妊娠期肝内胆汁郁积症患者胎盘细胞凋亡及调控基因的研究

Relationship between Apoptosis and It's Control Gene in Intrahepatic Cholestasis of Pregnancy

通过观察妊娠期肝内胆汁郁积症(ICP)患者胎盘细胞凋亡及其调控基因P53、bcl-2、bax在胎盘中的表达,探讨细胞凋亡基因在胎盘凋亡中的作用。方法采用光镜检查、原位末端标记法(TUNEL)和免疫组化法对32例ICP患者的胎盘组织中的P53、bcl-2、bax及凋亡指数进行检测,并以18例正常妊娠妇女的胎盘组织作为对照。结果①ICP患者胎盘发生梗死率明显高于正常妊娠组;②ICP患者胎盘细胞中细胞滋养层细胞、合体滋养层细胞、蜕膜细胞及绒毛间质细胞的凋亡指数分别为:42.72±23.73;45.34±21.97;23.03±27.10;34.13±22.49,明显高于正常妊娠组的9.80±9.06;11.20±8.39;4.33±7.69;5.53±7.65,P<0.01。③调控基因P53、bcl-2、bax的表达在两组中无显著性差异。结论①ICP患者胎盘组织中梗死及细胞凋亡明显增加,提示ICP患者围生儿不良结局可能与胎盘组织凋亡水平升高有关;②ICP患者胎盘组织的细胞凋亡是非P53依赖型,并与bcl-2、bax的表达无关。

Objective To investigate the changes of gene P53,bcl-2,bax expression and study the role on cell apoptosis in placenta with intrahepatlc cholestasis of pregnancy. Methods Light-microscope,TdT-mediated dUTP nick end labeling（TUNEL） and immuno-histochemistry methods were used for 32 placental samples with ICP and 18 normal placental samples to detect apoptosis and the expression of p53,bcl-2 and bax. Results ①There was significant more infarct in the placenta of ICP patients. ②Apoptosis index in placental cytotrophoblast, syncytitrophoblast, decldual cells and mediate cells in ICP group was corresponding as 42.72 ± 23.73 ; 45.34± 21.97 ; 23.03± 27.10 ; 34.13 ± 22. 49, which is significant higher than that in the control group 9.80 ± 9.06 ; 11.20 ± 8.39 ; 4.33 ± 7.69 ; 5.53 ± 7.65（P〈0.01）. There was no significant difference of p53/bcl-2 and bax gene express in ICP placenta. Conclusion The infarct and apoptosis of ICP is higher than the normal pregnancy placenta. There maybe a relationship between prenatal infants mortality of ICP and infarct and cell apoptosis in placenta. The placenta cell apoptosis is p53 independent and also there was no relationship with bc112, bax gene.