论文部分内容阅读
目的观察妊娠期肝内胆汁淤积症患者母儿红细胞中脂质过氧化水平及其对红细胞ATP酶的影响,探讨妊娠肝内胆汁淤积症胎儿窘迫发生的原因。方法 抽取32例ICP孕妇(ICP组)和30例健康产妇(对照组)空腹肘静脉血和脐血采用硫代巴比妥比色法测定血浆中丙二醛(MDA)水平,黄嘌呤氧化法测定红细胞超氧化物歧化酶(SOD)活性,无机磷测定法测定红细胞Na+-K+-ATP酶、Ca2+-Mg2+-ATP酶活性。结果两组母儿血SOD活性和MDA的比较,ICP组母血红细胞SOD活性和MDA均较对照组显著升高(P分别<0.05,<0.001),而脐血红细胞MDA显著高于对照组(P<0.001),脐血红细胞SOD活性亦高于对照组,但差异无统计学意义(P>0.05)。两组母儿红细胞Na+-K+-ATP酶、Ca2+-Mg2+-ATP酶活性比较,ICP组母儿红细胞Na+-K+-ATP酶活性均较对照组低(P<0.001)、母儿红细胞Ca2+-Mg2+-ATP酶活性也均较对照组低(P<0.01,P<0.001)。ICP组内围生儿有胎儿窘迫组MDA显著高于无胎儿窘迫组(P<0.05),红细胞Na+-K+-ATP酶、Ca2+-Mg2+-ATP酶活性均较无胎儿窘迫组低,差异有统计学意义(P<0.01,P<0.05或P<0.001)。ICP患者母儿红细胞Na+-K+-ATP酶活性与MDA浓度呈显著负相关关系(P均<0.01)。结论 ICP患者胎儿宫内窘迫的发生可能与红细胞ATP酶活性降低有关,红细胞ATP酶活性受脂质过氧化的影响,抗氧化剂的应用可能会减少ICP患者胎儿宫内窘迫的发生。
Objective To observe the level of lipid peroxidation in maternal erythrocytes and the effect on erythrocyte ATPase in patients with intrahepatic cholestasis of pregnancy and to investigate the causes of fetal distress in intrahepatic cholestasis of pregnancy. Methods Plasma levels of malondialdehyde (MDA) in 32 pregnant women with ICP (ICP group) and 30 healthy pregnant women (control group) were measured by thiobarbituric colorimetry. The levels of plasma xanthine oxidase The activities of superoxide dismutase (SOD) in erythrocytes were measured. The activities of Na + -K + -ATPase and Ca2 + -Mg2 + -ATPase in erythrocytes were determined by inorganic phosphorus assay. Results Compared with control group, SOD activity and MDA of maternal blood erythrocytes in ICP group were significantly increased (P <0.05, <0.001, respectively), and MDA in umbilical cord blood erythrocytes were significantly higher than those in control group P <0.001). The activity of SOD in umbilical cord blood erythrocytes was also higher than that in control group, but the difference was not statistically significant (P> 0.05). The activities of Na + -K + -ATPase and Ca2 + -Mg2 + -ATPase in the maternal erythrocytes in the two groups were lower than those in the control group (P <0.001). The levels of Ca2 + -Mg2 + -ATP enzyme activity were also lower than the control group (P <0.01, P <0.001). The ICP group had higher levels of MDA in the fetal distress group than in the fetal distress group (P <0.05). The activities of Na + -K + -ATPase and Ca2 + -Mg2 + -ATPase in erythrocytes were lower than those in the non-fetal distress group Significance (P <0.01, P <0.05 or P <0.001). There was a significant negative correlation between MDA level and Na + -K + -ATPase activity in maternal erythrocytes of ICP patients (all P <0.01). Conclusion The incidence of fetal distress in ICP patients may be related to the decrease of ATPase activity of erythrocytes. The ATPase activity of erythrocytes is affected by lipid peroxidation. The application of antioxidants may reduce the occurrence of fetal distress in ICP patients.