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论文摘要

妊娠肝内胆汁淤积症患者血浆尿皮素水平下降的临床意义

Decreased Maternal Plasma Urocortin Level in Intrahepatic Cholestasis of Pregnancy

作者:张丽, 孙琴, 王晓东等

Author:ZHANG Li, SUN Qin, WANG Xiao-dong. et al

收稿日期:          年卷(期)页码:2015,46(2):263-266

期刊名称:四川大学学报(医学版)

Journal Name:JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCE EDITION)

关键字:胆汁淤积症,肝内胎儿缺氧尿皮素促肾上腺皮质激素释放激素受体

Key words:Cholestasis intrahepaticFetusAnoxiaUrocortinCorticotropin-releasing hormone receptor

基金项目:

中文摘要

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。

英文摘要

Objective To measure the plasma level of urocortin and the placenta expression of its receptor corticotropin-releasing hormone receptor (CRHR)-2 in 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 (34-37 weeks) 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 at 34 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\P>0.05). Conclusion The urocortin-mediated stress compensation insufficiency may be involved in the fetal outcomes in ICP.

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