妊娠期肝内胆汁淤积症患者不良妊娠结局的危险因素分析  

Analysis of risk factors for adverse pregnancy outcomes in patients with intrahepatic cholestasis of pregnancy

作　　者：陈文丹 韩凤琼 张金凤 林悦 郭俊豪 宋爱峰 潘海燕 CHEN Wen-dan;HAN Feng-qiong;ZHANG Jin-feng;LIN yue;GUO Jun-hao;SONG Ai-feng;PAN Hai-yan(Department of Epidemiology and Medical Statistics,Guangdong Medical University,Dongguan,Guangdong 523808,China;Shunde Women and Children′s Hospital of Guangdong Medical University,Foshan 528300,China)

机构地区：[1]广东医科大学流行病与卫生统计学教研室,东莞523808 [2]广东医科大学顺德妇女儿童医院

出　　处：《肝脏》2023年第5期576-580,共5页Chinese Hepatology

基　　金：广东省自然科学基金面上项目(2019A1515010875);广东省普通高校重点科研平台重点领域专项项目(2020ZDZX3007);东莞市科技特派员项目(20201800500082)。

摘　　要：目的了解妊娠期肝内胆汁淤积症(ICP)患者发生不良妊娠结局的危险因素。方法纳入2019年6月至2021年12月广东医科大学顺德妇女儿童医院的ICP孕妇365例。根据ICP孕妇是否发生不良妊娠结局进行分组,观察两组临床特征差异,logistic回归分析ICP孕妇发生不良妊娠结局的危险因素。结果单因素分析结果显示,ICP发病时间、年龄、总胆汁酸、直接胆红素、AST、ALT、双胎妊娠、胚胎移植等与不良妊娠结局有关(t/χ^(2)=29.369、2.342、4.006、2.111、2.622、2.089、27.801、11.795,P<0.05);产妇类型、BMI、妊娠期糖尿病等与不良妊娠结局无关(t/χ^(2)=0.193、0.517、1.321,P>0.05)。logistic回归分析显示,年龄(OR=1.087,95%CI:1.021~1.157,P=0.009)、总胆汁酸(OR=1.031,95%CI:1.015~1.047,P<0.01)、股骨长度(OR=0.781,95%CI:0.689~0.886,P<0.001)、双胎妊娠(OR=9.262,95%CI:1.055~81.284,P=0.045)、AST(OR=1.015,95%CI:1.002~1.029,P=0.023)及尿酸(OR=1.005,95%CI:1.001~1.008,P=0.008)是ICP孕妇发生不良妊娠结局的独立危险因素。结论年龄、总胆汁酸、股骨长度、双胎妊娠、AST及尿酸是ICP孕妇发生不良妊娠结局的危险因素。Objective To investigate the risk factors associated with the occurrence of adverse pregnancy outcomes in patients with intrahepatic cholestasis of pregnancy(ICP).Methods Three hundred and sixty-five pregnant women with ICP who delivered at Shunde Women and Children′s Hospital of Guangdong Medical Universityt,Foshan,Guangdong Province,from June 2019 to December 2021 were selected.Pregnant women with ICP were grouped according to whether they had adverse pregnancy outcomes,and the differences in clinical characteristics between the two groups were observed.Results Univariate analysis showed that time of ICP onset,age,total bile acid,direct bilirubin,glutamic oxalacetic transaminase,glutamic alanine transaminase,twin pregnancy,and embryo transfer were associated with adverse pregnancy outcome(t/χ^(2)=29.369、2.342、4.006、2.111、2.622、2.089、27.801、11.795,P<0.05);maternal type,BMI,and gestational diabetes were not associated with adverse pregnancy outcome(t/χ^(2)=0.193、0.517、1.321,P>0.05).logistic regression analysis showed that age(31.04±5.13year),total Bile acid(37.17±30.70μmol/L),femur length(64.88±6.52 mm),twin pregnancy,glutathione(34.51±46.37 U/L)and uric acid(369.69±117.78μmol/L)were independent risk factors for adverse pregnancy outcome in pregnant women with ICP(P<0.05).Conclusion Age,total bile acids,femur length,twin pregnancy,glutathione and uric acid are high risk factors for adverse pregnancy outcomes in pregnant women with ICP.

关 键 词：妊娠期肝内胆汁淤积症 不良妊娠结局 危险因素 胆汁酸 

分 类 号：R714.255[医药卫生—妇产科学]