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目的探讨胆盐载体MRP1、MRP2在妊娠期肝内胆汁淤积症(ICP)胎盘的表达,分析胎盘胆盐载体与ICP发病的关系。方法收集8例正常早孕妇女绒毛组织、7例正常中孕妇女胎盘组织、20例正常晚孕妇女(对照组)胎盘组织,以及20例ICP患者胎盘组织,检测收集组织中胆盐载体MRP1和MRP2 mRNA的表达。结果ICP和正常妊娠各期胎盘组织中均有MRP2 mRNA的表达,而MRP1 mRNA在大部分标本上有表达;ICP组MRP1 mRNA和MRP2 mRNA表达量与对照组相比(99.94±73.17 vs 99.20±68.65;95.78±56.50 vs 142.20±91.27)差异无统计学意义(P>0.05);ICP组未用地塞米松治疗胎盘MRP2 mRNA表达量低于对照组(91.82±48.08 vs 142.20±91.27,P<0.05)。结论在未用地塞米松治疗的ICP患者胎盘组织中,MRP2 mRNA的表达量降低,这可能是引起ICP患者胎盘胆汁酸转运障碍,从而引起胎儿体内胆汁淤积的机制之一。
Objective To investigate the expression of MRP1 and MRP2 in placenta of pregnant women with intrahepatic cholestasis of pregnancy (ICP) and to analyze the relationship between placental bile salt carrier and ICP. Methods Totally 8 cases of normal pregnant women with villi, 7 cases of normal pregnant women with placenta, 20 cases of normal pregnant women (control group) placenta tissue and 20 cases of ICP patients with placental tissue were collected to detect the bile salts MRP1 and MRP2 mRNA expression. Results MRP2 mRNA was expressed in both placenta of ICP and normal pregnancy, while MRP1 mRNA was expressed in most of the specimens. The expression of MRP1 mRNA and MRP2 mRNA in ICP group was significantly higher than that in control group (99.94 ± 73.17 vs 99.20 ± 68.65 ; 95.78 ± 56.50 vs 142.20 ± 91.27). There was no significant difference between the two groups (P> 0.05). The expression of MRP2 mRNA in the untreated group was lower than that in the control group (91.82 ± 48.08 vs 142.20 ± 91.27, P <0.05). Conclusion The decreased expression of MRP2 mRNA in the placenta of ICP patients without dexamethasone treatment may be one of the mechanisms that cause obstruction of bile acid transport in the placenta of ICP patients and cause cholestasis in the fetus.