妊娠母羊胆酸灌注对胎儿和新生儿的影响

Effects of intravenous infusion of sodium cholate in pregnant ewes on fetus and Neonates

妊娠期肝内胆汁淤积症(Intrahepatic cholestasis of pregnancy,ICP)是孕妇在妊娠晚期出现的以瘙痒和黄疸为特征的肝病,是一种高危产科疾病,严重影响胎儿的健康。为了更好地研究ICP的发病机制,本试验以妊娠母羊为动物模型,分别通过大剂量(2 mg/kg)和小剂量(1.1 mg/kg)的胆酸盐静脉灌注怀孕后期的母羊,同时进行胎儿血管造瘘手术,目的是研究ICP的发病模型和胆酸对胎儿和新生儿的影响机制。结果显示,给妊娠母羊大剂量多次静脉灌注胆酸盐,引起母体难产,导致胎儿宫内窘迫和死亡;小剂量灌注,导致胎儿的低出生重,但胎儿在出生后15 d时,羔羊的体质量与正常的羔羊没有差异,体现了追赶生长的特性。结果表明以妊娠母羊为动物模型,通过静脉灌注胆酸盐可以作为研究妊娠期肝内胆汁淤积症的疾病模型,为进一步探索ICP发病时胆酸对胎儿的影响机制提供实验依据。

Intrahepatic cholestasis of pregnancy（ICP） is a specific liver disease,characterized by generalized pruritus and mild jaundice,which occurs predominantly during the late period of pregnancy women.ICP is considered as a high-risk obstetric disease and accounts for a diminished fetal well-being.To study the mechanisms of bile acid effects on fetus and neonates during ICP,pregnant ewes were infused with sodium cholate（2 mg/kg body weight and 1.1 mg/ kg body weight） through jugular vein in late gestation,and fetal vascular fistula operations were performed so as to collect fetal blood samples for the analysis of bile acid and hormone levels.The results showed that high-dosed infusion of sodium cholate led to dystocia of pregnant ewes,fetal stress and intrauterine death,while low-dosed infusion resulted in a low birth weight compared with normal lambs,but after birth,the lambs caught up growth quickly and reached the normal lamb values in 15th days.Consequently,intravenous infusion of sodium cholate in pregnant ewes could be served as a model to study ICP,and this model provides experimental basis to study the mechanisms of bile acid influence on the fetus during ICP.