本文選題：妊娠期肝內(nèi)膽汁淤積癥 + CHOL�。� 參考：《中南大學(xué)》2014年碩士論文

【摘要】：目的： 研究ICP孕婦外周血和胎盤組織中PLTP表達(dá)水平及血脂的變化,探討PLTP、血脂的變化與ICP發(fā)病的關(guān)系。 方法： 選取ICP患者30例作為研究組(ICP組),其中輕度20例,重度10例,同期正常孕婦20例作為對照組(正常妊娠組)。利用酶循環(huán)法測定血清總膽汁酸水平,氧化酶法測定血清中總膽固醇和甘油三酯水平,均相酶法測定高密度脂蛋白和低密度脂蛋白水平,酶聯(lián)免疫吸附試驗(ELISA)檢測兩組孕婦血漿中PLTP的濃度,利用實時熒光定量(RT-PCR)檢測兩組孕婦胎盤組織中PLTP mRNA的相對表達(dá)量。比較兩組孕婦外周血和胎盤組織中PLTP的表達(dá)和血脂的水平及PLTP與血脂、膽汁酸代謝的關(guān)系。 結(jié)果： 1.ICP組TBA、CHOL、LDL、TG的濃度分別為(32.49±20.68)ummol/L、(4.67±1.88) mmol/L、(3.64±1.27) mmol/L、(2.68±0.89mmol/L),均高于正常妊娠組(3.68±2.21) ummol/L、(2.81±0.78) mmol/L、(2.40±0.60) mmol/L、(1.82±0.32) mmol/L,而HDL(1.24±0.33) mmol/L低于正常妊娠組(1.94±0.41) mmol/L,兩組間的差異具有統(tǒng)計學(xué)意義(P0.001)。重度組TBA、CHOL、LDL.TG的濃度分別為(52.31±13.06) ummol/L、(6.10±1.27) mmol/L、(4.45±1.05)mmol/L、(3.30±0.76)mmol/L,均高于輕度組(16.35±6.87)ummol/L.(3.15±1.02) mmol/、(2.71±0.90) mmol/L、(2.01±0.48) mmol/L,而HDL(1.16±0.30)mmol/L低于輕度組(1.31±0.32)mmol/L,均與ICP病情的嚴(yán)重程度有關(guān),兩組間的差異具有統(tǒng)計學(xué)意義(P0.001)。 2.ICP患者外周血漿PLTP的水平：ICP組外周血漿中PLTP的濃度(5.13±1.39) pg/ml明顯高于正常妊娠組(2.74±0.18) pg/ml,兩組間的差異有統(tǒng)計學(xué)意義(P0.001)。重度組(6.28±1.07) pg/ml高于輕度組(3.93±0.29) pg/ml,與ICP病情的嚴(yán)重程度有關(guān),兩組間的差異具有統(tǒng)計學(xué)意義(P0.001)。 3.ICP患者胎盤組織PLTP mRNA的表達(dá)：ICP組胎盤中PLTP的相對表達(dá)量(15.13±3.39)明顯高于正常妊娠組(2.89±1.05),差異有統(tǒng)計學(xué)意義(P0.001)。重度組(16.32±4.15)明顯高于輕度組(7.47±2.50),與ICP病情的嚴(yán)重程度有關(guān),兩組間的差異具有統(tǒng)計學(xué)意義(P0.001)。 4.ICP組總膽固醇、低密度脂蛋白、甘油三酯與膽汁酸水平呈正相關(guān)(r=0.860, P0.01; r=0.724, P0.01; r=0.782, P0.01),高密度脂蛋白與總膽汁酸水平呈負(fù)相關(guān)(r=-0.615,P0.01)。 5.ICP組胎盤組織中PLTP mRNA的表達(dá)水平與外周血漿PLTP水平呈正相關(guān),r=0.897, P0.01。ICP組血漿PLTP水平與膽汁酸、總膽固醇、低密度脂蛋白、甘油三酯水平呈正相關(guān)(r=0.959, P0.01; r=0.815, P0.01; r=0.692, P0.01; r=0.758, P0.01),與高密度脂蛋白呈負(fù)相關(guān)(r=-0.598,P0.01)。 6.ICP組總膽固醇、高密度脂蛋白及血漿中PLTP與血清總膽汁酸水平呈直線回歸關(guān)系,多元線性回歸方程為Y=-33.7+2.329XcHoL-1.876XHDL+10.895XpLTP,R2=0.961,(P0.01). 結(jié)論： 1.ICP患者體內(nèi)總膽固醇、低密度脂蛋白、甘油三酯的水平明顯升高,而高密度脂蛋白的水平降低,且與ICP病情的嚴(yán)重程度有關(guān),提示ICP患者存在血脂代謝的紊亂。 2.PLTP在ICP孕婦胎盤及外周血中表達(dá)水平升高,并影響血脂及膽汁酸代謝過程,可能是導(dǎo)致ICP發(fā)生的原因之一。
[Abstract]:Purpose :

The changes of PLTP expression level and blood lipids in peripheral blood and placenta tissues of ICP pregnant women were studied , and the relationship between the changes of PLTP and blood lipid and the incidence of ICP were discussed .

