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目的探讨ICP胎盘中FXR、BSEP的表达,以及母、脐血清中CG(甘胆酸)水平的变化,进而从胎盘角度探讨ICP发病机制。方法以35例ICP患者为ICP组,对照组为40例正常妊娠者。测定两组母、脐血清CG水平、母血清肝功能指标、两组胎盘组织中FXR、BSEP的表达。结果 ICP组胎盘组织中FXR的表达与母血清、脐血清CG水平呈正相关性。BSEP的表达量与母血清、脐血清CG水平呈负相关性。结论 ICP组母、脐血清CG水平明显高于对照组。ICP时,患者胎盘上FXR表达虽明显增强,但BSEP的表达并未因此而上调,反而表达减低,引起胎盘排泌胎儿胆汁酸下降,胎儿体内胆汁酸瘀积,可能是ICP发病机制之一。
Objective To investigate the expression of FXR and BSEP in ICP placenta and the changes of CG (glycocholic acid) in maternal and umbilical serum, and to explore the pathogenesis of ICP from the perspective of placenta. Methods 35 cases of ICP patients for the ICP group, the control group of 40 cases of normal pregnancy. The level of CG of maternal and umbilical cord serum, the indexes of liver function of maternal serum and the expression of FXR and BSEP in the two groups of placenta were measured. Results The expression of FXR in the placenta of ICP group was positively correlated with CG level of maternal serum and umbilical serum. The expression level of BSEP was negatively correlated with CG level of maternal serum and umbilical serum. Conclusion The levels of CG in mother and umbilical serum in ICP group were significantly higher than those in control group. Although the expression of FXR in the placenta of ICP patients was significantly increased at ICP, the expression of BSEP was not increased, but the expression of BSEP was reduced. The decrease of fetal biliary acid secretion and the bile acid accumulation in the fetus may be one of the pathogenesis of ICP.