妊娠期肝内胆汁淤积症患者糖脂代谢特点及其围产结局的观察  

Study of characteristic of Glucolipid Metabolism in pregnent women with Intrahepatic Cholestasis and analysis of the relation of disease and pregnancy outcomes

作　　者：李嘉蔚[1] 牛建民[1] 周平[1] 洪小山[1] 郑瑛[1] 饶美兰[1] 

机构地区：[1]广东省妇幼保健院产科,广州510010

出　　处：《中国计划生育学杂志》2015年第12期815-818,821,共5页Chinese Journal of Family Planning

基　　金：广东省中医药局科研课题(项目编号:20132091)

摘　　要：目的:探讨妊娠期肝内胆汁淤积症(ICP)的糖脂代谢特点及其围产结局。方法:回顾性收集广东省妇幼保健院产检并分娩的ICP患者资料86例,根据ICP发病孕周不同,分为早发型组30例(发病孕周<28周),晚发型组56例(发病孕周≥28周),选择同期正常妊娠孕妇60例作为对照组。比较3组的糖脂代谢生化指标及围产结局。结果:ICP组孕妇血清空腹血糖(FPG)、空腹胰岛素(FINS)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、载脂蛋白B(ApoB)水平均明显高于对照组,而高密度脂蛋白(HDL-C)、载脂蛋白A(ApoA)和ApoA/ApoB均低于对照组,差异均有统计学意义(P<0.05)。ICP组剖宫产率、早产率、羊水污染发生率、产后出血量、新生儿窒息率等均高于对照组,分娩孕周及新生儿出生体重均低于对照组(P<0.05)。在ICP早发型组的FPG、FINS、TG、TC、LDL-C和ApoB水平均高于晚发型组(P<0.05),而HDL-C和ApoA/ApoB均低于晚发型组(P<0.05)。早发型组早产率、羊水污染率、新生儿窒息率明显高于晚发型组,新生儿出生体重则低于晚发型组,差异均有统计学意义(P<0.05)。结论:早发型ICP更易出现糖脂代谢异常及不良围产结局,需引起重视。Objective： To explore the characteristic of glucolipid metabolism and pregnancy outcome in women with intrahepatic cholestasis of pregnancy（ICP）. Methods： Total 86 women with ICP were recruited, who visited Guangdong Maternal and Child health Hospital for maternity and child care and delivery. The two observation groups included 30 women with early-onset ICP or 56 women with late-onset ICP, respectively. Another 60 normal pregnant women in the same period were in the control group. Pregnancy outcome and serum levels of glucose and lipid metabolism were compared among the three groups. Results： Levels of fasting blood-glucose（FPG）, fasting insulin（FINS）, triglyceride（TG）, total cholesterol（TC）, low density lipoprotein cholesterol（LDL-C） and apolipoprotein B（ApoB） of women in control groups were all higher than those of women in control group, but levels of the high density lipoprotein cholesterol（HDL-C）, apolipoprotein A（ApoA） and ApoA/ApoB were lower than those of women in control group, the differences were statistically significant（P 〈0.05）. Compared with normal pregnant women, the incidences of cesarean section, preterm birth, meconium-stained fluid, postpartum bleeding volume and asphyxia neonatorum were higher, but the gestational weeks when delivery and neonate birth weight were lower, the differences were statistically significant（P 〈0.05）. The levels of FPG, FINS, TG, TC, LDL-C and ApoB of women with the early-onset ICP were significantly higher than those of women with the late-onset ICP （P 〈0.05）.The incidences of preterm birth, meconium-stained fluid and asphyxia neonatorum of women with the early-onset ICP were significantly higher than those of women with the late-onset ICP （P 〈0.05）, but neonate birth weight was significantly lower （P 〈0.05）. Conclusion： The levels of glucose and lipid metabolism in pregnant women with ICP may reflect the gravity of disease. As these changes appear earlier in pregnant, adverse pregnancy outcom

关 键 词：妊娠期肝内胆汁淤积症 早发 糖脂代谢 妊娠结局 

分 类 号：R714.7[医药卫生—妇产科学]