[1]王 彤a,曾观银a,徐凤丹a,等.血清游离胆汁酸 CA,LCA及胎盘 HIF-1α表达水平与 ICP患者不良妊娠结局的相关性研究[J].现代检验医学杂志,2022,37(01):52-55.[doi:10.3969/j.issn.1671-7414.2022.01.011]
 WANG Tonga,ZENG Guan-yina,XU Feng-dana,et al.Correlation between Serum Free Bile Acid CA, LCA and Placental HIF-1α Expression Levels and Adverse PregnancyOutcomes in Patients with ICP[J].Journal of Modern Laboratory Medicine,2022,37(01):52-55.[doi:10.3969/j.issn.1671-7414.2022.01.011]
点击复制

血清游离胆汁酸 CA,LCA及胎盘 HIF-1α表达水平与 ICP患者不良妊娠结局的相关性研究()
分享到:

《现代检验医学杂志》[ISSN:/CN:]

卷:
第37卷
期数:
2022年01期
页码:
52-55
栏目:
论 著
出版日期:
2022-01-15

文章信息/Info

Title:
Correlation between Serum Free Bile Acid CA, LCA and Placental HIF-1α Expression Levels and Adverse PregnancyOutcomes in Patients with ICP
文章编号:
1671-7414(2022)01-052-05
作者:
王 彤a曾观银a徐凤丹a罗 虹a高博翰a谢树锋b程楚云a
(广东省东莞市第八人民医院/ 东莞市儿童医院a. 产科;b. ICU, 广东东莞 523325)
Author(s):
WANG Tonga ZENG Guan-yina XU Feng-dana LUO Honga GAO Bo-hana XIE Shu-fengb CHENG Chu-yuna
(a.Department of Obstetric;b.Department of ICU,the Eighth People’s Hospital of Dongguan City / DongguanChildren’s Hospital,Guangdong Dongguan 523325,China)
关键词:
关键词 :妊娠期肝内胆汁淤积症妊娠期无症状高胆汁酸血症胆汁酸缺氧诱导因子 -1α
分类号:
R714.2;R446.11
DOI:
10.3969/j.issn.1671-7414.2022.01.011
文献标志码:
A
摘要:
目的 探究血清游离胆汁酸胆酸(cholic acid, CA)、石胆酸 (litho cholic acid, LCA)以及胎盘组织缺氧诱导因子 -1α(hypoxia-inducible factor-1α, HIF-1α)表达水平与妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy, ICP)患者不良妊娠结局间的关系。方法 选择 2020年 3月 ~2021年 4月于广东省东莞市第八人民医院就诊的妊娠期肝内胆汁淤积症患者 48例和无症状高胆汁酸血症( asymptomatic hypercholanemia of pregnancy, AHP)70例作为研究对象,分别记为 ICP组和 AHP组。所有孕妇分娩前抽取静脉血用于检测肝功能指标 [总胆汁酸( TBA)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶( AST)]以及胆汁酸亚型 [(胆酸 (CA)、脱氧胆酸 (DCA)、鹅脱氧胆酸 (CDCA)、熊脱氧胆酸 UDCA)、石胆酸 (LCA))]水平。产妇分娩后,记录两组产妇的妊娠结局,留取胎盘组织检测 HIF-1α的阳性表达率。比较 ICP产妇和 AHP产妇一般临床指标间的差异并探究影响产妇不良妊娠结局的独立相关因素。结果 ICP组和 AHP组产妇 TBA(46.54±6.58 μmol/L vs 47.21±6.38 μmol/L),ALT(38.26±5.37 U/L vs 36.58±5.72 U/L), AST(28.48±3.54 U/L vs 28.92±3.85 U/L)组间差异无统计学意义(t=0.639~1.889, 均 P>0.05);ICP组和 AHP组产妇 CA(3.78±0.63 μmol/L vs 1.24±0.56 μmol/L),LCA(7.86±0.54 μmol/L vs 1.13±0.17 μmol/L)组间差异有统计学意义( t=26.100~113.936, P<0.001)。ICP组产妇 HIF-1α阳性表达率( 68.75%)显著高于 AHP组(41.43%),差异有统计学意义( χ2=12.359, P<0.05)。ICP组不良妊娠结局的发生率显著高于 AHP组(50.00% vs 28.57%),差异有统计学意义( χ2=5.591, P=0.018)。TBA,CA,LCA以及 HIF-1α均是影响不良妊娠结局的独立相关因素( Waldχ2=6.516,
Abstract:
Objective To explore serum free bile acid (CA), lithocholic acid (LCA) and hypoxia inducible factor-1 (HIF-1) inplacenta α( HIF-1 α)and investigate the relationship between the expression level and adverse pregnancy outcomes inpatients with intrahepatic cholestasis of pregnancy (ICP). Methods 48 patients with intrahepatic cholestasis of pregnancy (ICP)and 70 patients with asymptomatic hypercholanemia of pregnancy (AHP) from March 2020 to April 2021 were selected asobjects. Venous blood before delivery were collected to detect liver function [total bile acid (TBA), alanine aminotransferase(ALT), aspartate aminotransferase (AST)] and the levels of bile acid subtypes [cholic acid (CA), deoxycholic acid (DCA),chenodeoxycholic acid (CDCA), ursodeoxycholic acid (UDCA), lithocholic acid (LCA)]. After the parturients gave birth, thepregnancy outcomes of the two groups were recorded, and the placental tissues were collected to detect the rate of positiveexpression of hypoxia inducible factor-1α. The differences of general clinical indicators between two groups were conpared, andthe independent related factors that affect the adverse pregnancy outcomes of women were analysed. Results There was asignificant difference between the two group(t=0.639~1.889, all P>0.05) of TBA (46.54±6.58 μmol/L vs 47.21±6.38 μmol/L),ALT (38.26±5.37 U/L vs 36.58±5.72 U/L) and AST (28.48±3.54 U/L vs 28.92±3.85 U/L) in the ICP group and AHP group ofmaternal. There was a significant difference between the two groups (t=26.100~113.936, all P<0.05) of CA (3.78±0.63 μmol/Lvs 1.24±0.56 μmol/L ), LCA (7.86±0.54 μmol/L vs 1.13±0.17 μmol/L) in ICP group and AHP group of maternal. Thepositive expression rate of HIF-1α in the ICP group (68.75%) was significantly higher than that of the AHP group(41.43%), thedifference was statistically significant(χ2=12.359,P<0.05). The incidence of adverse pregnancy outcomes in the ICP groupwas significantly higher than that in the AHP group (50.00% vs 28.57%), the difference was statistically significant(χ2=5.591,P=0.018). CA,LCA and HIF-1α were independent factors that affect adverse pregnancy outcomes(Waldχ2=6.516, 7.215, 8.446,8.516, P=0.008, 0.038, 0.042, 0.016). Conclusion Serum CA and LCA in ICP patients were significantly higher than those ofthe AHP. The high expression of HIF-1α was associated with the adverse pregnancy outcome of ICP.

