瘦素与妊娠期肝内胆汁淤积症的相关性研究

The relationship between Leptin and Cholestasis of Pregnancy(ICP)

目的:观察瘦素(Leptin)在妊娠期肝内胆汁淤积症(ICP)患者血清及蜕膜组织中的表达,并探讨其与ICP的相关性。方法:将80例肝功能正常ICP患者、80例肝功异常ICP患者及100例正常妊娠妇女(对照组)作为研究对象,采用放射免疫法和Western blot法检测三组孕妇产前、产后、脐带血血清及蜕膜组织中Leptin的表达水平。结果:两组ICP患者产前血清Leptin表达水平明显高于产后(P<0.05);肝功异常组产前血清Leptin表达水平及蜕膜组织Leptin表达水平明显高于肝功正常组(P<0.05),两组分别高于对照组(P<0.05);而产后血清及脐带血Leptin表达水平三组间无明显差异(P>0.05)。肝功异常ICP组、肝功正常ICP组孕妇羊水粪染、胎儿窘迫、低体重儿发生率均较对照组高,差异有统计学意义(P<0.05),且两组间相比,差异也具有统计学意义(P<0.05);新生儿窒息、产后出血发生率肝功异常ICP组比对照组高,差异有统计学意义(P<0.05);但肝功异常ICP组与肝功正常ICP组、肝功正常ICP组与对照组相比,差异无明显统计学意义(P>0.05)。结论:Leptin可以作为评估1CP患者病情严重程度的实验室检测指标,也可以在临床上指导ICP的预防及治疗,从而改善ICP对孕妇及胎儿造成的严重影响,提高产科质量。

Objective： to explore the expression of leptin in the serum and decidual tissues in patients suffering ICP and the potential relationship between leptin and ICP.Methods： 80 ICP patients with normal hepatic function were from group1;and 80 ICP patients with abnormal hepatic function were listed in group 2;100 healthy pregnant women were enrolled as comparison group.With the help of ELISA and Western blot,the concentrations of Leptin in the serum from umbilical vessels of these 3 groups before and after delivery were detected.Moreover,the expression of Leptin in decidual tissues from these groups was also determined.Results： In both group 1 and group 2,significantly higher expression of Leptin in the serum （P〈0.05） before delivery was observed.There were significantly elevated expression of Leptin expression in the serum and decidual tissues in ICP patients with abnormal hepatic function （group 2） when compared with ICP patients with normal hepatic function （group 1）.Significantly difference were detected in the expression of Leptin in both group 1 and group 2 （P〈0.05） comparing with group 3,respectively.However,there were no significant differences in the expression of Leptin after delivery among these 3 groups （P〉0.05）.The occurrence of fetal distress,infant of low-birth weight were much higher in group 1 and group 2 （P〈0.05） comparing with group 3,also,there were significant difference （P〈0.05） between group 1 and group 2 in the occurrence rate of these complications.There were obviously higher occurrence rate of neonatal asphyxia and after-delivery bleeding in group 2 than group 3 （P〈0.05）,however,there were no significant difference in when comparing the occurrence rated of neonatal asphyxia and after-delivery bleeding between group 1 and group 2,as well as between group 1 and group 3 （P〉0.05）.Conclusion： Leptin can be an important parameter to evaluate the progression of ICP.Thus,it can be much useful in the prevention and therapeutic guidance of ICP.