Method :

Serum levels of serum total cholesterol and triglyceride were measured by enzyme - linked immunosorbent assay ( ELISA ) , and the relative expression of PLTP mRNA in placenta tissues of both groups was determined by enzyme - linked immunosorbent assay ( ELISA ) .

Results :

1 . The concentrations of TBA , CHOL , LDL and TG in ICP group were ( 32.49 鹵 20.68 ) ummol / L , ( 3.64 鹵 1.27 ) mmol / L , ( 3.64 鹵 1.27 ) mmol / L , ( 2.81 鹵 0.78 ) mmol / L , ( 4.45 鹵 1.05 ) mmol / L and ( 3.30 鹵 0.76 ) mmol / L , respectively .

2 . Plasma PLTP levels in peripheral blood plasma of ICP patients were significantly higher than those in the normal pregnancy group ( 2.74 鹵 0.18 ) pg / ml ( P < 0.001 ) . There was significant difference between the two groups ( 6.28 鹵 1.07 ) pg / ml , which was higher than that in the mild group ( 3.93 鹵 0.29 ) pg / ml .

3 . The expression of PLTP mRNA in the placenta of ICP patients was significantly higher than that in the normal pregnancy group ( 15.13 鹵 3.39 ) , which was significantly higher than that in the normal pregnancy group ( 2.89 鹵 1.05 ) . The severe group ( 16.32 鹵 4.15 ) was significantly higher than that in the mild group ( 7.47 鹵 2.50 ) , which was related to the severity of the ICP . The difference between the two groups was statistically significant ( P 0.001 ) .

4 . The levels of total cholesterol , low density lipoprotein , triglyceride and bile acid in ICP group were positively correlated ( r = 0.860 , P0.01 ; r = 0.724 , P0.01 ; r = 0.782 , P0.01 ) .

5 . The expression level of PLTP mRNA in ICP group was positively correlated with the level of PLTP in peripheral blood plasma ( r = 0.897 , P0.01 ) . Plasma PLTP levels in ICP group were positively correlated with bile acid , total cholesterol , low density lipoprotein , triglyceride level ( r = 0.959 , P0.01 ; r = 0.815 , P0.01 ; r = 0.692 , P0.01 ; r = 0.758 , P0.01 ) .

6 . The levels of total cholesterol , high density lipoprotein and serum total bile acid in ICP group were linear regression , and the multivariate linear regression equation was Y = - 33.7 + 2.329 XcHoL - 1.876XHDL + 10.895XpLTP , R2 = 0.961 , ( P0.01 ) .

Conclusion :

1 . The levels of total cholesterol , low density lipoprotein and triglyceride in ICP patients were significantly increased , while the level of high density lipoprotein decreased and correlated with the severity of ICP , suggesting that there was a disorder of lipid metabolism in ICP patients .

2 . The expression of PLTP in the placenta and peripheral blood of ICP pregnant women is increased , and the lipid and bile acid metabolism process may be one of the causes of ICP .
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R714.25

【參考文獻(xiàn)】

相關(guān)期刊論文 前9條

1 劉靜,蔣犁;妊娠期膽汁淤積癥對新生兒中樞神經(jīng)的影響[J];中國交通醫(yī)學(xué)雜志;2004年06期

2 秦樹存;葉平;;磷脂轉(zhuǎn)運蛋白的生物學(xué)特性及其與脂蛋白代謝相關(guān)疾病的關(guān)系[J];中華老年心腦血管病雜志;2008年08期

3 胡超峰;張素英;王海娜;蔣優(yōu)芬;艾文峰;;妊娠期肝內(nèi)膽汁淤積癥孕婦的血脂變化及其臨床意義[J];現(xiàn)代實用醫(yī)學(xué);2007年12期

4 秦樹存;于楊;;磷脂轉(zhuǎn)運蛋白與脂蛋白代謝和動脈粥樣硬化[J];中國動脈硬化雜志;2013年09期

5 王浩;于楊;秦樹存;;磷脂轉(zhuǎn)運蛋白對中樞神經(jīng)腦組織代謝的可能作用及其生物學(xué)意義[J];中華老年心腦血管病雜志;2014年03期

6 翟寧鳳;王繼文;;磷脂轉(zhuǎn)移蛋白的功能及其表達(dá)調(diào)節(jié)[J];生命的化學(xué);2007年02期

7 孫寶治;妊娠期高脂血癥的研究進(jìn)展[J];現(xiàn)代婦產(chǎn)科進(jìn)展;1996年03期

8 史佃云,陳華,周溶;妊娠期肝內(nèi)膽汁瘀積癥血脂改變及其臨床意義[J];中華圍產(chǎn)醫(yī)學(xué)雜志;2000年01期

9 祝娉婷;卜平;孫云;鄭新梅;;冠心病患者血清磷脂轉(zhuǎn)運蛋白及膽固醇脂轉(zhuǎn)運蛋白水平與中醫(yī)證型相關(guān)性研究[J];中國中西醫(yī)結(jié)合雜志;2011年06期

相關(guān)博士學(xué)位論文 前1條

1 張科;磷脂轉(zhuǎn)運蛋白對動脈粥樣硬化斑塊發(fā)展和穩(wěn)定性作用的實驗研究[D];山東大學(xué);2012年

，

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