参考文献/References:

[1] OH C C, OON H. Intrahepatic cholestasis ofpregnancy[J]. Cutis, 2018, 102(3): E26-E27.
[2] BICOCCA M J, SPERLING J D, CHAUHAN S P.Intrahepatic cholestasis of pregnancy: Review of sixNational and regional guidelines[J]. European Journalof Obstetrics & Gynecology and Reproductive Biology,2018, 231: 180-187.
[3] CHEN Rong, DENG Mei, RAUF Y M, et al.Intrahepatic cholestasis of pregnancy as a clinicalmanifestation of Sodium-Taurocholate cotransportingpolypeptide deficiency[J]. The Tohoku Journal ofExperimental Medicine, 2019, 248(1): 57-61.
[4] CHEN Xiao, ZHANG Xiaoqing, XU Biao, et al. Theurinary bile acid profiling analysis of asymptomatichypercholanemia of pregnancy: A pseudo-targetedmetabolomics study[J]. Clinica Chimica Acta, 2019,497 : 67-75.
[5] 杨琳, 李慧敏, 朱艳. 妊娠期肝内胆汁淤积症患者肝功能、胎盘组织中HSP70,HIF-1α 的表达变化及其意义[J]. 中国生育健康杂志, 2019, 30(4):367-370.YANG Lin, LI Huimin, ZHU Yan. Changes in theexpression of HSP70 and HIF-1α in liver function andplacenta tissue in patients with intrahepatic cholestasisof pregnancy and their significance[J]. Chinese Journalof Reproductive Health, 2019, 30(4):367 -370.
[6] 中华医学会妇产科学分会产科学组. 妊娠期肝内胆汁淤积症诊疗指南(2015)[J]. 中华妇产科杂志,2015, 50(7):481-485.Obstetrics Subgroup,Chinese Society of Obstetrics,Chinese Medical Association. Guidelines for themanagement of intrahepatic cholestasis of pregnancy(2015)[J].Chinese Journal of Obstetrics andGynecology, 2015, 50(7):481-485.
[7] SMITH D D, ROOD K M. Intrahepatic cholestasisof pregnancy[J]. Clinical Obstetrics and Gynecology,2020, 63(1): 134-151.
[8] BEUERS U, DE VRIES E. Reply to: “UDCA therapyin intrahepatic cholestasis of pregnancy?”[J]. Journalof Hepatology, 2020, 72(3): 587-588.
[9] KUMAR P, KULKARNI A.UDCA therapy inintrahepatic cholestasis of pregnancy?[J]. Journal ofHepatology, 2020, 72(3): 586-587.
[10] MEI Youwen, LIN Yonghong, LUO Dan, et al. Perinataloutcomes in intrahepatic cholestasis of pregnancy withmonochorionic diamniotic twin pregnancy[J]. BMCPregnancy and Childbirth, 2018, 18(1): 321-323.
[11] PALMER K R, XIAOHUA L, MOL B W. Managementof intrahepatic cholestasis in pregnancy[J]. Lancet,2019, 393(1174): 853-854.
[12] WHITTINGTON J R, ALLEN L R, ENNEN C S, et al.Relationship between maternal serum bile acid levelsand fetal cardiac Troponin-I levels in asymptomaticpregnant patients at term:a cross-sectional observationalstudy[J]. Cureus, 2019, 11(8): e5508.
