肝内胆汁淤积症孕妇总胆汁酸水平与新生儿脐血胆汁酸及围生儿结局的关系  

A Correlative Study of Total Bile Acid in the Mothers with Intrahepatic Cholestasis and Perinatal Infants

作　　者：何静媛[1] HE Jingyuan(Department of Gynaecology and Obstetrics,Deyang,Sichuan 618000)

机构地区：[1]四川省德阳市人民医院妇产科,618000

出　　处：《临床输血与检验》2020年第2期181-184,共4页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的 了解妊娠期肝内胆汁淤积症孕妇的外周血血清总胆汁酸水平与新生儿脐血胆汁酸值的相关性,并分析脐血胆汁酸水平对围生儿结局的影响。方法 选取德阳市人民医院2015年12月~2017年5月住院治疗的123例妊娠期肝内胆汁淤积症孕妇的临床资料,检测其外周血血清胆汁酸值、转氨酶值,新生儿脐血胆汁酸值以及计算围生期并发症发生率,根据血清总胆汁酸值及临床症状分为2组:组1孕妇血清总胆汁酸值10~40 μmol/L,临床症状以皮肤瘙痒为主,无明显其他症状;组2孕妇血清总胆汁酸值>40 μmol/L,临床瘙痒重,可能合并复发ICP、多胎妊娠等高危因素。同时选取同期住院分娩、无妊娠期合并症的正常孕妇96例作为对照组。结果 和对照组比较,组1及组2孕妇血清总胆汁酸水平均高于对照组,差异有统计学意义(P<0.05),相关分析显示新生儿脐血胆汁酸水平与孕妇血清胆汁酸水平呈正相关(r=0.903,P<0.05);新生儿脐血胆汁酸水平与孕妇转氨酶水平的相关性无统计学意义(r分别为0.13、-0.07,P值分别为0.12、0.53),组2早产、新生儿窒息、羊水污染发生率明显高于对照组,差异有统计学意义。结论 重度ICP孕妇的新生儿围产期并发症明显高于对照组,妊娠期肝内胆汁酸淤积症的分度有助于判断以及评估围生儿的预后。Objective To investigate the relationship between the total serum bile acid(TSBA)and its value in pregnant women with intrahepatic cholestasis of pregnancy,and to analyze the influence of bile acid in cord blood on the outcomes of perinatal infants.Methods Clinical data of 123 cases were collected from Dec 2015 to May 2017 and the TSBA and transaminase were detected.The frequencies of perinatal complications were analyzed.The pregnant women were divided into two groups based on the level of TSBA and their clinical menifestations.Group 1 included the patients with 10-40 mol/L TSBA and skin itching whereas group 2,with 40 mol/L TSBA and severe pruritus associated with recurrent ICP and multiple pregnancy risk factors.Ninety six cases of normal pregnant women were taken as control.Results The pregnant women of both groups showed a high TSBA level compared with the control(P<0.05).A positive correlation of bile acid level was found between the neonatal cord blood and maternal peripheral blood(r=0.903,P<0.05).Patients of group 2 had high frequencies of premature birth,neonatal asphyxia,amniotic fluid contamination.Conclusion Neonatal perinatal complications in severe ICP pregnant women were frquently noted and grading of intrahepatic cholestasis during pregnancy may help determine the perinatal prognosis.

关 键 词：妊娠期肝内胆汁淤积症 总胆汁酸 脐血总胆汁酸 围生儿结局 

分 类 号：R575.22[医药卫生—消化系统] R446.11[医药卫生—内科学]