妊娠期肝内胆汁淤积症患者的早产预测指标

目的：评估临床症状和生化指标对妊娠期肝内胆汁淤积症（ ICP）患者发生早产的预测价值。方法回顾性分析2008年4月至2013年2月就诊于广东省阳江市人民医院的60例ICP患者。用多元回归分析法寻找早产的预测指标。结果分娩的平均时间是38．1±1．7周，未出现死产婴儿。其中8例患者（13．3％）出现早产。与足月分娩相比，早产分娩者的总空腹血清胆汁酸水平更高（t＝2．46，P＜0．05）。多元回归分析发现，早发性瘙痒症状（OR＝1．71，95％CI：1．24～2．79，P＜0．05）和血清胆汁酸（OR＝2．23，95％CI：1．23～3．43，P＜0．05）是早产的独立预测指标。结论早发瘙痒症状和高水平血清胆汁酸是ICP患者发生早产的预测指标，并可用于界定具有不良婴幼儿结局的风险。

Predictors of premature delivery in patients with intrahepatic cholestasis of pregnancy

Objective To evaluate the predictive value of clinical symptoms and biochemical parameters for prematurity in patients with intrahepatic cholestasis of pregnancy （ ICP） .Methods Sixty symptomatic patients with ICP visiting Yangjiang People ’ s Hospital during the period of April 2008 to February 2013 were included in this retrospective analysis .Predictors of premature delivery were disclosed by multivariate logistic regression analysis .Results Mean time of delivery was 38.1 ±1.7 week.No stillbirths occurred.Premature delivery was observed in 8（13.3%） patients.Total fasting serum bile acids of patients with premature delivery were higher when compared to those with term delivery （t=2.46,P〈0.05）.Multivariate logistic regression analysis revealed that early onset of pruritus （OR=1.71,95%CI：1.24-2.79,P〈0.05） and serum bile acid （OR=2.23,95%CI：1.23-3.43,P〈0.05） were independent predictors of premature delivery . Conclusion Early onset of pruritus and high level of serum bile acids predict premature delivery in ICP patients , and they can be borrowed to define a subgroup of patients at risk for poor neonatal outcomes .