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投稿时间：2021-11-24 网络发布日期：2022-06-20
投稿时间：2021-11-24 网络发布日期：2022-06-20
中文摘要: 目的 探讨妊娠期肝内胆汁淤积症（ICP）血清甘胆酸水平对妊娠结局的影响。方法 采用回顾性研究方法，选取无锡妇幼保健院2020年1月至12月就诊的73例ICP患者为ICP组，以同期73例正常孕妇作为对照组。采用电化学发光法检测血清甘胆酸水平，并分析血清甘胆酸与妊娠结局的关系。结果 ICP患者血清甘胆酸水平为(15.50±9.01) μg/ml，显著高于对照组的(1.15±0.64) μg/ml（P＜0.05＝。ICP组围生结局发生率如产后出血（10.96%）、胎儿宫内窘迫（16.44%）、新生儿窒息（10.96%）、早产（26.03%）、羊水污染（24.66%）明显高于对照组（1.37%，4.11%，1.37%，6.85%，5.48%），差异均有统计学意义（P<0.05， P<0.01）；ICP组新生儿Apgar评分明显低于对照组（7.95±1.52 vs 9.02±1.45，P<0.01）。将ICP组孕妇按血清甘胆酸水平分为低（≤10 μg/ml）、中（>10～15 μg/ml）、高（≥15 μg/ml）三组，随着孕妇血清甘胆酸水平的升高，胎儿宫内窘迫发生率随之升高（P＜0.05），而新生儿Apgar 评分伴随降低（P＜0.01）。结论 ICP对妊娠结局影响显著，血清甘胆酸的升高对妊娠结局有一定预警作用，监测血清甘胆酸有利于尽早实施临床治疗，降低不良结局的发生率。
中文关键词: 妊娠期肝内胆汁淤积症 甘胆酸 妊娠结局 围产结局 胎儿宫内窘迫 新生儿Apgar评分
Abstract:Objective To investigate the relationship between serum cholyglycine level and pregnancy outcome in intrahepatic cholestasis of pregnancy (ICP). Methods A retrospective analysis was performed on 73 patients with ICP admitted to Wuxi Maternal and Child Health Hospital from January to December 2020 (ICP group), and 73 normal pregnant women at the same period were served as control group. Cholyglycine level was detected by electrochemiluminescence (ECL), and the relationship between serum cholyglycine level and pregnancy outcome was analyzed. Results The serum cholyglycine level in ICP group was significantly higher than that in control group ［(15.50±9.01) μg/ml vs (1.15±0.64) μg/ml, P＜0.05］. The incidences of postpartum hemorrhage (10.96% vs 1.37%), fetal distress (16.44% vs 4.11%), neonatal asphyxia (10.96% vs 1.37%), preterm delivery (26.03% vs 6.85%) and amniotic fluid contamination (24.66% vs 5.48%) in ICP group were significantly higher than those in control group （P<0.05， P<0.01）. The Apgar score of newborns in ICP group was significantly lower than that in control group (7.95±1.52 vs 9.02±1.45, P<0.01). In ICP group, the pregnant women were divided into low (≤10 μg/ml), middle （>10-15 μg/ml）and high （≥15 μg/ml）cholyglycine level groups, and the incidence of fetal distress increased with the increase of serum cholyglycine level (P<0.05), while the neonatal Apgar score decreased with the increase of serum cholyglycine level (P<0.01). Conclusion ICP has a significant impact on pregnancy outcome. The increased serum cholyglycine level has a certain value in predicting pregnancy outcome. Monitoring serum glycocholic acid is conducive to the early clinical treatment and the decreased incidence of adverse outcomes.
keywords: Intrahepatic cholestasis of pregnancy Cholyglycine Pregnancy outcome Perinatal outcome Intrauterine fetal distress Neonatal Apgar score
文章编号： 中图分类号：R714.25 文献标志码：A
基金项目:江苏省科技发展重大专项（BE2017628）；无锡市妇幼保健院“头雁计划”（HB2020009）
引用文本：
张慧芳，王高莹，邹萍，王晶，董蕊锐，张婷，孟西娜.妊娠期肝内胆汁淤积症血清甘胆酸水平与妊娠结局的关系[J].中国临床研究,2022,35(6):793-796.
张慧芳，王高莹，邹萍，王晶，董蕊锐，张婷，孟西娜.妊娠期肝内胆汁淤积症血清甘胆酸水平与妊娠结局的关系[J].中国临床研究,2022,35(6):793-796.