肝内胆汁淤积症孕妇胎盘中胎儿窘迫与红细胞膜脂质过氧化及三磷酸腺苷酶的相关性

Correlation of lipid peroxidation and ATP enzyme on erythrocyte membrane with fetal distress in the uterus in patients with intrahepatic cholestasis of pregnancy.

机构信息

Department of Obstetrics, Jining No. 1 People's Hospital, Jining, P. R. China.

出版信息

Eur Rev Med Pharmacol Sci. 2019 Mar;23(6):2318-2324. doi: 10.26355/eurrev_201903_17371.

DOI:10.26355/eurrev_201903_17371

PMID:30964154

Abstract

OBJECTIVE

This paper aims to investigate the correlation of lipid peroxide in erythrocytes and ATP (Adenosine Triphosphate) enzyme activity of erythrocyte membrane with fetal distress in patients with intrahepatic cholestasis of pregnancy (ICP).

PATIENTS AND METHODS

Forty-three patients with ICP treated at Jining No. 1 People's Hospital were enrolled as a study group, and another forty healthy parturient women in the same period were enrolled as a control group, to extract their elbow venous blood and fetal umbilical cord blood. Thiobarbituric acid (TBA) was used to detect superoxide dismutase (SOD) activity of erythrocytes, malondialdehyde (MDA) activity in plasma, Na+-K+-ATP enzyme activity and Ca2+-Mg2+-ATP enzyme activity of erythrocytes, which were compared between the study and control groups. The correlation of MDA, Na+-K+-ATP enzyme and Ca2+-Mg2+-ATP enzyme activities with fetal distress in the study group was analyzed, and the correlation of MDA with Na+-K+-ATP enzyme activity was investigated.

RESULTS

SOD and MDA activities of erythrocytes in maternal blood of the study group were significantly higher than those in the control group (p<0.05, p<0.001, respectively), but MDA activity in umbilical cord blood of the study group was markedly higher than that in the control group (p<0.001). Na+-K+-ATP enzyme and Ca2+-Mg2+-ATP enzyme activities of maternal and fetal erythrocytes of the study group were remarkably lower than those of the control group (p<0.001). MDA in the fetal distress group was significantly higher than that in the no fetal distress group in the study group (p<0.001). Na+-K+-ATP enzyme activity was negatively correlated with MDA concentration in maternal and fetal erythrocytes of patients with ICP (both p<0.001).

CONCLUSIONS

Lipid peroxidation in patients with ICP will affect ATP enzyme activity of erythrocyte membrane, and the down-regulation of ATP enzyme activity in umbilical cord blood of patients with ICP may cause fetal distress in the uterus.

摘要

目的

探讨妊娠肝内胆汁淤积症（ICP）患者红细胞脂质过氧化物（LPO）与红细胞膜三磷酸腺苷（ATP）酶活性与胎儿窘迫的相关性。

方法

选取济宁市第一人民医院收治的 43 例 ICP 患者为观察组，同期选取 40 例健康产妇为对照组，采集其肘静脉血和胎儿脐静脉血，采用硫代巴比妥酸（TBA）法检测红细胞超氧化物歧化酶（SOD）活性、血浆丙二醛（MDA）含量、红细胞 Na+-K+-ATP 酶和 Ca2+-Mg2+-ATP 酶活性，比较两组上述指标。分析观察组中 MDA、Na+-K+-ATP 酶和 Ca2+-Mg2+-ATP 酶活性与胎儿窘迫的相关性，并探讨 MDA 与 Na+-K+-ATP 酶活性的相关性。

结果

观察组产妇血红细胞 SOD 及 MDA 活性明显高于对照组（p<0.05，p<0.001），但观察组脐带血 MDA 活性明显高于对照组（p<0.001）；观察组产妇及胎儿血红细胞 Na+-K+-ATP 酶和 Ca2+-Mg2+-ATP 酶活性明显低于对照组（p<0.001）。观察组中胎儿窘迫组 MDA 明显高于无胎儿窘迫组（p<0.001）。观察组 ICP 患者中，Na+-K+-ATP 酶活性与产妇及胎儿红细胞 MDA 浓度呈负相关（均 p<0.001）。