妊娠期肝内胆汁淤积症孕妇血清CG、TSH水平变化及意义  

Changes and significance of the serum levels of CG and TSH in gravida with intrahepatic cholestasis of pregnancy

作　　者：占华 王慧华 潘惠玉 ZHAN Hua;WANG Huihua;PAN Huiyu(General Outpatient Service,Tongxiang Fourth People’s Hospital,Jiaxing 314500,China;Department of Obstetrics and Gynecology,Tongxiang First People’s Hospital,Jiaxing 314500,China;Department of Obstetrics and Gynecology,Tongxiang Maternal and Child Health Hospital,Jiaxing 314500,China)

机构地区：[1]桐乡市第四人民医院全科门诊,浙江嘉兴314500 [2]桐乡市第一人民医院妇产科,浙江嘉兴314500 [3]桐乡市妇幼保健院妇产科,浙江嘉兴314500

出　　处：《健康研究》2022年第2期212-215,共4页Health Research

摘　　要：目的探讨妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)孕妇血清甘胆酸(CG)、促甲状腺激素(TSH)水平变化及其临床意义。方法比较轻度ICP(149例)、重度ICP(108例)、健康对照孕妇(60例)的血清CG、总胆汁酸(TBA)、丙氨酸氨基转移酶(ALT)、天冬氨酸转移酶(AST)、TSH水平及围产儿不良结局的发生率,并利用受试者工作曲线(ROC)评价CG、TSH鉴别重度ICP的效能。结果3组间CG、TBA、ALT、AST、TSH水平比较,均为ICP组高于对照组、重度ICP组高于轻度ICP组,差异均有统计学意义(P<0.05)。3组间早产、胎儿窘迫等围产儿不良结局发生率差异有统计学意义(χ^(2)=10.381、20.256,均P<0.05)。ROC分析结果显示,CG、TSH诊断重度ICP的AUC分别为0.890、0.837。结论ICP孕妇血清CG、TSH水平增高,对重度ICP的诊断均有一定的价值,且CG的诊断效能更高。Objective To investigate the changes and clinical significance of the serum levels of cholyglycine(CG)and thyroid stimulating hormone(TSH)in pregnant women with intrahepatic cholestasis of pregnancy(ICP).Methods The serum levels of CG,total bile acid(TBA),alanine aminotransferase(ALT),aspartate transferase(AST)and TSH and the incidence of adverse outcomes in perinatal infants were compared among mild ICP(149 cases),severe ICP(108 cases)and healthy control pregnant women(60 cases).Receiver operating characteristic(ROC)curve was used to assess the efficiency for CG and TSH to identify severe ICP.Results By comparing the three groups,the levels of CG,TBA,ALT,AST and TSH of the ICP group were higher than those of the control group,and those of the severe ICP group were higher than those of the mild ICP group.The differences were statistically significant(P<0.05).There were conspicuous differences in the incidence of adverse outcomes such as premature delivery and fetal distress in perinatal infants among the three groups(χ^(2)=10.381,20.256,P<0.05).The results of ROC analysis showed that AUC values of CG and TSH in the diagnosis of severe ICP were 0.890 and 0.837,respectively.Conclusions The serumlevels of CG and TSH were increased in pregnant women with ICP,which were of certain diagnostic value for severe ICP,and the diagnostic efficiency of CG was higher.

关 键 词：妊娠期 肝内胆汁淤积症 甘胆酸 促甲状腺激素 

分 类 号：R714.255[医药卫生—妇产科学]