胎盘ABCB4表达下调对胆汁酸排泌功能的负性调节作用及其对围生儿预后的影响

目的: 研究妊娠期肝内胆汁淤积症(ICP)患者胎盘ABCB4表达下调对胎儿胆汁酸排泌代谢的影响及其与胎儿围生期预后的关系。方法: 采用RT-PCR和免疫组化技术检测妊娠晚期ICP患者(30例,ICP组)和正常晚孕妇女(30例,对照组)胎盘组织中ABCB4 mRNA和蛋白的表达情况,采用化学氧化法和酶动力学法检测母血胆红素及转氨酶,采用放射免疫分析方法检测母血及脐血中的甘氨胆酸(GA)含量,并与胎儿围生期预后进行相关性分析。结果: 对照组胎儿围生期预后明显好于ICP组,其新生儿体重和Apgar评分均高于ICP组(P<0.01),而羊水粪染率低于ICP组(P<0.01)。两组胎盘组织中均检测到ABCB4 mRNA和蛋白的表达,但与对照组相比,ICP组胎盘组织ABCB4 mRNA和蛋白均明显降低(P<0.01)。ICP组母血中丙氨酸转氨酶、总胆红素以及母血、脐血中GA水平均高于对照组(P<0.01),而且,脐血GA、母血GA水平与ABCB4 mRNA呈明显负相关(r=-0.627;r=-0.795,均P<0.01)。结论: 胎盘ABCB4表达下调对胎盘胆汁酸的排泌功能有负性调节作用,这可能是引起ICP围生儿预后不良的重要机制之一。

Down-regulation of ABCB4 expression in placenta inhibits glycocholic acid evacuation in fetus and is related with poor prognosis

AIM: To investigate the relationship between ABCB4(ATP-binding cassette,sub-family B,member 4) expression in placenta and glycocholic acid(GA) evacuation in fetus for evaluating the prognosis of fetus from women with intrahepatic cholestasis of pregnancy(ICP).METHODS: Normal pregnant women(control group,n=30) and ICP women(ICP group,n=30) hospitalized in our department were selected.The expression of ABCB4 mRNA and protein in placenta was detected by RT-PCR and immunohistochemistry,respectively.The total bi...