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目的 :探讨妊娠肝内胆汁淤积症 (ICP)患者血清中一氧化氮 (NO)、内皮素(ET)、游离雌三醇 (E3 )水平的变化和胎盘雌激素受体 (ER)表达强度在ICP病理生理改变中的作用。方法 :以ICP组 30例为研究组 ,手术前 30min取外周静脉血测定NO、ET及游离E3 的含量 ,以年龄相近同期手术的 30例正常孕妇作为对照组 ,产后从研究组和对照组中随机抽取 2 0例的胎盘中央组织块用免疫组化法检测ER的表达强度。结果 :ICP组的血清ET水平明显高于对照组 (P <0 .0 5 ) ,NO水平与对照组差异无显著性 (P >0 .0 5 )。ICP组血清游离E3 水平显著高于对照组 (P <0 .0 1) ,胎盘ER阳性表达百分比显著高于对照组 (P <0 .0 5 ) ,血清中E3 水平与胎盘组织中ER水平间呈正相关 (r′s=0 .5 98,P <0 .0 1)。结论 :雌激素水平升高及胎盘中ER表达增强和ET水平的升高可能与ICP的发生、发展有关。
Objective: To investigate the changes of serum levels of nitric oxide (NO), endothelin (ET), free estriol (E3) and the expression of placental estrogen receptor (ER) in patients with intrahepatic cholestasis of pregnancy Role of ICP in pathophysiological changes. Methods: 30 cases of ICP group were taken as study group. Peripheral venous blood was collected 30 min before operation to determine the contents of NO, ET and free E3. Thirty normal pregnant women with same age and similar operation were taken as control group. 20 cases of placental central plaque were randomly selected to detect the expression of ER by immunohistochemistry. Results: The level of serum ET in ICP group was significantly higher than that in control group (P <0.05). There was no significant difference between NO level and control group (P> 0.05). The level of serum free E3 in ICP group was significantly higher than that in control group (P <0.01), and the percentage of placental ER positive expression was significantly higher than that in control group (P <0.05). The level of E3 in serum and ER level in placenta Was positively correlated (r’s = 0.988, P <0.01). CONCLUSIONS: Elevated estrogen levels and enhanced expression of ER in the placenta and elevated ET levels may be related to the occurrence and development of ICP.