本文選題：ICP　切入點(diǎn)：Smac　出處：《川北醫(yī)學(xué)院》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:觀察妊娠期肝內(nèi)膽汁淤積癥(Intrahepatic Cholestasis of Pregnancy,ICP)患者與正常孕婦胎盤組織中Smac、HSP70的表達(dá)差異,探討細(xì)胞線粒體氧化應(yīng)激在ICP發(fā)病機(jī)制中的作用及臨床意義,為進(jìn)一步研究ICP發(fā)病機(jī)制,尋找預(yù)測ICP病情、監(jiān)測胎兒宮內(nèi)情況、預(yù)測新生兒預(yù)后和尋找臨床終止妊娠的實(shí)驗(yàn)室指標(biāo)。方法:收集2013年10月—2015年10月在川北醫(yī)學(xué)院附屬醫(yī)院產(chǎn)科住院的ICP患者60例作為實(shí)驗(yàn)組(其中輕度組30例,重度組30例),選擇同期住院的無內(nèi)外科合并癥及妊娠相關(guān)性疾病的單胎妊娠孕婦30例,作為對照組;均在臨產(chǎn)前行剖宮產(chǎn)術(shù)終止妊娠,術(shù)中收集胎盤。對患者的一般資料、臨床相關(guān)指標(biāo)進(jìn)行對比分析;使用免疫組化(一步法)檢測胎盤組織中Smac、HSP70表達(dá)情況。結(jié)果:1、Smac在ICP組及對照組均有表達(dá),主要表達(dá)在胎盤滋養(yǎng)細(xì)胞胞漿,重度ICP組陽性率為100.00%,輕度ICP組陽性率為83.33%,對照組陽性率為70.00%,3組在陽性表達(dá)率上差異有統(tǒng)計學(xué)意義(x~2=10.320,P0.01);3組在表達(dá)強(qiáng)度上差異有統(tǒng)計學(xué)意義(x~2=34.441,P0.01);Smac在ICP組表達(dá)強(qiáng)度明顯高于對照組(x~2=78.750,P0.01);Smac在ICP重度組胎盤滋養(yǎng)細(xì)胞中表達(dá)強(qiáng)于輕度組,差異有統(tǒng)計學(xué)意義(x~2=11.978,P0.05)。2、HSP70在ICP組及對照組均有表達(dá),主要表達(dá)在胎盤滋養(yǎng)細(xì)胞胞漿及胞核,其中重度ICP組陽性率為93.33%,輕度ICP組陽性率為83.33%,對照組陽性率為66.67%,3組在陽性表達(dá)率上差異有統(tǒng)計學(xué)意義(x~2=7.107,P0.05);3組在表達(dá)強(qiáng)度上差異有統(tǒng)計學(xué)意義(x~2=32.827,P0.01);ICP組表達(dá)強(qiáng)度高于對照組(x~2=19.167,P0.01);HSP70在ICP重度組胎盤滋養(yǎng)細(xì)胞中的表達(dá)強(qiáng)度高于ICP輕度組(x~2=14.000,P0.05)。3、HSP70與Smac在ICP組患者胎盤組織中的表達(dá)呈正相關(guān)(r=0.968,P0.05)。4、ICP組平均孕周36.59+1.58周,對照組平均孕周39.02+1.66周,兩組孕周比較,差異有統(tǒng)計學(xué)意義(t=6.780,P0.01)。結(jié)論:1、Smac在ICP組及對照組胎盤組織中均有表達(dá),ICP組胎盤中表達(dá)明顯增強(qiáng),ICP重度組表達(dá)高于輕度組,提示Smac在ICP組的表達(dá)明顯增強(qiáng),且與疾病程度正相關(guān);2、HSP70在ICP組及對照組胎盤組織中均有表達(dá),ICP組HSP70表達(dá)強(qiáng)于對照組,且ICP重度組表達(dá)明顯高于輕度組,提示HSP70在ICP組表達(dá)且與病情呈正相關(guān);3、氧化應(yīng)激相關(guān)蛋白HSP70和Smac在ICP組患者胎盤組織滋養(yǎng)細(xì)胞中的表達(dá)呈正相關(guān),提示線粒體氧化應(yīng)激反應(yīng)可能在ICP發(fā)病機(jī)制中起著重要作用,二者極有可能共同參與了ICP的發(fā)生、發(fā)展。
[Abstract]:Objective: to investigate the expression of Smaca HSP70 in placental tissues of intrahepatic Cholestasis of pregnancy-induced cholestasis of pregnancy and normal pregnant women, and to explore the role of mitochondrial oxidative stress in the pathogenesis of ICP and its clinical significance in order to further study the pathogenesis of ICP. To find out how to predict the condition of ICP and monitor the fetal intrauterine condition. Methods: from October 2013 to October 2015, 60 ICP patients hospitalized in obstetrical department of affiliated Hospital of North Sichuan Medical College were collected as experimental group (30 cases in mild group). In the severe group, 30 pregnant women with single pregnancy without internal and surgical complications and pregnancy-related diseases were selected as the control group, all the patients were treated with cesarean section to terminate pregnancy, and placenta was collected during the operation, and the general data of the patients were collected. The expression of Smaca HSP70 in placenta tissue was detected by immunohistochemistry (one step method). Results the expression of Smac in ICP group and control group was detected, mainly in the cytoplasm of placenta trophoblast. The positive rate of severe ICP group was 100.000.The positive rate of mild ICP group was 83.33, and the positive rate of control group was 70.003.33.The positive rate of ICP group was significantly higher than that of ICP group. The expression of Smac in placental trophoblastic cells in the severe ICP group was higher than that in the mild group, and the expression of SMAC in the placental trophoblastic cells in the severe ICP group was higher than that in the mild group. The difference was statistically significant in the expression of HSP70 in ICP group and control group, mainly in the cytoplasm and nucleus of placental trophoblast. The positive rate of severe ICP group was 93.33, that of mild ICP group was 83.33, and the positive rate of control group was 66.67%. The expression of HSP70 in placental trophoblastic cells in severe ICP group was higher than that in mild ICP group (P 0.05N. 3HSP70). There was a positive correlation between HSP70 expression and Smac expression in placental tissue of ICP group. The average gestational week was 36.59 1.58 weeks in ICP group. The average gestational age in the control group was 39.02 1.66 weeks, and the difference between the two groups was statistically significant. Conclusion the expression of Smac in ICP group and control group is significantly increased. The expression of SMAC in severe ICP group is significantly higher than that in mild group. It was suggested that the expression of Smac in ICP group was higher than that in control group, and the expression of HSP70 was significantly higher in ICP group and control group than in control group, and the expression of HSP70 in severe ICP group was significantly higher than that in mild group. The results suggest that the expression of HSP70 in ICP group is positively correlated with the severity of ICP, and that the expression of oxidative stress-related protein HSP70 and Smac in placental trophoblast of ICP group is positively correlated, suggesting that mitochondrial oxidative stress may play an important role in the pathogenesis of ICP. Both are likely to participate in the occurrence and development of ICP.
【學(xué)位授予單位】：川北醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R714.255

