达,阳性物质分布于胞浆内,胞核为阴性反应。结论:(1)ICP患者母血血浆和脐血血浆CO的水平降低,胎盘组织中HO-2表达减少。HO/CO体系与ICP的发生发展及患者胎儿的不良结局有关;(2)HO在体外分离培养人胎盘滋养层细胞有表达,阳性物质分布于胞浆内,胞核为阴性反应。

The change of heme oxygenase in the intrahepatic cholestasis of pregnancy

Objective:To study the change of heme oxygenase/carbon monoxide system to make the difference of the pathogenesis of intrahepatic cholestasis of pregnancy(ICP) and the bad outcome of fetal.Methods:25 ICP women(ICP group) and 25 normal women(control group)in third pregnancy were investigated.The serum of CO in the maternal plasm and the plasm of umbilical blood were measured with the double wavelength scanning by pectrophotometer.Immunocytochemical analysis was used to detect the expression of heme oxygenase protein in the placenta villi.After isolation,culture and purification of primary human placenta trophoblast cell,the immunocytochemical method of SABC was used to detect the expression of heme oxygenase of the cells cultured in vitro.Results:(1)Spectrophotometer analysis demonstrated that the level of endogenous CO in the maternal plasm of ICP group and control group were 33.0±10.9μmol/L and 38.3±6.1μmol/L,there was significant difference between the ICP group and the control group(P<0.05);(2)The level of endogenous CO in the umbilical blood plasm of ICP group was 26.7±7.0μmol/L,significantly lower than that of the control group(31.1±7.7μmol/L)(P<0.05);(3)There was relationship between the level of CO and the value of TBA(r=-0.32,P<0.05);(4)There were no relationship between the level of CO and fetal weigh,Apgar score,gestation and the value of S/D in umbilical artery;(5)The semi-quantitative analysis demonstrated that the OD value of HO-2 in the ICP group placenta was 0.88±0.41,significantly lower than that of the control group(P<0.05);(6)The heme oxygenase was expressed in isolated and cultured human trophoblast cells.The positive grain was expressed in their cytoplasm.Conclusion:The level of CO is reduced and the expression level of HO-2 proteion is decreased in ICP group.HO/CO as endogenous system may regulate feto-placenta circulation,indicated their change correlated with the bad outcome of fetal in ICP group;(2)The heme oxygenase is expressed in isolated and cultured the human trophoblast cells.The positive grain is expressed in their cytoplasm.