妊娠期肝内胆汁淤积症患者胎盘abcb4基因的表达与围产儿预后的相关性研究

目的 分析妊娠期肝内胆汁淤积症(ICP)患者胎盘abcb4基因的表达与围产儿预后的相关性。 方法 选取2015年5月-2017年5月期间德阳市人民医院定期产检的60例ICP孕妇设为ICP组,包括轻度ICP 36例、重度ICP 24例;另选取同期产检正常的30例孕妇设为对照组。分别采用RT-PCR法、免疫组化法测定胎盘组织中abcb4 mRNA、abcb4蛋白表达水平,分析其与羊水污染、新生儿Apgar评分及不良预后的关系。 结果 与对照组相比,ICP组患者羊水污染率明显升高,新生儿Apgar评分明显较低,早产、新生儿窒息、低体重儿发生率明显升高,差异均有统计学意义(均P<0.05);轻度ICP、重度ICP患者羊水污染率、新生儿Apgar评分及早产、新生儿窒息发生率比较差异均有统计学意义(均P<0.05)。与对照组相比,ICP组abcb4 mRNA水平明显下降,abcb4蛋白表达强度明显降低(均P<0.05);与轻度ICP相比,重度ICP患者abcb4 mRNA水平明显下降,abcb4蛋白表达强度明显降低(均P<0.05)。Pearson相关性分析显示,ICP患者胎盘组织abcb4 mRNA水平、abcb4蛋白表达强度与羊水污染率、Apgar评分及早产、新生儿窒息发生率均呈负相关(均P<0.05)。 结论 ICP患者胎盘abcb4基因表达水平与围产儿预后密切相关,尤其是abcb4基因表达水平下降可增加羊水污染、早产、新生儿窒息风险。 

Correlation between expression of placental abcb4 gene and prognosis of perinatal infants in patients with intrahepatic cholestasis of pregnancy

Objective To analyze the correlation between expression of placental abcb4 gene and prognosis of perinatal infants in patients with intrahepatic cholestasis of pregnancy (ICP). Methods Sixty cases of ICP pregnant women who were regularly given production inspection in our hospital from May, 2015 to May, 2017 were set as ICP group, including 36 cases of mild ICP and 24 cases of severe ICP. Another 30 cases of pregnant women with normal checkups were selected as control group. The expressions levels of abcb4 mRNA and abcb4 protein in placenta were determined by RT-PCR and immunohistochemistry, and their relationship with amniotic fluid contamination, neonatal Apgar score and poor prognosis were analyzed. Results Compared with control group, the amniotic fluid contamination rate was significantly higher in ICP group while the neonatal Apgar score was significantly lower, and the incidence rates of premature delivery, neonatal asphyxia and low birth weight infants were significantly higher (P<0.05). There were statistically significant differences in the amniotic fluid contamination rate, neonatal Apgar score, incidence rates of premature delivery and neonatal asphyxia between mild ICP patients and severe ICP patients (P<0.05). Compared with control group, the abcb4 mRNA level in ICP group was significantly decreased, and the abcb4 protein expression intensity was significantly decreased (P<0.05). Compared with mild ICP patients, the abcb4 mRNA level was significantly decreased in severe ICP patients, and the abcb4 protein expression intensity was significantly decreased (P<0.05). Pearson correlation analysis showed that abcb4 mRNA level and abcb4 protein expression intensity in placenta of ICP patients were negatively correlated with amniotic fluid contamination rate, Apgar score and incidence rates of premature delivery and neonatal asphyxia (P<0.05). Conclusion The expression level of abcb4 gene in placenta of ICP patients is closely related to the prognosis of perinatal infants. Especially the decrease of abcb4 gene expression level can increase the risk of amniotic fluid contamination, premature delivery and neonatal asphyxia.