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作 者:吴海怡 李义琴 WU Haiyi;LI Yiqin(Department of Obstetrics and Gynecology,the Fourth Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210000,China)
机构地区:[1]南京医科大学第四附属医院妇产科,江苏南京210000
出 处:《中国优生与遗传杂志》2024年第2期321-326,共6页Chinese Journal of Birth Health & Heredity
摘 要:目的 探讨总胆汁酸(TBA)水平和血压对妊娠期肝内胆汁淤积症(ICP)妊娠结局的交互作用。方法 113例ICP孕妇作为研究对象,76例同期健康孕妇作为对照组,对比两组TBA和血压指标。再将患者分为不良妊娠结局组(n=42)和良好妊娠结局组(n=71),分析ICP孕妇不良妊娠结局的危险因素,讨论TBA和血压对ICP患者妊娠结局的关联性,及其在ICP孕妇妊娠结局中的交互作用。结果 ICP组早产人数、SBP、DBP及TBA显著高于对照组(P<0.05),分娩方式、孕期吸烟、孕产史、谷草转氨酶(AST)、谷丙转氨酶(ALT)、SBP、DBP、TBA及总胆红素(TBIL)水平显著影响ICP孕妇的妊娠结局(P<0.05);TBA、SBP及DBP水平与ICP患者妊娠结局显著相关;TBA≥39.27μmol/L与高血压两因素共同存在时ICP患者不良妊娠结局发生风险更高。结论 TBA、SBP和DBP均为ICP患者不良妊娠结局的危险因素,随着TBA、SBP及DBP水平的升高,其关联效应值也相应增高,TBA和血压在ICP孕妇的妊娠结局中的存在交互作用。Objective To investigate the interaction effect of total bile acid(TBA) level and blood pressure on the pregnancy outcome of intrahepatic cholestasis of pregnancy(ICP).Methods 113 pregnant women with ICP and 76 healthy pregnant women with the same period were used as the control group.TBA and blood pressure indexes were compared between the two groups.The patients were then divided into the adverse pregnancy outcome group(n=42) and the good pregnancy outcome group(n=71) to analyze the risk factors of adverse pregnancy outcome in ICP pregnant women,and discuss the correlation between TBA and blood pressure on pregnancy outcome in ICP pregnant women,and their interaction in pregnancy outcome in ICP pregnant women.Results The number of preterm births,SBP,DBP and TBA in ICP group were significantly higher than those in control group(P<0.05).Mode of delivery,smoking during pregnancy,gestational history,levels of aspartate aminotransferase(AST),alanine aminotransferase(ALT),SBP,DBP,TBA and total bilirubin(TBIL) significantly affected the pregnancy outcome of ICP pregnant women(P<0.05).The levels of TBA,SBP and DBP were significantly correlated with pregnancy outcomes in ICP patients.When TBA≥39.27 μmol/L and hypertension co-exist,the risk of adverse pregnancy outcomes in ICP patients is higher.Conclusion TBA,SBP and DBP are all risk factors for adverse pregnancy outcomes in ICP patients,and with the increase of TBA,SBP and DBP levels,their association effect sizes also increase.There is an interaction between TBA and blood pressure in pregnancy outcomes of ICP pregnant women.
关 键 词:总胆汁酸 血压 妊娠期肝内胆汁淤积症 妊娠结局
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