98例贵州布依族妊娠期肝内胆汁淤积症患者临床分析  

Clinical analysis of 98 patients with intrahepatic cholestasis of pregnancy in the Buyi nationality of Guizhou

作　　者：杨秀莲[1] 李津 YANG Xiulian;LI Jin(Department of Obstetrics and Gynecology,the Third People′s Hospital of Huizhou,Guangdong Province,Huizhou516000,China;Department of Obstetrics and Gynecology,the People′s Hospital of Cehe)

机构地区：[1]广东省惠州市第三人民医院妇产科,广东惠州516000 [2]贵州省册亨县人民医院妇产科,贵州册亨552200

出　　处：《中国当代医药》2022年第29期24-28,共5页China Modern Medicine

摘　　要：目的通过对98例贵州省布依族患有妊娠期肝内胆汁淤积症(ICP)孕产妇的临床资料进行分析,探讨贵州布依族患者患ICP的临床特征。方法选取2018年1月至2022年1月在黔西南州册亨县人民医院妇产科住院分娩的98例布依族患ICP孕产妇的临床资料作为病例组,根据病情严重程度将病例组分为轻度组(67例)与重度组(31例),根据有无皮肤瘙痒将病例组分为瘙痒组(50例)与无瘙痒组(48例);另选取同期110名住院分娩的健康布依族孕产妇作为对照组,分析各组间皮肤瘙痒、肝功能水平和不良妊娠结局。结果病例组中皮肤瘙痒发生率、谷丙转氨酶(ALT)和谷草转氨酶(AST)水平、羊水污染、胎儿生长受限、胎儿窘迫、早产、新生儿窒息的发生率均高于对照组,差异有统计学意义(P<0.05)。病例组中的重度组在皮肤瘙痒发生率、ALT和AST水平、羊水污染、胎儿窘迫、胎儿生长受限、早产、新生儿窒息和围生儿死亡的发生率均高于轻度组,差异有统计学意义(P<0.05)。病例组中瘙痒组的总胆汁酸(TBA)、ALT和AST水平均高于无瘙痒组,差异有统计学意义(P<0.05)。结论加强贵州省布依族孕妇孕期保健意识,倡导健康饮食,重视孕妇孕期瘙痒症状及潜在危害,早期诊断,积极治疗,严密监护,选择最佳的分娩时机和方式,是降低当地ICP不良妊娠结局的关键。Objective To analyze the clinical data of 98 cases of pregnant women with intrahepatic cholestasis(ICP)of Buyi nationality in Guizhou province,and to explore the clinical characteristics of ICP.Methods The clinical data of 98 buyi pregnant women with ICP who delivered in the Department of Obstetrics and Gynecology of the People′s Hospital of Ceheng County from January 2018 to January 2022 were selected as the case group.According to the severity of the disease,the case group was divided into mild group(67 cases)and severe group(31 cases).According to the presence or absence of skin pruritus,the patient group was divided into itch group(50 cases)and non-itch group(48 cases).Another 110 healthy pregnant women of Buyi nationality who gave birth in this hospital were selected as the control group,and the skin pruritus,liver function and adverse pregnancy outcome among the groups were analyzed.Results The incidence of pruritus,alanine aminotransferase(ALT)and aspartate aminotransferase(AST)levels,amniotic fluid contamination,fetal growth restriction,fetal distress,premature delivery and neonatal asphyxia in case group were higher than those in control group,and the differences were statistically significant(P<0.05).The incidence of pruritus,ALT and AST levels,amniotic fluid contamination,fetal distress,fetal growth restriction,premature delivery,neonatal asphyxia and perinatal death in severe group were higher than those in mild group,and the differences were statistically significant(P<0.05).The levels of total bile acid(TBA),ALT and AST in pruritus group were higher than those in non-pruritus group,with statistical significances(P<0.05).Conclusion Strengthening the awareness of pregnancy health care,advocating healthy diet,paying attention to pruritus symptoms and potential hazards during pregnancy,early diagnosis,active treatment,close monitoring,and choosing the best delivery time and way are the keys to reduce the adverse pregnancy outcome of local ICP.

关 键 词：妊娠期肝内胆汁淤积症 贵州 布依族 皮肤瘙痒 肝功能 不良妊娠结局 

分 类 号：R575[医药卫生—消化系统]