妊娠期胆汁瘀积症患者脂质代谢及血液流变学变化  

The Changes of Lipid Metabolism and Hemorrheology in Intrahepatic Cholestasis During Pregnancy

作　　者：戴华康[1] 金杭美[1] 贺晶[1] 

机构地区：[1]浙江医科大学附属妇产科医院

出　　处：《中华妇产科杂志》1997年第12期728-731,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的：探讨妊娠期胆汁瘀积症（ＩＣＰ）患者血清甘胆酸（ＣＧ）水平升高对脂质代谢及血液流变学的影响。方法：对６８例孕妇用放射免疫法测定血ＣＧ，酶法测定血总胆固醇（ＣＨ）、甘油三酯（ＴＧ）、高密度脂蛋－胆固醇（ＨＤＬ－Ｃ）、低密度脂蛋白－胆固醇ＬＤＬ－Ｃ及ＬＤＬ－Ｃ／ＨＤＬ－Ｃ比值，并测定全血比粘度高切（ＨＳ）、低切（ＬＳ）、血浆比粘度（ＰＶ）和红细胞压积（ＨＣＴ）。以血ＣＧ≥６μｍｏｌ／Ｌ为标准组成ＩＣＰ组（３５例）；血ＣＧ＜６μｍｏｌ／Ｌ为正常妊娠组（３３例）。另选取３０例非妊娠妇女作血ＣＧ及血脂水平检查的对照组。结果：除ＩＣＰ组ＨＤＬ－Ｃ外，两组ＣＧ及血脂水平均明显高于对照组（Ｐ＜０．０２～０．００１），ＩＣＰ组ＬＤＬ－Ｃ及ＬＤＬ－Ｃ／ＨＤＬ－Ｃ比值，以及血液Ｌ５、ＰＶ和ＨＣＴ均明显高于正常妊娠组（Ｐ＜０．０２～０．００１）。结论：ＩＣＰ患者脂质代谢和血液流变学均有明显变化，随着妊娠终止及血ＣＧ浓度降低，ＩＣＰ患者脂质代谢的病理生理改变得以改善，说明该病的病理生理变化与血清ＣＧ浓度增高有关。Objective: To identify the influence of the increased level of serum cholyglycine (CG) on lipid metabolism and hemorrheology in patients with intrahepatic cholestasis during pregnancy (ICP). Methods: The concentrations of serum CG, total cholesterol (CH), triglycerides (TG), high density lipoproteincholesterol (HDLC), low density lipoproteincholesterol (LDLC), high shear and low shear of blood specific viscosity (HS and LS), plasma specific viscosity (PV) and hematocrit (HCT) were measured in 68 cases of primiparas with single pregnancy and 30 healthy nonpregnant women respectively. The group of ICP was composed of 35 cases with CG>6 μmol/L, the group of normal pregnancy, 33 cases with CG<6μmol/L. Results: The means of CG and the lipidic parameters in the two pregnant groups were significantly higher than those in the nonpregnancy group(P<0.02～0.001) except the means of HDLC between the groups of ICP and nonpregnancy. The levels of LDLC, LDLC/HDLC, LS, PV and HCT in the ICP were significantly higher than those in the normal pregnancy group (P<0.02～0.001). Conclusions: There are significant changes of lipid metabolism and hemorrheology in patients with ICP. However, these changes could be corrected after pregnancy termination, when the level of serum CG returned to normal. The results suggest that the pathophysiologic changes of ICP are associated with increased level of serum CG.

关 键 词：胆汁郁积 血液流变学 妊娠期 脂质代谢 

分 类 号：R714.255[医药卫生—妇产科学] R575.6[医药卫生—临床医学]