重症妊娠肝内胆汁淤积症临床危险因素的初步分析  

A preliminary analysis of clinical risk factors for severe intrahepatic cholestasis of pregnancy

作　　者：沈建芳 祝亚平[2] 谷雷雷[3] 张欣欣[3] 孔晓飞 SHEN Jian-fang;ZHU Ya-ping;GU Lei-lei;ZHANG Xin-xin;KONG Xiao-fei(The First People^s Hospital of Kunshan,Jiangsu 215300,China)

机构地区：[1]昆山市第一人民医院妇产科,江苏215300 [2]上海交通大学附属第一人民医院妇产科 [3]上海交通大学医学院附属瑞金医院感染科 [4]Division of Digestive and Liver Diseases,Department of Medicine,New York-Presbyterian Hospital/Columbia University Medical Center

出　　处：《肝脏》2018年第10期870-872,共3页Chinese Hepatology

摘　　要：目的研究影响妊娠肝内胆汁淤积症(ICP)严重程度的相关危险因素。方法采用单中心回顾性研究,收集79例ICP患者的临床信息,包括基本情况,肝脏损伤,对分娩和胎儿预后的影响。根据胆汁酸水平,将79例患者分为重症与轻症两组,进行临床数据比较。结果 ICP重症患者的怀孕年龄偏高,重症组平均年龄为(31.0±3.6)岁,轻症组平均年龄为(28.9±4.1)岁,(P=0.034)。妊娠周期中起病时间较早,分别为(250.2±26.57)d vs(258.2±13.27)d,(P=0.079)。HBV感染在重症患者中常见(33.33%vs 14.55%,P=0.056),后两个变量在两组之间差异有边缘性统计学意义(0.05<P<0.10)。绝大部分重症患者(92%)采用剖腹产进行分娩,明显高于轻症组患者(58%),(P=0.006),而新生儿的存活率在轻重症患者之间差异无统计学意义。结论年龄是与ICP严重程度相关的危险因素,起病时间、HBV感染与疾病严重程度的相关性有边缘性统计学意义。Objective To investigate the potential risk factors for severe intrahepatic cholestasis of pregnancy(ICP).Methods A retrospective single-center study was conducted in 79 patients with ICP.Their clinical data was analyzed,including basic information,liver injuries,impacts on delivery and neonates.According to the level of bile acid,79 ICP patients were divided into mild(n=55)and severe groups(n=24).Results Patients inseveregroupwereolder(31.04±3.56 years old vs.28.95±4.13 years old,P=0.034)and had earlier onset time during pregnancy(250.2±26.57 days vs.258.2±13.27 days,P=0.079)than those inmild group.The prevalence of hepatitis B virus(HBV)infection was found to be significantly higher in those with severe ICP(33.33%vs.14.55%,P=0.056).The cesarean rate of severe group was significantly higher than that of mild group(92%vs.58%,P=0.006).No statistical difference was observed in the survival rate of neonates.Conclusion The older age,earlier onset time and HBV infection are associated with an increased risk of developing severe ICP.

关 键 词：肝内胆汁淤积症 临床研究 

分 类 号：R714.255[医药卫生—妇产科学]