妊娠期肝内胆汁淤积症患者血清甘胆酸及终止妊娠时间对围产儿结局影响  

Influence of serum glycocholic acid level and time of pregnancy termination of pregnant women with intrahepatic cholestasis of pregnancy on the outcomes of their perinatal infants

作　　者：李冰洋 田红 范晓艳 LI Bingyang;TIAN Hong;FAN Xiaoyan(The First Affiliated Hospital of the Air Force Military Medical University,Shaanxi Province,710032;Air Force 986th Hos pital;Shaanxci Provincial Rehabilitation Hospital)

机构地区：[1]空军军医大学第一附属医院,西安710032 [2]空军第九八六医院 [3]陕西省康复医院

出　　处：《中国计划生育学杂志》2022年第6期1425-1428,共4页Chinese Journal of Family Planning

摘　　要：目的:探讨血清甘胆酸(CG)水平及终止妊娠时间对妊娠期肝内胆汁淤积症(ICP)患者围产儿结局的影响。方法:回顾性收集2018年7月—2020年7月本院收治的112例ICP孕妇作为ICP组,根据血清CG水平分为低CG组(2.7-13.5mg/L,63例)、高CG组(≥13.5mg/L,49例),根据终止妊娠时间分为<36周组(46例)、≥36周组(66例)。健康孕妇60例为对照组。采用全自动生化分析仪检测血清CG水平,比较各组围产儿不良结局,分析ICP患者围产儿不良结局影响因素。结果:ICP组血清TBIL(14.79±3.36μmol/L)、天冬氨酸转氨酶(AST)(65.61±4.63 U/L)、丙氨酸转氨酶(ALT)(89.57±11.23 U/L)、CG(15.47±6.34 mg/L)水平均高于对照组(6.37±2.83μmol/L、15.27±2.82 U/L、14.35±3.26 U/L、1.63±0.54 mg/L),围产儿不良结局发生率高CG组高于低CG组、<36周组高于≥36周组(均P<0.05)。多因素logistic回归分析显示,血清CG≥13.5mg/L(OR=2.16,95%CI:1.30-3.57)、终止妊娠时间<36周(OR=2.10,95%CI=1.29-3.42)是ICP患者围产儿不良结局的危险因素(P<0.05)。结论:血清CG水平异常升高、终止妊娠时间<36周与ICP患者围产儿不良结局的发生有关,建议临床对ICP孕妇妊娠时间≥36周终止妊娠可降低围产儿不良结局。Objective:To investigate the influence of serum glycocholic acid(CG)level and time of pregnancy termination of pregnant women with intrahepatic cholestasis of pregnancy(ICP)on the outcomes of their perinatal infants.Methods:112 pregnant women with ICP were selected in study group and 69 healthy pregnant women were selected in control group from July 2018 to July 2020.According to the serum CG level of the women in the study group,the women were divided into group A(63 women with low level CG of 2.7-13.5 mg/L)and group B(49 women with high level CG of≥13.5 mg/L).And according to the time of the pregnancy termination of the women in the study group,the women were also divided into group C(46 women with termination of pregnancy during<36 gestational weeks)and group D(466 women with termination of pregnancy during≥36 gestational weeks).The serum CG level of all these women was detected by automatic biochemical analyzer.And the adverse outcomes of the perinatal infants were compared among these groups.The influencing factors of the adverse outcomes of the perinatal infants of the women with ICP were analyzed.Results:The levels of serum total bilirubin(TBIL)(14.79±3.36μmol/L),aspartate transaminase(AST)(65.61±4.63 U/L),alanine transaminase(ALT)(89.57±11.23 U/L),and CG(15.47±6.34 mg/L)of the women in the study group were significantly higher than those(6.37±2.83μmol/L,15.27±2.82 U/L,14.35±3.26 U/L,and 1.63±0.54 mg/L)of the women in the control group.The incidence of perinatal adverse outcomes of the women in group B was significantly higher than that of the women in group A,and which of the women in group C was significantly higher than that of the women in group D(all P<0.05).Multivariate logistic regression analysis showed that the serum CG level≥13.5 mg/L(OR=2.16,95%CI:1.30-3.57)and the time of pregnancy termination<36 gestational weeks(OR=2.10,95%CI=1.29-3.42)of the women with ICP were the risk factors of the adverse outcomes of their perinatal infants(P<0.05).Conclusion:Abnormal high level of serum

关 键 词：妊娠期肝内胆汁淤积症 血清甘胆酸 终止妊娠时间 不良围产结局 

分 类 号：R714.255[医药卫生—妇产科学]