【摘要】目的:探讨可溶性血管细胞粘附分子1(soluble vascular cell adhesion molecule-l, sVCAM-1)在妊娠肝内胆汁淤积症(Intrahepatic cholestasis of pregnancy, ICP)发病中的作用。方法： 酶联免疫吸附法(ELISA)测定49例孕妇血清中sVCAM-1水平。结果： 重型ICP组血清中sVCAM-1水平显著高于正常妊娠组(P<0.01)， ICP组随着病情的加重该指标升高，差异有统计学意义(P<0.01); 产后该项指标下降与正常妊娠组无显著性差异(P>0.05);sVCAM-1的升高与胆汁酸(TBA)、血清丙氨酸氨基转移酶(ALT)、血清天冬氨酸氨基转移酶(AST)呈正相关(P<0.01，P<0.05)。 结论：粘附分子的异常表达可能是ICP发病机制的一个重要环节。
【关键词】 妊娠肝内胆汁淤积症; 血管细胞粘附分子1
Expressina of Soluble Vascular Cell Adhesion Molecule-l in the Pathogenesis of Intrahepatic Cholestasis of Pregnancy
FANG Cai-yun, FANG Yan-mei, GUO Li-li
(Department of Gynaecology and Obstetrics, Taihe Hospital, Yunyang Medical College, Shiyan,Hubei 44200，China)
Abstract：Objective To investigate the role of serum soluble vascular cell adhesion molecule-l( sVCAM-1) in the pathogenesis of intrahepatic cholestasis of pregnancy(ICP). Methods The serum sVCAM-1 levels were determined in 49 by ELISA. Results The level of serum sVCAM-1 was significantly elevated in women with mild and severe ICP compared with control subjects(P<0.01), and it markedly decreased 5 days after delivery, with no significant difference compared with control subjects(P>0.05). The levels of sVCAM-1 from women with ICP had a significant positive correlation with total bile acid(TBA), alanine aminotransferase(ALT) and aspartate aminotransferase(AST)(P<0.01 and P<0.05,respectively). Conclusion The abnormal expression of adlesion molecule may play an important role in the pathogenesis of ICP.
Key words： Intrahepatic cholestasis of pregnancy(ICP); Soluble vascular cell adhesion molecule-l
妊娠肝内胆汁淤积症(Intrahepatic cholestasis of pregnancy,ICP)是发生于妊娠中晚期，以皮肤瘙痒、黄疸、胆汁酸(TBA)、血清丙氨酸氨基转移酶(ALT)、血清天冬氨酸氨基转移酶(AST)轻到中度升高，产后症状迅速消失为特征的妊娠期并发症，因易引起胎儿窘迫、早产、死胎、死产而被列为高危妊娠之一。其病因目前仍不明确。最近国内外大量研究表明，ICP的发生与免疫功能的改变有关[1]。可溶性血管细胞粘附分子1(soluble vascular cell adhesion molecule-l,sVCAM-1)的含量改变是抗免疫反应的结果。本研究通过测定ICP患者血清中可溶性血管细胞粘附分子-1水平
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