妊娠期肝内胆汁淤积症孕妇血清总胆汁酸水平与胎儿宫内窘迫关系及预测缺氧程度价值  

Correlation between the serum total bile acid level of women with intrahepatic cholestasis of pregnancy and their fetal distress and its value for predicting the hypoxia degree of their fetuses

作　　者：钱静 闻明[1] QIAN Jing;WEN Ming(The First Hospital of Wuhu,Anhui Province,241000)

机构地区：[1]安徽省芜湖市第一人民医院,241000

出　　处：《中国计划生育学杂志》2022年第10期2386-2388,2393,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)孕妇血清总胆汁酸水平与胎儿宫内窘迫发生关系及预测缺氧程度价值.方法:回顾性收集2016年1月-2020年1月本院收治的ICP患者98例为ICP组,均单胎妊娠,按出生时lmin Apgar评分确诊为胎儿宫内窘迫,分为轻度窒息组(71例)和重度窒息组(27例),产前检查正常孕妇50例为对照组.ICP患者入院后均给予对症治疗,采用全自动生化分析仪检测两组外周静脉血及新生儿出生后48h内股静脉血血清总胆汁酸水平,采用多元线性回归分析相关性,诊断效果评价采用受试者工作特征曲线(ROC).结果:ICP组血清总胆汁酸水平(23.16±5.26mmol/L)高于对照组(1.92±0.03mmol/L),重度窒息新生儿(17.39±7.43mmol/L)高于轻度窒息新生儿(12.09±4.06mmol/L)(均P<0.05);多元线性回归分析结果显示,ICP孕妇血清总胆汁酸水平与胎儿宫内窘迫发生存在正相关(P<0.05);ICP孕妇血清总胆汁酸诊断胎儿宫内缺氧程度的曲线下面积为0.800(95%CI 0.693~0.907),诊断临界值为18.107mmol/L,此时敏感度60.0%,特异度92.6%,准确度82.7%结论:ICP患者血清总胆汁酸水平异常升高,且水平与胎儿宫内窘迫存在正相关,诊断患儿缺氧程度的特异性较高.重度窒息患儿血清总胆汁酸水平高于轻度窒息患儿.Objective: To investigate the correlation between the serum total bile acid level of pregnant women with intrahepatic cholestasis of pregnancy(ICP) and their fetal distress, and to study its value for predicting the hypoxia degree of their fetuses. Methods: 98 single pregnant women with ICP treated from January 2016 to January 2020 were collected in study group retrospectively. These women were divided in group A(71 cases with fetal mild asphyxia) and group B(27 cases with fetal severe asphyxia) according to the l min Apgar score of the newborns. 50 normal pregnant women who underwent physical examination were selected in control group during the same period. All the women with ICP were given symptomatic treatment after admission. The serum levels of total bile acids in peripheral venous blood and femoral venous blood of the newborns within 48 hours after birth were detected by automatic biochemical analyzer. Multiple linear regression analysis was used to analyze the correlation. Receiver operating characteristic(ROC) curve was used to evaluate the diagnostic effect. Results: The serum total bile acid level(23.16±5.26 mmol/L) of the women in the study group was significantly higher than that(1.92±0.03 mmol/L) of the women in the control group, and the serum total bile acid level(17.39±7.43 mmol/L) of the women in group B was significantly higher than that(12.09±4.06 mmol/L) of the women in group A(all P<0.05). Multiple linear regression analysis showed that the serum total bile acid level of the pregnant women with ICP was positively correlated with the occurrence of their fetal intrauterine distress(P<0.05). The area under the curve of the serum total bile acid level of the pregnant women with ICP for diagnosing their fetal degree of intrauterine hypoxia was 0.800(95%CI 0.693-0.907),and the diagnostic critical value,the sensitivity,the specificity,and the accuracy of which were 18.107 mmol/L,60.0%,92.6%,and82.7%,respectively.Conclusion:The level of serum total bile acid of the pregnant women with ICP increa

关 键 词：妊娠期肝内胆汁淤积症 胎儿宫内窘迫 血清胆汁酸 缺氧程度 相关性 诊断价值 

分 类 号：R714.255[医药卫生—妇产科学] R714.5[医药卫生—临床医学]