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目的探讨婴儿胆汁淤积性肝炎肝组织中多药耐药蛋白3(MDR3)和法尼醇受体(FXR)的表达及意义。方法 2000年1月-2009年10月就诊于广西医科大学第一附属医院儿科的婴儿胆汁淤积性肝炎患儿21例。男14例,女7例,男女比例2:1;年龄(2.96±1.19)个月。收集其临床资料,进行肝组织活检。正常对照组10例,为肝移植供体,肝功能和病理检查正常。采用免疫组织化学法检测婴儿胆汁淤积性肝炎患儿及正常肝组织中MDR3、FXR的表达,通过图像分析技术进行定量分析。分析MDR3蛋白水平与血清γ-谷氨酰转肽酶及FXR蛋白水平的关系。结果 MDR3在正常肝组织的表达位于肝细胞膜,胆汁淤积性肝炎肝组织MDR3表达增强。胆汁淤积性肝炎组和正常对照组MDR3表达吸光度(A)值分别为0.13±0.02和0.11±0.03,二组比较差异有统计学意义(t=-2.239,P<0.05)。MDR3表达水平与γ-谷氨酰转肽酶水平无相关性(r=0.869,P>0.05)。正常对照组肝组织FXR表达位于肝细胞核,正常对照组和胆汁淤积性肝炎组肝组织FXR表达A值分别为0.07±0.02和0.08±0.02,二组比较差异无统计学意义(t=-1.539,P>0.05)。MDR3表达与FXR水平无相关性(r=-2.680,P>0.05)。结论在婴儿胆汁淤积性肝炎中,肝组织MDR3表达增强可能是机体的适应反应,以利于增强磷脂的转运,MDR3的上调可能与FXR无关。
Objective To investigate the expression of multidrug resistance protein 3 (MDR3) and farnesol receptor (FXR) in infantile cholestatic hepatitis and its significance. Methods From January 2000 to October 2009, 21 infants with cholestatic hepatitis were admitted to the pediatric department of the First Affiliated Hospital of Guangxi Medical University. There were 14 males and 7 females, the ratio of male to female was 2: 1. The age was (2.96 ± 1.19) months. Collect their clinical data and perform liver biopsy. Normal control group of 10 cases, donor for liver transplantation, liver function and pathological examination were normal. Immunohistochemistry was used to detect the expression of MDR3 and FXR in infantile cholestatic hepatitis and normal liver tissues. Quantitative analysis was carried out by image analysis technique. The relationship between MDR3 protein level and serum γ-glutamyl transpeptidase and FXR protein levels was analyzed. Results The expression of MDR3 in normal liver tissue was located in the liver cell membrane, and the expression of MDR3 in cholestatic liver increased. The absorbance (A) values of MDR3 in cholestatic hepatitis group and normal control group were 0.13 ± 0.02 and 0.11 ± 0.03, respectively. The difference between the two groups was statistically significant (t = -2.239, P <0.05). There was no correlation between MDR3 expression and γ-glutamyl transpeptidase (r = 0.869, P> 0.05). The expression of FXR in liver tissue of normal control group was located in the nucleus of hepatic cells. The A value of FXR expression in the liver tissue of normal control group and cholestatic hepatitis group were 0.07 ± 0.02 and 0.08 ± 0.02, respectively, with no significant difference between the two groups (t = -1.539, P> 0.05). There was no correlation between MDR3 expression and FXR level (r = -2.680, P> 0.05). Conclusion In infants with cholestatic hepatitis, the enhancement of MDR3 expression in liver tissue may be the body’s adaptive response, in order to facilitate enhanced phospholipid transport, MDR3 may not be related to the up-regulation of FXR.