妊娠期肝内胆汁淤积症孕妇血清CG、TBA、IL-6水平变化及其临床意义  

Changes and Clinical Significance of Serum CG,TBA and IL-6 Levels in Puerperae with Intrahepatic Cholestasis of Pregnancy

作　　者：汤敏 TANG Min(Yichun Maternal and Child Health Hospital,Jiangxi Province,Yichun 336000,China)

机构地区：[1]江西省宜春市妇幼保健院,江西宜春336000

出　　处：《中国医学创新》2022年第2期44-48,共5页Medical Innovation of China

摘　　要：目的:研究妊娠期肝内胆汁淤积症(ICP)孕妇血清甘胆酸(CG)、总胆汁酸(TBA)、白介素-6(IL-6)水平变化及其临床意义。方法:回顾性分析2018年1月-2020年10月于宜春市妇幼保健院就诊的80例妊娠期发生肝内胆汁淤积症的孕妇病例,作为ICP组;另选择同期于本院进行常规产检的健康孕妇84例,作为正常组。比较ICP组与正常组血清CG、TBA、IL-6水平差异,绘制受试者工作曲线(ROC)评价各项指标及联合检测对ICP的诊断价值,根据肝功能损害程度将ICP孕妇分为轻度组51例、中度组23例和重度组6例,依据ICP孕妇发病时间将其分为早发型ICP组47例和晚发型ICP组33例,根据ICP孕妇分娩结局将其分为分娩正常组26例和分娩异常组54例,比较不同亚组CG、TBA、IL-6水平表达情况。结果:ICP组CG、TBA、IL-6水平均高于正常组(P<0.05);CG、TBA、IL-6诊断ICP的截点值分别为9.47 mg/L、28.12μmol/L、35.67 ng/L,CG、TBA、IL-6及联合诊断ICP的曲线下面积分别为0.866、0.845、0.804、0.975,且联合诊断价值高于单一指标诊断价值(P<0.05);肝功能损伤重度组CG、TBA、IL-6水平均高于中度组,中度组CG、TBA、IL-6水平均高于轻度组(P<0.05);早发型ICP组CG、TBA、IL-6水平均高于晚发型ICP组(P<0.05);分娩正常组CG、TBA、IL-6水平均低于分娩异常组(P<0.05)。结论:ICP孕妇血清CG、TBA、IL-6水平与肝功能损害程度、发病时间和妊娠结局存在一定联系,单一指标及联合诊断ICP均具有临床应用价值。Objective:To study the changes and clinical significance of serum cholyglycine(CG),total bile acid(TBA)and interleukin-6(IL-6)levels in puerperae with intrahepatic cholestasis of pregnancy(ICP).Method:A total of 80 ICP puerperae treated in the Yichun Maternal and Child Health Hospital from January 2018 to October 2020 were enrolled as ICP group,while another 84 healthy puerperae undergoing routine obstetric examination during the same period were enrolled as normal group.The differences in serum CG,TBA,IL-6 levels between the two groups were compared.The diagnostic value of each index and their combination for ICP was evaluated by receiver operator characteristic(ROC)curves.According to the severity of liver damage,ICP puerperae were divided into mild group(51 cases),moderate group(23 cases)and severe group(6 cases).According to different onset time of ICP,ICP puerperae were divided into early-onset ICP group(47 cases)and late-onset ICP group(33 cases).According to different delivery outcomes,ICP puerperae were divided into normal delivery group(26 cases)and abnormal delivery group(54 cases).The levels of CG,TBA and IL-6 in different subgroups were compared.Result:The levels of CG,TBA and IL-6 in ICP group were higher than those in normal group(P<0.05).The cut-off values of CG,TBA and IL-6 for the diagnosis of ICP were 9.47 mg/L,28.12μmol/L and 35.67 ng/L,respectively,the area under the curve(AUC)values of CG,TBA,IL-6 and their combination for the diagnosis of ICP were 0.866,0.845,0.804 and 0.975,respectively.The diagnostic value of their combination was higher than those of single index(P<0.05).The levels of CG,TBA and IL-6 in the severe liver function injury group were higher than those in the moderate group,and the levels of CG,TBA and IL-6 in the moderate group were higher than those in the mild group(P<0.05).The levels of CG,TBA and IL-6 in early-onset ICP group were higher than those in late-onset ICP group(P<0.05).The levels of CG,TBA and IL-6 in normal delivery group were lower than those in abnormal del

关 键 词：妊娠期肝内胆汁淤积症 甘胆酸 总胆汁酸 白介素-6 

分 类 号：R714.255[医药卫生—妇产科学]