脂质过氧化对妊娠肝内胆汁淤积症患者母儿红细胞ATP酶的影响

目的观察妊娠期肝内胆汁淤积症患者母儿红细胞中脂质过氧化水平及其对红细胞ATP酶的影响,探讨妊娠肝内胆汁淤积症胎儿窘迫发生的原因。方法 抽取32例ICP孕妇（ICP组）和30例健康产妇（对照组）空腹肘静脉血和脐血采用硫代巴比妥比色法测定血浆中丙二醛（MDA）水平,黄嘌呤氧化法测定红细胞超氧化物歧化酶（SOD）活性,无机磷测定法测定红细胞Na＋-K＋-ATP酶、Ca2＋-Mg2＋-ATP酶活性。结果两组母儿血SOD活性和MDA的比较,ICP组母血红细胞SOD活性和MDA均较对照组显著升高（P分别〈0.05,〈0.001）,而脐血红细胞MDA显著高于对照组（P〈0.001）,脐血红细胞SOD活性亦高于对照组,但差异无统计学意义（P〉0.05）。两组母儿红细胞Na＋-K＋-ATP酶、Ca2＋-Mg2＋-ATP酶活性比较,ICP组母儿红细胞Na＋-K＋-ATP酶活性均较对照组低（P〈0.001）、母儿红细胞Ca2＋-Mg2＋-ATP酶活性也均较对照组低（P〈0.01,P〈0.001）。ICP组内围生儿有胎儿窘迫组MDA显著高于无胎儿窘迫组（P〈0.05）,红细胞Na＋-K＋-ATP酶、Ca2＋-Mg2＋-ATP酶活性均较无胎儿窘迫组低,差异有统计学意义（P〈0.01,P〈0.05或P〈0.001）。ICP患者母儿红细胞Na＋-K＋-ATP酶活性与MDA浓度呈显著负相关关系（P均〈0.01）。结论 ICP患者胎儿宫内窘迫的发生可能与红细胞ATP酶活性降低有关,红细胞ATP酶活性受脂质过氧化的影响,抗氧化剂的应用可能会减少ICP患者胎儿宫内窘迫的发生。

Influence of Lipid Peroxide on Erythrocyte ATPase in Intrahepatic Cholestasis of Pregnancy

Objective To study the correlation of lipid peroxidation, ATPase in erythrocyte and fetal stress of intrahepatic cholestasis of pregnancy(ICP). Methods Thirty normal pregnant women and 32 women who were diagnosed as ICP were included in this study.Their limosis vein blood and umbilical venous blood were collected to determine MDA,SOD and erythrocyte ATPase by thibabituric acid method,xanthine oxidase method,and chemical method,respectively. Results MDA and SOD in women of ICP group were increased significantly than those in normal control group(P<0.05,P<0.001).MDA and SOD in neonates’ cord blood of ICP group were both higher than those in normal control group(P<0.001, P<0.05),but no statistically significant difference was found between the two groups(P>0.05).Erythrocyte ATPase activities in mothers and fetuses of ICP group were significantly lower than those in normal control group(P<0.01,P<0.001).MDA in neonates’ cord blood of the fetal distress group was significantly higher than that in non-distress group(P<0.05),while erythrocyte ATPase activities were significantly lower than those in non-distress group,and the difference was statistically significant(P<0.01,P<0.05 or P<0.001).There was a negative correlation between Na+-K+-ATPase and malondialdehyde level in ICP patients(Both P<0.01). Conclusions The results suggest that the fetal distress in ICP patients associates with activity of erythrocyte ATPase,and there has an influence of lipid peroxide in intrahepatic cholestasis of pregnancy on erythrocyte ATPase.Application of antioxidant may be one of the methods to decrease fetal distress in ICP.