妊娠期肝内胆汁淤积症孕妇脐动脉血流参数、血清总胆汁酸、甘胆酸与新生儿肺损伤关系  

Correlation of the blood flow parameters of umbilical artery and the levels of serum total bile acid and cholylglycine of pregnant women with intrahepatic cholestasis of pregnancy and their neonatal lung injury occurrence

作　　者：程佳梨 梁月月 朱玲 CHENG Jiali;LIANG Yueyue;ZHU Ling(The Ninth People’s Hospital of Hangzhou, Zhejiang Province, 311225;Shaoxing Maternal and Child Health Care Hospital)

机构地区：[1]浙江省杭州市第九人民医院,311225 [2]浙江省绍兴市妇幼保健院

出　　处：《中国计划生育学杂志》2021年第10期2138-2141,共4页Chinese Journal of Family Planning

摘　　要：目的:探讨妊娠期肝内胆汁淤积症(ICP)孕妇脐动脉血流参数、血清总胆汁酸(TBA)、甘胆酸(CG)与新生儿肺损伤(ALI)相关性。方法:收集2017年3月—2020年9月本院诊治的ICP孕妇113例临床资料,按照是否发生ALI分为ICP组及ICP+ALI组,将发生ALI再分为暂时性呼吸增快症(TTPN)和新生儿呼吸窘迫综合征(RDS),超声测量脐动脉血流参数,酶循环法检测血清TBA及CG水平。结果:ICP+ALI组重度ICP比例、血清TBA、CG水平,以及脐动脉血流S/D、RI值均大于ICP组(P<0.001),脐动脉血流PI值两组无差异(P>0.05);发生ALI中,RDS组血清TBA、CG水平及脐动脉RI值大于TTPN组(P<0.05),脐动脉S/D、PI值两组无差异(P>0.05)。重度ICP、血清TBA、CG水平、脐动脉RI值是ALI的独立危险因素,血清TBA、CG水平是RDS的独立危险因素(均P<0.05);TBA+RI、CG+RI、TBA+CG对ALI均具有预测效能(P<0.05)。结论:ICP孕妇发生新生儿ALI与脐动脉RI、血清TBA、CG有关,3项联合检测对ALI有预测价值。Objective:To investigate the correlation between the blood flow parameters of umbilical artery and the levels of serum total bile acid(TBA)and cholylglycine(CG)of pregnant women with intrahepatic cholestasis of pregnancy(ICP)and their neonatal lung injury(ALI)occurrence.Methods:113 pregnant women with ICP were selected as study subjects from March 2017 to September 2020.According to the occurrence of ALI,these women were divided into group A(women without ALI)and group B(women with ALI).The women in group B were further divided into group B1(newborns with Transient Hyperrespiratory syndrome)and group B2(newborns with respiratory distress syndrome).The blood flow parameters of umbilical artery were measured by ultrasound,and the levels of TBA and CG were measured by enzyme circulation.Results:The proportion of severe ICP,serum TBA and CG levels,and the values of S/D and RI of umbilical blood flow of the women in group B were all significant higher than those of the women in group A(P<0.001),and there was no significant difference in the PI value of umbilical blood flow of the women between the two groups(P>0.05).The serum levels of TBA and CG,and the RI value of umbilical artery of the women in B2 group were significant higher than those of the women in group B1(P<0.05),while the S/D and PI values of umbilical artery of the women had no significant different between group B1 and group B2(P>0.05).Severe ICP,serum TBA and CG levels,and umbilical artery RI value were the independent risk factors of ALI,and serum TBA and CG levels were the independent risk factors of respiratory distress syndrome(P<0.05).TBA+RI,CG+RI,and TBA+CG all had some value for predicting ALI(P<0.05).Conclusion:The incidence of neonatal ALI in ICP pregnant women is related to their umbilical artery RI value,and their serum TBA and CG levels.The combination of umbilical artery RI value,and serum TBA and CG levels of the pregnant women has some predictive value for ALI.

关 键 词：妊娠期肝内胆汁淤积症 新生儿肺损伤 脐动脉 总胆汁酸 甘胆酸 预测 

分 类 号：R714.255[医药卫生—妇产科学]