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目的 探讨妊娠妇女血硒及胎盘硒水平与妊娠肝内胆汁淤积症 (ICP)患者胎盘组织形态学改变的关系。方法 采用催化极谱法及 5 ,5 ’ 二硫代双 (二硝基苯甲酸 )直接法 ,检测ICP患者 30例 (ICP组 )及正常妊娠妇女 30例 (对照组 )血硒和胎盘硒水平 ,以及全血谷胱甘肽过氧化物酶 (GSH Px)活性的变化 ;并对ICP患者及正常妊娠妇女各 10例胎盘组织进行病理学观察。结果 (1)ICP组血硒水平为 (0 .0 389± 0 .0 0 90 )mg/L ,胎盘硒水平为 (0 .3770± 0 .0 96 4)mg/Kg ,GSH Px活性为 (5 9.31±11.42 )活力单位 ;对照组血硒水平为 (0 .0 477± 0 .0 0 94)mg/L ,胎盘硒水平为 (0 .45 5 4± 0 .0 6 2 6 )mg/kg,GSH Px活性为 (6 8.48± 10 .47)活力单位 ;两组比较 ,差异均有极显著性 (P <0 .0 0 2 )。 (2 )血硒水平与GSH Px活性在ICP组 (r=0 .0 5 498)和对照组 (r=0 .0 6 2 34 )均呈正相关 (P <0 .0 0 1) ;ICP组血硒与胎盘硒水平呈正相关 (r=0 .6 473,P <0 .0 0 1) ,对照组血硒与胎盘硒水平无明显相关。 (3)ICP组胎盘组织病理观察可见绒毛水肿 ,纤维素坏死 ,合体细胞结节增多 ,血管合体膜增厚 ,绒毛间隙狭窄 ;对照组未见明显上述病理改变。结论 硒是GSH Px的活性成分 ,ICP患者胎盘硒水平降低 ,可导致胎盘GSH Px活性下?
Objective To investigate the relationship between placental selenium levels and placental selenium levels in pregnant women and placenta histological changes in patients with intrahepatic cholestasis of pregnancy (ICP). Methods Selenium and selenium levels in 30 ICP patients and 30 normal pregnant women (control group) were detected by catalytic polarography and direct 5, 5 ’dithiobis (dinitrobenzoate) , And glutathione peroxidase (GSH Px) activity. The pathological changes of placenta in 10 cases of ICP patients and normal pregnant women were also observed. Results The levels of selenium in ICP group were (0. 389 ± 0. 0 0 90) mg / L, the levels of selenium in the ICP group were (0.3770 ± 0. 0 96 4) mg / 5 9.31 ± 11.42). The selenium level in the control group was (0. 477 ± 0. 0 0 94) mg / L and the level of selenium in the control group was (0 .45 54 ± 0 .06 6) mg / kg, GSH Px activity was (6 8.48 ± 10 .47) units of activity. There was significant difference between the two groups (P <0.05). (2) There was a positive correlation between selenium level and GSH Px activity in ICP group (r = 0.05498) and control group (r = 0.60234) (P <0.01) Blood selenium and placental selenium levels were positively correlated (r = 0.6747, P <0.001), selenium levels in the control group and placental selenium levels were not significantly correlated. (3) Histopathological examination of placenta in ICP group showed villus edema, necrosis of cellulose, increased nodules of syncytial cells, thickened vascular conjunctivae and stenosis of villus. No obvious pathological changes were observed in the control group. Conclusion Selenium is the active component of GSH Px. Placenta selenium level is reduced in ICP patients and leads to placental GSH Px activity.