谷丙转氨酶/碱性磷酸酶对妊娠期肝内胆汁淤积症孕妇早产发生的预测研究  

Predictive Study of Alanine Aminotransferase/Alkaline Phosphatase for Preterm Delivery in Intrahepatic Cholestasis of Pregnancy

作　　者：李文君 Li Wenjun(Department of Obstetrics,Luohe Maternal and Child Health Hospital,Luohe,Henan,462000,China)

机构地区：[1]漯河市妇幼保健院产科,河南漯河462000

出　　处：《黑龙江医学》2024年第19期2350-2353,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨谷丙转氨酶(ALT)/碱性磷酸酶(ALP)对妊娠期肝内胆汁淤积症孕妇早产的预测价值,以期为改善妊娠结局提供理论支持。方法:采用前瞻性研究方法,选取2020年1月—2022年1月漯河市妇幼保健院130例妊娠期内胆汁淤积症孕妇作为研究对象,检测28孕周时孕妇的ALT、ALP并计算ALT/ALP,同时收集孕妇基线资料,根据是否早产分为早产组和足月分娩组,比较两组孕妇的ALT、ALP、ALT/ALP及基线资料;采用logistic回归分析影响妊娠期肝内胆汁淤积症孕妇早产的相关因素;绘制受试者工作曲线(ROC),分析ALT/ALP对妊娠期肝内胆汁淤积症孕妇早产的预测价值。结果:130例孕妇中有40例早产,早产发生率为30.77%。两组孕妇在ALT、ALP、ALT/ALP及血清总胆汁酸(TBA)方面比较,差异均有统计学意义(t=3.651、3.055、5.229、6.752,P<0.05)。logistic回归分析结果显示,ALT、ALP、ALT/ALP及TBA是影响妊娠期肝内胆汁淤积症孕妇早产的影响因素,差异有统计学意义(P<0.05)。ROC曲线显示,ALT、ALP对妊娠期肝内胆汁淤积症孕妇早产的预测价值较低,曲线下面积(AUC)分别为0.686、0.655;ALT/ALP对妊娠期肝内胆汁淤积症具有中等预测价值,AUC为0.743。结论:妊娠期肝内胆汁淤积症孕妇早产风险较高,主要受ALT、ALP、ALT/ALP及TBA水平影响,ALT/ALP可作为临床预测妊娠期肝内胆汁淤积症孕妇早产的敏感指标。Objective:To explore the predictive value of alanine aminotransferase(ALT)/alkaline phosphatase(ALP)in preterm delivery of pregnant women with intrahepatic cholestasis of pregnancy,so as to provide theoretical support for improving pregnancy outcomes.Methods:A prospective cohort study was conducted to select 130 pregnant women with intrahepatic cholestasis of pregnancy from January 2020 to January 2022.ALT,ALP and ALT/ALP of pregnant women in 28 gestational weeks were detected and calculated.At the same time,the baseline data of pregnant women were collected.According to whether premature delivery was divided into premature delivery group and full-term delivery group,ALT,ALP,ALT/ALP and baseline data of the two groups were compared.Logistic regression analysis was used to analyze the related factors affecting premature delivery in pregnant women with intrahepatic cholestasis of pregnancy.The receiver operating curve(ROC)was drawn to analyze the predictive value of ALT/ALP for preterm birth in pregnant women with intrahepatic cholestasis of pregnancy.Results:Among 130 pregnant women,40 were born prematurely,with an incidence rate of 30.77%.There were statistical significant differences in ALT,ALP,ALT/ALP and serum total Bile acid(TBA)between the two groups(t=3.651,3.055,5.229,6.752;P<0.05).Logistic regression analysis showed that ALT,ALP,ALT/ALP and TBA were the influencing factors for premature delivery in pregnant women with intrahepatic cholestasis of pregnancy(P<0.05).ROC showed that ALT and ALP had low predictive value for preterm delivery of pregnant women with intrahepatic cholestasis of pregnancy,and the area under the curve(AUC)was 0.686 and 0.655 respectively.ALT/ALP had moderate predictive value for intrahepatic cholestasis of pregnancy,with an AUC of 0.743.Conclusion:Pregnant women with intrahepatic cholestasis of pregnancy have a higher risk of premature birth,which is mainly influenced by the levels of ALT,ALP,ALT/ALP,and TBA.ALT/ALP can be used as a sensitive clinical indicator for predicting premat

关 键 词：妊娠期肝内胆汁淤积症 谷丙转氨酶 碱性磷酸酶 预测 

分 类 号：R714.21[医药卫生—妇产科学]