摘要
目的观察妊娠肝内胆汁淤积症（ICP）患者孕34~37周血浆尿皮素（UCN）水平及其胎盘受体促肾上腺皮质激素释放激素受体-2（CRHR-2）表达,探讨ICP患者血浆UCN水平下降的临床意义。方法纳入正常妊娠妇女及ICP患者各20例。通过酶联免疫法（ELISA）测定ICP组与正常对照组不同孕周（34、35、36、37周）血浆UCN水平,并采用免疫组织化学技术观察其胎盘组织UCN受体CRHR-2表达情况。结果正常妊娠组孕34周〔（79.47±11.35）pg/mL）〕、35周〔（83.00±12.67）pg/mL〕、36周〔（80.28±11.48）pg/mL〕、37周〔（84.24±13.62）pg/mL〕血浆UCN水平随孕周增加升高趋势不明显（F=0.67,P〉0.05）;与正常妊娠比较,ICP患者孕34周〔（68.53±16.95）pg/mL,t=2.40,P〉0.05〕、35周〔（64.19±22.50）pg/mL,t=3.26,P=0.05〕、36周〔（50.06±13.98）pg/mL,t=7.47,P=0.05〕、37周〔（47.91±15.65）pg/mL,t=7.83,P=0.05〕血浆UCN水平随孕周增加呈下降趋势（F=6.78,P=0.05）,尤其是35周后明显下降,且明显低于正常水平。胎盘组织绒毛合体滋养层细胞、绒毛血管内皮细胞胞浆内均有CRHR-2表达;ICP胎盘组织CRHR-2表达IOD值（111.83±35.02）与正常妊娠（101.09±27.21）无明显差异（t=0.29,P〉0.05）。结论 ICP胎盘-胎儿单位神经应激肽UCN表达下降可能与其不良妊娠结局相关。
Objective To measure the plasma level of urocortin and the placenta expression of its receptor corticotropin-releasing hormone receptor（CRHR）-2in the patients with intrahepatic cholestasis of pregnancy（ICP）.Methods This study enrolled 20 patients with ICP and 20 normal pregnant women（control group）.The plasma level of urocortin at different gestational age（34-37weeks）was measured by enzyme-linked immunosorbent assay（ELISA）,and the placenta expression of CRHR-2 was investigated by immunohistochemical technique.Results The plasma urocortin levels at different gestational age in normal pregnany were（79.47±11.35）pg/mL at34 weeks,（83.00±12.67）pg/mL at 35 weeks,（80.28±11.48）pg/mL at 36 weeks,and（84.24±13.62）pg/mL at 37 weeks,respectively.No upward tendency was observed along with the increase of gestational age（F=0.67,P〉0.05）.Compared with normal pregnany,ICP patients had novel down trend of the plasma urocortin levels（F=6.78,P〈0.05）,which were（68.53±16.95）pg/mL at 34 weeks,（64.19±22.50）pg/mL at 35 weeks,（50.06±13.98）pg/mL at 36 weeks,（47.91±15.65）pg/mL at 37 weeks,CRHR-2staining was found in syncytiotrophoblast and feto-placental vascular endothelium cells of placenta,and there was no statistical differences found for integral optical density value of CRHR-2staining between control（101.09±27.21）and ICP（111.83±35.02）groups（P〉0.05）.Conclusion The urocortin-mediated stress compensation insufficiency may be involved in the fetal outcomes in ICP.
出处
《四川大学学报（医学版）》
CAS
CSCD
北大核心
2015年第2期263-266,共4页
Journal of Sichuan University(Medical Sciences)
基金
四川省科技厅科技支撑计划项目(No.2009SZ0016)资助
