早发型妊娠期肝内胆汁淤积症患者血清总胆汁酸水平和围产儿结局的关联性分析  

Correlation of serum total bile acid levels with perinatal outcomes in patients with early-onset intrahepatic cholestasis of pregnancy

作　　者：王子梅 王宁宁 贾秀改 Wang Zimei;Wang Ningning;Jia Xiugai(Department of Obstetrics,Zhengzhou Yihe Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州颐和医院产科,郑州450000

出　　处：《中国实用医刊》2022年第14期50-53,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析早发型妊娠期肝内胆汁淤积症(ICP)患者血清总胆汁酸(TBA)水平和围产儿结局的关联性。方法抽取2018年2月至2022年2月郑州颐和医院收治的早发型ICP患者78例,将血清TBA水平为10~40μmol/L的45例患者作为低水平组,将血清TBA>40μmol/L的33例患者作为高水平组。检测并比较两组肝功能指标[天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)],比较两组分娩孕周、分娩方式、围产儿结局及新生儿并发症发生率。结果低水平组AST、ALT、TBIL水平低于高水平组(t=41.66、37.71、32.65,P均<0.05)。低水平组分娩孕周长于高水平组,且分娩方式优于高水平组(P<0.05)。低水平组宫内发育迟缓、宫内窘迫、新生儿窒息发生率分别为6.67%(3/45)、15.56%(7/45)、13.33%(6/45),低于高水平组的30.30%(10/33)、45.45%(15/33)、39.39%(13/33),P<0.05。低水平组病理性黄疸、颅内出血、吸入性肺炎、缺血缺氧性脑病发生率分别为13.33%(6/45)、2.22%(1/45)、4.44%(2/45)、4.44%(2/45),低于高水平组的48.48%(16/33)、21.21%(7/33)、27.27%(9/33)、27.27%(9/33),P<0.05。结论早发型ICP患者血清TBA水平越高,肝功能越差,不良分娩结局、不良围产儿结局、新生儿并发症发生率越高,临床应及时监测血清TBA水平,积极治疗并结合患者病情实际情况适时终止妊娠,以改善围产儿结局。Objective To analyze correlation of serum total bile acid(TBA)levels with perinatal outcomes in patients with early-onset intrahepatic cholestasis of pregnancy(ICP).Methods A total of 78 patients with early-onset ICP admitted to Zhengzhou Yihe Hospital from February 2018 to February 2022 were selected.Among them,45 patients with serum TBA levels of 10-40μmol/L were regarded as the low-level group,while 33 patients with serum TBA>40μmol/L were selected as the high-level group.The liver function indexes of the two groups,including aspartate aminotransferase(AST),alanine aminotransferase(ALT),total bilirubin(TBIL),were detected and compared.The gestational age,mode of delivery,perinatal outcome,and incidence of neonatal complications were compared between the two groups.Results The levels of AST,ALT and TBIL in the low-level group were lower than those in the high-level group(t=41.66,37.71,32.65;all P<0.05).The delivery gestational age in the low-level group was longer than that in the high-level group,and the mode of delivery in the low-level group was better than that in the high-level group(P<0.05).The incidence rates of intrauterine growth retardation,intrauterine distress and neonatal asphyxia in the low-level group were 6.67%(3/45),15.56%(7/45)and 13.33%(6/45),respectively,which was lower than 30.30%(10/33),45.45%(15/33)and 39.39%(13/33)in the high-level group,P<0.05.The incidences of pathological jaundice,intracranial hemorrhage,aspiration pneumonia,and hypoxic ischemic encephalopathy in the low-level group were 13.33%(6/45),2.22%(1/45),4.44%(2/45),and 4.44%(2/45),respectively,which were lower than 48.48%(16/33),21.21%(7/33),27.27%(9/33)and 27.27%(9/33)in the high-level group,P<0.05.Conclusions With the increase in serum TBA level in patients with early-onset ICP,the liver function get worse,while the incidence of adverse delivery outcomes,adverse perinatal outcomes,and neonatal complications get higher.Serum TBA levels should be monitored in a timely manner,active treatment should be performed,and pregnanc

关 键 词：妊娠 肝内胆汁淤积症 胆汁酸 

分 类 号：R714.255[医药卫生—妇产科学]