Abstract:

Abstract：Objective　To explore the expression of MDR3 in liver tissue and the relationship between human cytomegalovirus infection and biliary atresia. Methods　Clinical data of patients were collected，who were refferred to the First Affiliated Hospital of Guangxi Medical University for further investigations of CMV hepatitis and EHBA from Jan. 2000 to Oct. 2009. In the liver tissue samples from children with CMV hepatitis （n = 12） and EHBA（n = 20），and normal children （n = 10），MDR3 expression was examined immunohistochemically. The image analysis technology was used to quantitatively analyze the protein expression. Results　Immunohistochemically，strong canalicular staining for MDR3 was observed in the EHBA liver. Optical density value of MDR3 expression in CMV hepatitis liver，EHBA liver and normal control liver was 0.13±0.02，0.18±0.06 and 0.10±0.03，respectively. MDR3 expression levels in the EHBA were significantly higher than in the normal control liver and CMV hepatitis liver（P < 0.05）. Serum levels of γ-glutamyl transpeptidase were positively correlated with MDR3 levels（r = 0.438，P = 0.003）.Conclusion　MDR3 is associated with cholestasis. In EHBA，MDR3 expression levels are up-regulated，which may represent an adaptive response aimed at the enhanced phosphatidylcholine excretion，which normally protects the biliary epithelium from bile salt toxicity.

Key words: multidrug resistance protein 3, extrahepatic biliary atresia, cytomegalovirus, infant

摘要：

摘要：目的　研究肝外胆道闭锁及巨细胞病毒性肝炎患儿肝组织中的多药耐药蛋白3（MDR3）的表达，探讨MDR3与胆汁淤积的关系。方法　收集2000年1月至2009年10月广西医科大学第一附属医院儿童病例，分为肝外胆道闭锁（EHBA）组20例，CMV肝炎组12例，正常对照组10例，采用免疫组化法检测肝组织中MDR3的表达情况，通过图像分析技术进行定量分析。结果　MDR3在正常对照组、EHBA和CMV肝炎组患儿肝组织均有不同程度表达，以肝细胞膜表达最为明显，MDR3在肝组织的阳性表达随γ-GT的增高而增强，呈正相关（r = 0.438，P = 0.003），CMV肝炎组、EHBA组和正常对照组MDR3表达吸光度值分别为0.13±0.02、0.18±0.06和0.10±0.03，MDR3在EHBA肝组织中的表达强度明显高于CMV肝炎组和对照组（P < 0.05）。结论　MDR3蛋白水平与胆汁淤积程度密切相关，EHBA肝组织MDR3的上调可能为机体的适应性反应，以利于增强磷脂的转运，减轻对胆管上皮的损伤。

关键词: 多药耐药蛋白3, 肝外胆道闭锁, 巨细胞病毒, 婴儿