妊娠期肝内胆汁淤积症围生儿不良结局的预测  

Predictors of fetal complications in patients with intrahepatic cholestasis of pregnancy

作　　者：王雪燕[1] 冯丽娟[1] 刘菊莲[1] 雷丽[1] 

机构地区：[1]重庆市妇幼保健院,400013

出　　处：《重庆医学》2009年第24期3051-3052,3055,共3页Chongqing medicine

基　　金：重庆市卫生局医学科研基金资助项目(05-2-219)

摘　　要：目的评估影响妊娠期肝内胆汁淤积症(ICP)围生儿不良结局潜在风险因素。方法将本院住院分娩的478例ICP患者按围生儿结局分成两组,选择出现围生儿不良结局(早产、胎儿窘迫、胎死宫内)中至少一项为A组218例,B组为无上述不良结局270例。观察两组患者初次诊断为ICP时检测的血生化指标(TBA、CG、TB、ALT、AST)、瘙痒程度和持续时间。结果发现围生儿不良结局的ICP患者在初次诊断时检测的TBA值比结局良好者高,其差异有统计学意义(P<0.01),初诊时瘙痒症状持续时间两组相比差异有统计学意义(P<0.05);但年龄、瘙痒程度和其他生化指标相比差异无统计学意义(P>0.05)。为揭示影响围生儿结局潜在风险因素,对临床指标中有显著意义的两种因素:TBA和瘙痒持续时间进行分析,发现二者作为预测不良围生儿结局的潜在风险因素有显著意义。结论ICP患者初次诊断时检测血生化指标中TBA和瘙痒症状持续时间,预测不良围生儿结局有显著意义。Objective To evaluate the predictive value of clinical symptoms and biochemical parameters for fetal complications in intrahepatic cholestasis of pregnancy（ICP）. Methods 478 symptomatic patients with ICP were included in this analysis, Fetal complications were defined as preterm delivery（before 37 week gestation） or and fetal distress or/and intrauterine fetal death. Clinical characteristics at the time of first presentation of patients with ICP fetal complication（n= 218） or without fetal counplications （n= 270）. Results The factors found to be significant or those with a trend towards significanee：TBA（P〈0, 01） and times of pruritus （P〈0.05） were selected for this model. TBA （OR 1. 091,95%CI 1.011 1.155,P〈0. 05 ） and times of pruritus（OR 4. 882,95% CI 1. 693-14. 093,P〈C0.01） were the most important independent variables predicting fetal complications. Conclusion TBA and times of pruritus at the time of first presentation of patients with ICP were found to be predictive.

关 键 词：妊娠期肝内胆汁淤积症 围生儿 结局 预测 

分 类 号：R714.7[医药卫生—妇产科学]