血清TBA、α-HBDH和E2在ICP患者中的表达及与病情、围生儿结局的关联性  

Expressions of serum TBA,α-HBDH and E2 in patients with intrahepatic cholestasis and its correlation with state of illness and perinatal outcomes

作　　者：许剑萍[1] 徐月华 李健霞 钱静[1] 马艾[1] XU Jianping;XU Yuehua;LI Jianxia(The Fifth Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050021,China;不详)

机构地区：[1]河北省石家庄市第五医院,050021 [2]河北省滦平县红旗镇人民政府 [3]河北省平山县中医院

出　　处：《河北医药》2021年第10期1497-1500,共4页Hebei Medical Journal

基　　金：石家庄市科学技术局(编号:171791953)。

摘　　要：目的探讨血清总胆汁酸(TBA)、α羟丁酸脱氢酶(α-HBDH)、雌二醇(E2)在妊娠期肝内胆汁淤积症(ICP)患者中的表达及与其病情、围生儿结局的关系。方法选取2017年4月至2019年4月150例ICP患者为病例组,同期150例健康体检孕妇为健康对照组。测定对比2组血清TBA、α-HBDH、E2水平、病例组不同病情程度、不同围生儿结局患者血清TBA、α-HBDH、E2水平,并应用Spearman相关分析探讨血清TBA、α-HBDH、E2水平与ICP患者病情、围生儿结局的关联性,应用logistic回归分析探讨ICP发生影响因素,应用受试者工作特征曲线(ROC)评价上述血清指标对ICP患者出现围生儿并发症的预测价值。结果病例组血清TBA、α-HBDH、E2水平高于健康对照组(P<0.05);病例组病情程度为重度患者血清TBA、α-HBDH、E2水平高于轻度患者(P<0.05);病例组出现不良围生儿结局患者血清TBA、α-HBDH、E2水平高于未出现患者(P<0.05);Spearman相关分析,血清TBA、α-HBDH、E2水平与ICP患者病情程度呈正相关(r值分别为0.650、0.690、0.529,P<0.05),与ICP患者围生儿结局呈负相关(r值分别为-0.692、-0.786、-0.664,P<0.05);logistic回归分析可知,血清TBA、α-HBDH、E2均为ICP发生的重要危险因素(P<0.05);ROC分析显示,α-HBDH AUC为0.889,大于TBA(0.784)、E2(0.794),当截断值为>222.53时,敏感度83.02%,特异度为83.16%。结论血清TBA、α-HBDH、E2在ICP患者中呈高表达,且其表达与患者病情、围生儿结局密切相关,表达增高可作为预测患者出现不良围生儿结局的重要预测因子。Objective To investigate the expressions of serum total bile acid(TBA),αhydroxybutyrate dehydrogenase(α-HBDHB)and estradiol(E2)in patients with intrahepatic cholestasis of pregnancy(ICP)and its correlation with the state of illness and perinatal outcomes.Methods A total of 150 patients with ICP who were treated in our hospital from April 2017 to April 2019 were enrolled as case group,at the same time,the other 150 healthy pregnant women who had physical examination were enrolled as control group.The serum levels of TBA,α-HBDHB,E2 as well as the serum levels of TBA,α-HBDHB and E2 in the patients with different illness degree and different perinatal outcomes in case group were observed.The relevance between the serum TBA,α-HBDHB,E2 with and the pathogenetic condition of patients with ICP as well as the perineonate outcomes was analyzed by Spearman correlation analysis.Logistic regression analysis was used to investigate the influencing factors of ICP.The receiver operating characteristic curve(ROC)was used to evaluate the predictive value of the above indexes for the incidence of perineonate complications in patients with ICP.Results The serum levels of TBA,α-HBDHB and E2 in case group were significantly higher than those in control group(P<0.05).Moreover the serum levels of TBA,α-HBDHB and E2 in the severe case group were significantly higher than those in mild case group(P<0.05).The serum levels of TBA,α-HBDHB and E2 in patients with poor perineonate outcomes were significantly higher than those in the patients without poor outcomes(P<0.05).The Spearman correlation analysis showed that the serum levels of TBA,α-HBDHB and E2 were positively correlated with the illness degree of patients(P<0.05),however,which were negative correlated with the outcomes of perineonates(P<0.05).The Logistic regression analysis showed that the serum levels of TBA,α-HBDHB and E2 were the important risk factors for the incidence of ICP(P<0.05).ROC analysis showed that the AUC ofα-HBDHB AUC was 0.889,which was greater than that

关 键 词：妊娠期肝内胆汁淤积症 TBA Α-HBDH E2 病情程度 围生儿结局 

分 类 号：R714.25[医药卫生—妇产科学]