妊娠肝内胆汁淤积症患者SIRI、pro-ADM、MDH1水平与妊娠结局的关系  

Relationship of levels of SIRI,pro-ADM,and MDH1 with pregnancy outcomes in patients with intrahepatic cholestasis of pregnancy

作　　者：王亚桃 李锋 饶周舟[2] Wang Yatao;Li Feng;Rao Zhouzhou(Department of Gynecology and Obstetrics,Xi'an Third Hospital,Xi'an 710021,China;Department of Gynecology and Obstetrics,Xiangya Second Hospital,Central South University,Changsha 410008,China)

机构地区：[1]西安市第三医院妇产科,西安710021 [2]中南大学湘雅二医院妇产科,长沙410008

出　　处：《国际医药卫生导报》2025年第8期1287-1291,共5页International Medicine and Health Guidance News

基　　金：国家自然科学基金(81300502)。

摘　　要：目的研究全身炎症反应指数(SIRI)联合前促肾上腺素(pro-ADM)、乳酸脱氢酶1(MDH1)水平与妊娠肝内胆汁淤积症(ICP)患者妊娠结局的关系。方法采用回顾性研究,选取2021年7月至2024年6月西安市第三医院收治的124例ICP患者。根据妊娠结局分为不良组和良好组。不良组51例,年龄(28.94±3.27)岁,发病孕周(30.55±1.35)周;良好组73例,年龄(29.33±2.69)岁,发病孕周(31.12±1.29)周。比较两组患者发病孕周、发病程度、白蛋白(Alb)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆汁酸(TBA)、pro-ADM、MDH1、SIRI水平。logistic回归分析ICP患者妊娠结局的影响因素,评估SIRI联合pro-ADM、MDH1水平对不良妊娠结局的预测价值。统计学方法采用t检验、χ^(2)检验。结果不良组发病孕周低于良好组,重度发病占比、Alb、ALT、AST、TBA、pro-ADM、MDH1、SIRI水平高于良好组,差异均有统计学意义(t=2.395,χ^(2)=6.529,t=3.001、2.345、2.366、2.628、6.156、4.319、8.007,均P<0.05)。logistic分析结果显示,ICP患者发病孕周、发病程度、Alb、ALT、AST、TBA、pro-ADM、MDH1、SIRI水平均是影响妊娠结局的重要因素(均P<0.05)。受试者操作特征曲线(ROC)结果显示,pro-ADM、MDH1、SIRI联合的灵敏度和特异度分别为82.4%、93.2%。结论pro-ADM、MDH1、SIRI水平与ICP患者妊娠结局密切相关,提高监测有助于改善临床管理和预后。Objective To investigate the relationship of the levels of systemic inflammatory response index(SIRI),pro-adrenomedullin(pro-ADM),and lactate dehydrogenase 1(MDH1)with pregnancy outcomes in patients with intrahepatic cholestasis of pregnancy(ICP).Methods This is a retrospective study.One hundred and twenty-four patients with ICP treated at Xi'an Third Hospital from July 2021 to June 2024 were selected,and were divided into an adverse outcome group(51 cases),who were(28.94±3.27)years old and(30.55±1.35)weeks pregnant,and a favorable outcome group(73 cases),who were(29.33±2.69)years old and(31.12±1.29)weeks pregnant.The onset weeks of pregnancy,disease severities,and levels of albumin(Alb),alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bile acids,pro-ADM,MDH1,and SIRI were compared between the two groups.The logistic regression was used to analyze the factors affecting the patients'pregnancy outcomes.The predictive value of SIRI combined with pro-ADM and MDH1 for adverse pregnancy outcomes was assessed.t andχ^(2) tests were used for the statistical analysis.Results The adverse group had earlier onset of pregnancy,a higher proportions of severe case,and higher levels of Alb,ALT,AST,total bile acids,pro-ADM,MDH1,and SIRI than the favorable group(t=2.395;χ^(2)=6.529;t=3.001,2.345,2.366,2.628,6.156,4.319,and 8.007;all P<0.05).The logistic analysis indicated that the onset weeks of pregnancy,disease severity,and levels of Alb,ALT,AST,total bile acids,pro-ADM,MDH1,and SIRI were significant factors influencing pregnancy outcomes(all P<0.05).The receiver operating characteristic curve showed that the combination of pro-ADM,MDH1,and SIRI had a sensitivity of 82.4%and a specificity of 93.2%.Conclusions The levels of pro-ADM,MDH1,and SIRI are closely related to pregnancy outcomes in patients with ICP.Enhancing monitoring of these markers can improve clinical management and their prognosis.

关 键 词：妊娠肝内胆汁淤积症 全身炎症反应指数 妊娠结局 预测价值 

分 类 号：R714.255[医药卫生—妇产科学]