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目的研究肝外胆道闭锁及巨细胞病毒性肝炎患儿肝组织中的多药耐药蛋白3(MDR3)的表达,探讨MDR3与胆汁淤积的关系。方法收集2000年1月至2009年10月广西医科大学第一附属医院儿童病例,分为肝外胆道闭锁(EHBA)组20例,CMV肝炎组12例,正常对照组10例,采用免疫组化法检测肝组织中MDR3的表达情况,通过图像分析技术进行定量分析。结果 MDR3在正常对照组、EHBA和CMV肝炎组患儿肝组织均有不同程度表达,以肝细胞膜表达最为明显,MDR3在肝组织的阳性表达随γ-GT的增高而增强,呈正相关(r=0.438,P=0.003),CMV肝炎组、EHBA组和正常对照组MDR3表达吸光度值分别为0.13±0.02、0.18±0.06和0.10±0.03,MDR3在EHBA肝组织中的表达强度明显高于CMV肝炎组和对照组(P<0.05)。结论 MDR3蛋白水平与胆汁淤积程度密切相关,EHBA肝组织MDR3的上调可能为机体的适应性反应,以利于增强磷脂的转运,减轻对胆管上皮的损伤。
Objective To investigate the expression of multidrug resistance protein 3 (MDR3) in liver of children with extrahepatic biliary atresia and cytomegalovirus hepatitis and to explore the relationship between MDR3 and cholestasis. Methods Children from January 2000 to October 2009 in the First Affiliated Hospital of Guangxi Medical University were collected and divided into 20 cases of extrahepatic biliary atresia (EHBA) group, 12 cases of CMV hepatitis group and 10 cases of normal control group. Immunohistochemistry Method to detect the expression of MDR3 in liver tissue and quantitative analysis by image analysis technology. Results The expression of MDR3 in liver tissue of normal control group, EHBA and CMV hepatitis group was different, and the expression of MDR3 in liver membrane was most obvious. The positive expression of MDR3 in liver tissue was positively correlated with the increase of γ-GT (r = 0.438, P = 0.003). The expression of MDR3 in CMV hepatitis group, EHBA group and normal control group were 0.13 ± 0.02,0.18 ± 0.06 and 0.10 ± 0.03, respectively. The expression of MDR3 in EHBA liver tissue was significantly higher than that in CMV hepatitis group And control group (P <0.05). Conclusion The level of MDR3 protein is closely related to the degree of cholestasis. The up-regulation of MDR3 in EHBA liver tissue may be the adaptive response of the organism in order to enhance the transport of phospholipids and reduce the damage to the bile duct epithelium.