妊娠期肝内胆汁淤积症患者体内PLTP的表达及血脂变化

发布时间：2018-06-22 14:44

本文选题：妊娠期肝内胆汁淤积症 + CHOL　；参考：《中南大学》2014年硕士论文

【摘要】：目的：研究ICP孕妇外周血和胎盘组织中PLTP表达水平及血脂的变化,探讨PLTP、血脂的变化与ICP发病的关系。方法：选取ICP患者30例作为研究组(ICP组),其中轻度20例,重度10例,同期正常孕妇20例作为对照组(正常妊娠组)。利用酶循环法测定血清总胆汁酸水平,氧化酶法测定血清中总胆固醇和甘油三酯水平,均相酶法测定高密度脂蛋白和低密度脂蛋白水平,酶联免疫吸附试验(ELISA)检测两组孕妇血浆中PLTP的浓度,利用实时荧光定量(RT-PCR)检测两组孕妇胎盘组织中PLTP mRNA的相对表达量。比较两组孕妇外周血和胎盘组织中PLTP的表达和血脂的水平及PLTP与血脂、胆汁酸代谢的关系。结果： 1.ICP组TBA、CHOL、LDL、TG的浓度分别为(32.49±20.68)ummol/L、(4.67±1.88) mmol/L、(3.64±1.27) mmol/L、(2.68±0.89mmol/L),均高于正常妊娠组(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低于正常妊娠组(1.94±0.41) mmol/L,两组间的差异具有统计学意义(P0.001)。重度组TBA、CHOL、LDL.TG的浓度分别为(52.31±13.06) ummol/L、(6.10±1.27) mmol/L、(4.45±1.05)mmol/L、(3.30±0.76)mmol/L,均高于轻度组(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低于轻度组(1.31±0.32)mmol/L,均与ICP病情的严重程度有关,两组间的差异具有统计学意义(P0.001)。 2.ICP患者外周血浆PLTP的水平：ICP组外周血浆中PLTP的浓度(5.13±1.39) pg/ml明显高于正常妊娠组(2.74±0.18) pg/ml,两组间的差异有统计学意义(P0.001)。重度组(6.28±1.07) pg/ml高于轻度组(3.93±0.29) pg/ml,与ICP病情的严重程度有关,两组间的差异具有统计学意义(P0.001)。 3.ICP患者胎盘组织PLTP mRNA的表达：ICP组胎盘中PLTP的相对表达量(15.13±3.39)明显高于正常妊娠组(2.89±1.05),差异有统计学意义(P0.001)。重度组(16.32±4.15)明显高于轻度组(7.47±2.50),与ICP病情的严重程度有关,两组间的差异具有统计学意义(P0.001)。 4.ICP组总胆固醇、低密度脂蛋白、甘油三酯与胆汁酸水平呈正相关(r=0.860, P0.01; r=0.724, P0.01; r=0.782, P0.01),高密度脂蛋白与总胆汁酸水平呈负相关(r=-0.615,P0.01)。 5.ICP组胎盘组织中PLTP mRNA的表达水平与外周血浆PLTP水平呈正相关,r=0.897, P0.01。ICP组血浆PLTP水平与胆汁酸、总胆固醇、低密度脂蛋白、甘油三酯水平呈正相关(r=0.959, P0.01; r=0.815, P0.01; r=0.692, P0.01; r=0.758, P0.01),与高密度脂蛋白呈负相关(r=-0.598,P0.01)。 6.ICP组总胆固醇、高密度脂蛋白及血浆中PLTP与血清总胆汁酸水平呈直线回归关系,多元线性回归方程为Y=-33.7+2.329XcHoL-1.876XHDL+10.895XpLTP,R2=0.961,(P0.01). 结论： 1.ICP患者体内总胆固醇、低密度脂蛋白、甘油三酯的水平明显升高,而高密度脂蛋白的水平降低,且与ICP病情的严重程度有关,提示ICP患者存在血脂代谢的紊乱。 2.PLTP在ICP孕妇胎盘及外周血中表达水平升高,并影响血脂及胆汁酸代谢过程,可能是导致ICP发生的原因之一。
[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 卤 20.68 ) ummol / L , ( 3.64 卤 1.27 ) mmol / L , ( 3.64 卤 1.27 ) mmol / L , ( 2.81 卤 0.78 ) mmol / L , ( 4.45 卤 1.05 ) mmol / L and ( 3.30 卤 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 卤 0.18 ) pg / ml ( P < 0.001 ) . There was significant difference between the two groups ( 6.28 卤 1.07 ) pg / ml , which was higher than that in the mild group ( 3.93 卤 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 卤 3.39 ) , which was significantly higher than that in the normal pregnancy group ( 2.89 卤 1.05 ) . The severe group ( 16.32 卤 4.15 ) was significantly higher than that in the mild group ( 7.47 卤 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 .
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.25

【参考文献】