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目的探讨血管内皮生长因子(VEGF)在妊娠期肝内胆汁淤积症(ICP)中的表达及其意义。方法选取2010年8月至2012年7月在杭州市第一人民医院剖宫产分娩的单胎妊娠ICP患者48例为研究组(轻度34例、重度14例),选择性剖宫产正常单胎妊娠45例为对照组。采用酶联免疫吸附试验法(ELISA)测定两组外周血清及其新生儿脐血VEGF的水平。结果①研究组(轻度)外周血清VEGF水平为167.25±56.78ng/L,研究组(重度)外周血清VEGF水平为103.48±60.68ng/L;对照组外周血清VEGF水平为245.71±68.02ng/L。研究组(轻度和重度)外周血清中VEGF水平显著低于对照组,差异有显著统计学意义;而研究组(重度)VEGF水平显著低于研究组(轻度)患者,差异有显著统计学差异。②研究组(轻度)脐血VEGF水平为418.42±142.11ng/L,研究组(重度)脐血VEGF水平为375.35±127.42ng/L;对照组脐血VEGF水平为467.22±138.23ng/L。研究组(轻度)患者脐血VEGF与对照组相比较,两组无明显差异;而研究组(重度)脐血VEGF水平显著低于研究组(轻度),差异有显著统计学意义。结论 ICP患者VEGF减少,出现胎盘血管内皮细胞受损,血管通透性下降。VEGF的异常表达可能与ICP发病存在一定的相关性。
Objective To investigate the expression of vascular endothelial growth factor (VEGF) in intrahepatic cholestasis of pregnancy (ICP) and its significance. Methods Forty-eight singleton pregnancies with cesarean delivery in First People’s Hospital of Hangzhou from August 2010 to July 2012 were selected as study group (mild 34 cases, severe 14 cases), normal cesarean section 45 cases of singleton pregnancy as control group. Enzyme-linked immunosorbent assay (ELISA) was used to determine the level of VEGF in cord blood of two groups of peripheral blood serum and its newborn. Results ① The level of VEGF in peripheral blood was 167.25 ± 56.78ng / L in study group (mild), 103.48 ± 60.68ng / L in peripheral blood of study group (severe), and 245.71 ± 68.02ng / L . The level of VEGF in the study group (mild and severe) was significantly lower than that in the control group, the difference was statistically significant; while the study group (severe) VEGF level was significantly lower than the study group (mild), the difference was statistically significant difference. ② The VEGF level of cord blood in study group (mild) was 418.42 ± 142.11ng / L, the level of VEGF in study group (severe) was 375.35 ± 127.42ng / L; the level of VEGF in control group was 467.22 ± 138.23ng / L. There was no significant difference between the two groups in the VEGF level of umbilical cord blood of study group (mild) and control group, while VEGF level of umbilical cord blood of study group (severe) was significantly lower than that of study group (mild), the difference was statistically significant. Conclusion There is a decrease of VEGF in ICP patients, impaired placental vascular endothelial cells and decreased vascular permeability. Abnormal expression of VEGF may have some relevance with the pathogenesis of ICP.