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張國銳;王元星;;誘導(dǎo)熱休克蛋白70形成預(yù)處理對心肌保護(hù)的研究進(jìn)展[J];現(xiàn)代醫(yī)藥衛(wèi)生;2016年14期

2 張春梅;袁貞明;田秀成;鄭紅艷;張紅麗;;熱休克蛋白70、90與卵巢上皮癌發(fā)生發(fā)展的相關(guān)性[J];華南國防醫(yī)學(xué)雜志;2016年05期

3 周旭春;楊波;黃白麗;鄧桃枝;何周桃;韓向陽;藍(lán)程;;誘導(dǎo)熱休克蛋白70對感染后腸易激綜合征小鼠的影響[J];廣東醫(yī)學(xué);2016年08期

4 譚美英;張楊;;Smac和Livin在宮頸鱗狀細(xì)胞癌組織中的表達(dá)及意義[J];中外醫(yī)學(xué)研究;2016年09期

5 褚靜;王海霞;賈敏;;熱休克蛋白70在妊娠期高血壓疾病孕婦血清、臍血及胎盤組織中的表達(dá)及其意義[J];中國婦幼保健;2016年04期

6 林培紅;胡繼芬;;子癇前期患者胎盤組織中HSP70和NF-κB的表達(dá)及意義[J];中國醫(yī)藥導(dǎo)報;2016年02期

7 劉金濤;;血清總膽汁酸檢測在妊娠期肝內(nèi)膽汁淤積癥中的臨床應(yīng)用價值[J];檢驗(yàn)醫(yī)學(xué);2015年05期

8 申舒靜;;子癇前期患者胎盤組織及外周血中Smac、Survivin和PTEN的表達(dá)及其相關(guān)性[J];中國生育健康雜志;2015年03期

9 趙東菊;石太新;王艷蕊;肖愛菊;李培嶺;;兒童急性白血病促凋亡蛋白Smac、HtrA2表達(dá)的意義[J];中華實(shí)用兒科臨床雜志;2015年03期

10 朱曉萍;李群鋒;陸曉青;;肝細(xì)胞生長因子在妊娠期肝內(nèi)膽汁淤積癥胎盤組織中的表達(dá)及意義[J];醫(yī)學(xué)理論與實(shí)踐;2014年21期

相關(guān)碩士學(xué)位論文 前3條

1 鄧彩鳳;妊娠期肝內(nèi)膽汁淤積癥胎盤中Caspase3、HSP70的表達(dá)及其臨床意義的初步探討[D];川北醫(yī)學(xué)院;2016年

2 胡海軍;妊娠期肝內(nèi)膽汁淤積癥患者胎盤組織中HSP70、HIF-1α的表達(dá)及意義[D];川北醫(yī)學(xué)院;2015年

3 郭瑩;HSP70、P38MAPK、Caspase3與胎盤細(xì)胞凋亡在妊娠期高血壓疾病中的作用[D];鄭州大學(xué);2011年

，

本文編號：1604680