[13] 俞黎铭, 施新颜, 陈益明, 等. 高效液相色谱串联质谱法检测妊娠期肝内胆汁淤积症7 种胆汁酸及其临床意义[J]. 中华全科医学,2020,18(7):1153-1156,1199.YU Liming, SHI Xinyan, CHEN Yiming, et al.Comparison of seven bile acids in intrahepaticcholestasis by HPLC-MS/MS at different gestationalstages and the clinical significance [J]. Chinese Journalof General Practice, 2020, 18(7):1153-1156,1199.
[14] HU Yiping, ZHANG Tiantian, CHEN Jingqin, etal. Downregulation of hypoxia-inducible factor-1αby RNA interference alleviates the development ofcollagen-induced arthritis in rats[J]. Molecular Therapy- Nucleic Acids, 2020, 19 : 1330-1342.
[15] DU Xiangnan, YANG Jian, LIU Cuiying, et al. Hypoxia-Inducible factor 1α and 2α have beneficial effectsin remote ischemic preconditioning against stroke bymodulating inflammatory responses in aged rats[J].Frontiers in Aging Neuroscience, 2020, 12:000 54.
[16] 陈兰羽, 马继征, 刘咏梅, 等. 基于HIF-1α 介导的VEGF mRNA 表达探讨膈下逐瘀汤抗肝纤维化血管新生的机制[J]. 中草药,2019,50(2):449-456.CHEN Lanyu, MA Jizheng, LIU Yongmei, et al.Mechanisms of Gexia Zhuyu Decoction on antiangiogenesisof hepatic fibrosis based on regulationof VEGF mRNA expression mediated by HIF-1α[J].Chinese Traditional and Herbal Drugs, 2019, 50(2):449-456.
[17] 宋熲. 西宁地区妊娠期肝内胆汁淤积症胎盘组织缺氧诱导因子HIF-1α 表达及其意义[J]. 饮食保健,2018, 5(28):286-287.SONG Jiong. Expression and significance of hypoxiainduciblefactor HIF-1α in placenta tissue ofintrahepatic cholestasis of pregnancy in Xining area[J].Diet & Health Care, 2018, 5(28):286-287.
[18] 赵雪晴, 陈辰, 陈亚军. 测定15 种胆汁酸亚型在妊娠期胆汁淤积症与高胆汁酸血症的鉴别诊断[J]. 现代妇产科进展, 2019, 28(12):917-919.ZHAO Xueqing, CHEN Chen, CHEN Yajun. Differentialdiagnosis of 15 subtypes of bile acid in pregnancycholestasis and hyperbiliru-binemia [J]. Progress in Obstetricsand Gynecology, 2019, 28(12):917-919 .
[19] CELIK S, CALISKAN C S, CELIK H, et al. Predictorsof adverse perinatal outcomes in intrahepatic cholestasisof pregnancy[J]. Ginekologia Polska, 2019, 90(4): 217-222.
[20] MAISKAR V, SURVE S. Early onset intrahepaticcholestasis of pregnancy: is progesterone supplementationto be blamed for?[J]. Journal of Obstetrics andGynaecology of India, 2019, 69(2): 192-193.
[21] 陈霄, 邵勇, 胥飚, 等. 妊娠期无症状高胆汁酸血症的临床特点分析[J]. 重庆医科大学学报, 2019,44(8):1059-1063.CHEN Xiao, SHAO Yong, XU Biao, et al. Aclinical analysis of asymptomatic hypercholanaemiaof pregnancy[J]. Journal of Chongqing MedicalUniversity, 2019, 44(8):1059-1063.

备注/Memo

备注/Memo:
基金项目:2019 年东莞市社会科技发展(重点)项目(201950715028173)。
作者简介:王彤(1982-),女,临床医学本科,主治医生,主研方向:产科。
通讯作者:程楚云,E-mail:yhnuj170@163.com。
更新日期/Last Update: 1900-01-01